Aims: This study evaluates the effectiveness of Geriatric Rapid Access Clinic (RAC) in reducing unplanned presentations to ED and subsequent need for hospitalisation. Primary outcomes included emergency department (ED) presentations and hospital admissions. Secondary outcomes examined outpatient adherence and the impact of targeted interventions.
Methods: A retrospective cohort study of 171 RAC patients analysed demographics, frailty status (Clinical Frailty Scale), cognitive status (MOCA/MMSE), falls history, and polypharmacy. ED presentations and hospital admissions were assessed at 1, 3, and 12 months pre- and post-clinic. Interventions, including medication reviews, allied health referrals, and mobility assessments were evaluated for their impact. The Wilcoxon signed-rank test assessed changes in healthcare utilization.
Results: The study observed a significant reduction in ED presentations from 112 to 77 in the 65-74-year-old age group (p = 0.0366) and from 175 to 137 in the 75-84-year-old age group (p = 0.00522) over 12 months pre- and post-clinic. Although hospital admissions showed a downward trend, statistical significance was not reached. Outpatient adherence improved, particularly in frail patients (p = 0.014). Cognitive impairment was common in our cohort (60.3%). 82% of our cohort received specific interventions, with medication reviews (45%) and allied health referrals (38%) being most frequent.
Conclusions: This single centre study observed that attendance to RAC led to reductions in both ED presentations and hospital admissions, reinforcing its role in improving healthcare utilization. The high rate of interventions highlights their importance in optimizing patient care and reducing healthcare burden on our strained ED services