Geriatric consultation service in emergency department: how does it work?
- Terry Man Yue Yuen1,
- Larry Lap Yip Lee1,
- Ikea Lai Chun Or1,
- Kwai Lin Yeung1,
- Jimmy Tak Shing Chan1,
- Catherine Pui Yuk Chui2,
- Emily Wai Lin Kun2
- 1Accident and Emergency Department, Alice Ho Miu Ling Nethersole Hospital, Hong Kong SAR, China
- 2Department of Medicine and Geriatrics, Tai Po Hospital, Hong Kong SAR, China
- Correspondence to Dr Terry Man Yue Yuen, Accident and Emergency Department, Alice Ho Miu Ling Nethersole Hospital, 11 Chuen On Road, Tai Po, New Territories, Hong Kong SAR, China;
Contributors TMYY is responsible for study design, data analysis, literature search and is the leading author of the article. LLYL is responsible for study design, data analysis, literature search and article's edition. ILCO is responsible for data collection. KLY is responsible for the study design and programme evaluation. CPYC is responsible for programme implementation and evaluation. EWLK is responsible for the programme design and is the supervisor of the whole programme. JTSC is responsible for the programme design, article's edition and is the supervisor of the whole programme. SYC is responsible for programme implementation and evaluation. KLC is responsible for programme design and evaluation.
- Accepted 15 February 2012
- Published Online First 23 March 2012
Background Hong Kong is having a significant prevalence of geriatric patients who usually require admission after presentation to the hospital through emergency departments. The geriatric consultation programme ‘We Care’ aims at lowering acute geriatric medical admission.
Objectives The study aims at analysing the impact of the geriatric consultation service on the acute medical admission, and to study the characteristics and outcome of geriatric patients.
Methods Retrospective study. Patients who received geriatric consultations during 1 January 2009 to 1 March 2011 were enrolled. The demographic information, diseases case mix, venue of discharge, clinical severity, community nursing service referrals and adverse outcomes were retrieved and analysed. The incidence of adverse outcomes under the presence of each factor was studied.
Results 2202 geriatric patients were referred. Their age ranged from 45 to 99 (mean 79.91, SD 7.45, median 80). These cases were categorised into: (1) chronic pulmonary disease (n=673; 30.6%), (2) debilitating cardiac disease (n=526; 23.9%), (3) geriatric syndromes (n=147; 6.7%), (4) neurological problems (n=416; 18.9%), (5) diabetes-related problems (n=146; 6.6%), (6) terminal malignancy (n=39; 1.8%), (7) electrolyte or input/output disturbance (n=137; 6.2%), (8) non-respiratory infections (n=36, 1.6%) and (9) others (n=82; 3.7%). Acute medical admission was evaded in 84.7% of all consultations with 1039 (47.2%) patients discharged home and 825 patients (37.5%) admitted to convalescent hospital. The incidence rate of adverse outcomes was 1.6%.
Conclusion Programme ‘We Care’ provided comprehensive geriatric assessment to suitable geriatric patients, resulting in an effective reduction of acute geriatric hospital admission.
Competing interests None.
Ethics approval Ethics approval was provided by The Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (CRE-2010.417).
Provenance and peer review Not commissioned; externally peer reviewed.