Implementation of risk prediction and stratification approaches for ageing populations in Australian healthcare: a systematic review

Despite widespread development of prognostic risk stratification tools, their implementation in Australian healthcare remains poorly characterised. This review identified tools implemented for adults aged ≥40 years and examined their real-world use. Following PRISMA and SWiM guidelines, MEDLINE, EMBASE, Web of Science, PsycINFO, and CINAHL Plus were searched from inception to 20th February 2026. Eligible studies reported implementation of a risk stratification tool in Australian healthcare and health, functional, or implementation outcomes. The Mixed Methods Appraisal Tool assessed study quality. Of 7115 records screened, 21 studies were included across primary care, hospitals, residential aged care, and community services. Interventions included electronic decision support, multifactorial assessments, structured clinical protocols, and AI-enabled screening. Studies that focused on early implementation outcomes (acceptability, feasibility, and adoption) rarely examined sustainability, penetration, and cost. Risk stratification tools are feasible and acceptable across Australian healthcare settings, but few are implemented as part of routine care. Registration PROSPERO—CRD420251028985.