Impact of Early Comprehensive Geriatric Assessment on Unscheduled Acute Medical Admissions through an Age Related Assessment Unit

Abstract Background Older patients often face prolonged hospital stays, leading to increased healthcare costs and potential complications. Comprehensive geriatric assessment (CGA) at the point of hospital entry may reduce length of stay (LOS) by addressing the multifaceted needs of older patients promptly. This study evaluates the potential impact of early targeted CGA on the length of hospital stay for older patients admitted unscheduled to our hospital. Methods A retrospective review of all admissions by our Age Related Assessment Unit (ARAU) Team was conducted from January to April 2024. A total of 82 admissions were analysed. Two patient pathways were identified: 84% (69 patients) were admitted via Pathway 1 for acute medical intervention only. 16% (13 patients) were admitted via Pathway 2 requiring acute medical admission plus additional care needs/supports to facilitate discharge. These 13 patients had inpatient stays exceeding 20 days, either requiring additional support for discharge (long-term care/home care package), or a period of rehabilitation. Results Patients on Pathway 1 had an average LOS of 6.6 days, in contrast to those on Pathway 2 who had an average LOS of 35.2 days. According to our annual hospital report from 2022, patients over 75 years old typically had an average LOS of 16.3 days. Conclusion Early commencement of a CGA enables a targeted approach for the effective treatment of older adults presenting via unscheduled care, significantly reducing the length of stay for patients on Pathway 1. This positively impacts patient outcomes by mitigating the risks associated with prolonged hospital admissions and lowering related costs. However, additional focus and resources are needed to further reduce the length of stay for patients requiring extra support to facilitate discharge from the acute care setting.