Aims
Front Door Frailty (FDF) services commenced in August 2024. The epidemiology of older adults accessing acute care is unknown and the aim of this study is to describe this alongside patient specific outcomes.
Methods
This is a prospective observational study of routinely collected clinical data to include descriptive epidemiology alongside 14-day, 28-day, 6-month and 12-month outcomes. Delirium is defined by a 4AT Score of >4. Clinical Frailty Scale Score and electronic Frailty Index (eFi) was assessed for all patients.
Results
473 older adults had at least one review during the first year of clinical care. The mean age of patients was 82. 20% of patients resided in residential aged care (RAC). 54.1% were female. Over 50% of patients reviewed had a neurocognitive disorder. 83% had a previous fall with 45% having previous fractures. This patient group were most commonly mildly frail.
The prevalence of acute delirium was 13.1%. 75.5% were discharged from ED within 24 hours with a same reason readmission rate at 28 days 10%. 28-day mortality was 6.4%. The 12-month mortality of this cohort to date is 45%.
Conclusions
There is a clear demand for specialist older person care in acute care settings with evidence of effectiveness in “same day” discharge, and safe admission avoidance rather than admission delay. 12-month mortality suggests that older adults living with frailty frequently access acute care at the end of life. This data will inform policy and planning activities at the local and Commonwealth level.