Does Case-Finding for Admission to Aged Care Rapid Investigation and Assessment Unit for Older Patients Improve Hospital Length of Stay? 'Evaluation of ARIA Unit'
Introduction: Many older people present to emergency departments annually, often with complex geriatric syndromes, yet current acute care models and traditional admissions process may under-serve their needs. The multidisciplinary Aged Care Rapid Investigation and Assessment (ARIA) Unit seeks to bri...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Ubiquity Press
2023-10-01
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| Series: | International Journal of Integrated Care |
| Subjects: | |
| Online Access: | https://account.ijic.org/index.php/up-j-ijic/article/view/7038 |
| _version_ | 1797503061457895424 |
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| author | Sundhar R. Balu Angela Khoo Carol Lu Hunter Danielle Ní Chróinín |
| author_facet | Sundhar R. Balu Angela Khoo Carol Lu Hunter Danielle Ní Chróinín |
| author_sort | Sundhar R. Balu |
| collection | DOAJ |
| description | Introduction: Many older people present to emergency departments annually, often with complex geriatric syndromes, yet current acute care models and traditional admissions process may under-serve their needs. The multidisciplinary Aged Care Rapid Investigation and Assessment (ARIA) Unit seeks to bridge this gap, by actively identifying and assessing patients. Methods: A prospective case-control study was undertaken at a single-centre tertiary referral institution. Patients were eligible for inclusion in ARIA group if admitted to ARIA via case-finding by the geriatrician or Aged Care Services Emergency Team, whilst standard geriatric admissions formed the control group. This study evaluates whether ARIA reduced hospital length-of-stay (LOS) and representation rates. Results: 370 patients were included (185 each arm) with similar baseline demographics, frailty scores, and Charlson Comorbidity Indices. Patients admitted to ARIA had significantly shorter hospital LOS than those via standard pathway (3.3 days [IQR2.2–5.8] vs 7.5 days [IQR4.2–13.7], p < 0.00001). There were no significant differences in 90-day representation rates (n = 66 [35.7%] vs n = 64 [34.6%], p = 0.82). Discussion/Conclusion: Introduction of an ARIA unit with a targeted approach to frontline geriatric services and case-finding is associated with improved LOS of older acute hospital patients. An economical cost analysis of this study would be beneficial in exploring potential financial savings. |
| first_indexed | 2024-03-10T03:45:07Z |
| format | Article |
| id | doaj.art-9ea091814f244ffdbf0b9cb39b7a77ab |
| institution | Directory Open Access Journal |
| issn | 1568-4156 |
| language | English |
| last_indexed | 2024-03-10T03:45:07Z |
| publishDate | 2023-10-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | International Journal of Integrated Care |
| spelling | doaj.art-9ea091814f244ffdbf0b9cb39b7a77ab2023-11-23T09:11:19ZengUbiquity PressInternational Journal of Integrated Care1568-41562023-10-01233310.5334/ijic.70384568Does Case-Finding for Admission to Aged Care Rapid Investigation and Assessment Unit for Older Patients Improve Hospital Length of Stay? 'Evaluation of ARIA Unit'Sundhar R. Balu0Angela Khoo1Carol Lu Hunter2https://orcid.org/0000-0001-9480-420XDanielle Ní Chróinín3Department of Geriatric Medicine, Liverpool Hospital, Liverpool; Department of Geriatric Medicine, Shoalhaven District Memorial Hospital, NowraDepartment of Geriatric Medicine, Liverpool Hospital, LiverpoolDepartment of Geriatric Medicine, Liverpool Hospital, Liverpool; South Western Sydney Clinical School, UNSW Sydney, LiverpoolDepartment of Geriatric Medicine, Liverpool Hospital, Liverpool; South Western Sydney Clinical School, UNSW Sydney, LiverpoolIntroduction: Many older people present to emergency departments annually, often with complex geriatric syndromes, yet current acute care models and traditional admissions process may under-serve their needs. The multidisciplinary Aged Care Rapid Investigation and Assessment (ARIA) Unit seeks to bridge this gap, by actively identifying and assessing patients. Methods: A prospective case-control study was undertaken at a single-centre tertiary referral institution. Patients were eligible for inclusion in ARIA group if admitted to ARIA via case-finding by the geriatrician or Aged Care Services Emergency Team, whilst standard geriatric admissions formed the control group. This study evaluates whether ARIA reduced hospital length-of-stay (LOS) and representation rates. Results: 370 patients were included (185 each arm) with similar baseline demographics, frailty scores, and Charlson Comorbidity Indices. Patients admitted to ARIA had significantly shorter hospital LOS than those via standard pathway (3.3 days [IQR2.2–5.8] vs 7.5 days [IQR4.2–13.7], p < 0.00001). There were no significant differences in 90-day representation rates (n = 66 [35.7%] vs n = 64 [34.6%], p = 0.82). Discussion/Conclusion: Introduction of an ARIA unit with a targeted approach to frontline geriatric services and case-finding is associated with improved LOS of older acute hospital patients. An economical cost analysis of this study would be beneficial in exploring potential financial savings.https://account.ijic.org/index.php/up-j-ijic/article/view/7038admission lengthemergency geriatricsrepresentation |
| spellingShingle | Sundhar R. Balu Angela Khoo Carol Lu Hunter Danielle Ní Chróinín Does Case-Finding for Admission to Aged Care Rapid Investigation and Assessment Unit for Older Patients Improve Hospital Length of Stay? 'Evaluation of ARIA Unit' International Journal of Integrated Care admission length emergency geriatrics representation |
| title | Does Case-Finding for Admission to Aged Care Rapid Investigation and Assessment Unit for Older Patients Improve Hospital Length of Stay? 'Evaluation of ARIA Unit' |
| title_full | Does Case-Finding for Admission to Aged Care Rapid Investigation and Assessment Unit for Older Patients Improve Hospital Length of Stay? 'Evaluation of ARIA Unit' |
| title_fullStr | Does Case-Finding for Admission to Aged Care Rapid Investigation and Assessment Unit for Older Patients Improve Hospital Length of Stay? 'Evaluation of ARIA Unit' |
| title_full_unstemmed | Does Case-Finding for Admission to Aged Care Rapid Investigation and Assessment Unit for Older Patients Improve Hospital Length of Stay? 'Evaluation of ARIA Unit' |
| title_short | Does Case-Finding for Admission to Aged Care Rapid Investigation and Assessment Unit for Older Patients Improve Hospital Length of Stay? 'Evaluation of ARIA Unit' |
| title_sort | does case finding for admission to aged care rapid investigation and assessment unit for older patients improve hospital length of stay evaluation of aria unit |
| topic | admission length emergency geriatrics representation |
| url | https://account.ijic.org/index.php/up-j-ijic/article/view/7038 |
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