Enhancing emergency care for geriatric patients: Insights from a dedicated outpatient clinic study.

AIM: This study aimed to compare the sociodemographic and clinical characteristics of geriatric patients presenting to the geriatric outpatient clinic, which operates during daytime hours (08:00-16:00 hours), with those presenting to the conventional emergency department outside these hours (16:00-08:00 hours).

METHODS

This retrospective study included patients aged ≥60 years who presented to the emergency department of Antalya Atatürk State Hospital in 2023, excluding those transported by ambulance, triaged as red zone or admitted to emergency surgical intervention room. Data were collected from electronic records for the entire year, including age, sex, waiting time and International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD) codes, while detailed clinical data were manually collected for March 2023. Patients were categorized based on presentation time: during geriatric outpatient clinic hours (08:00-16:00 hours), evening (16:00-00:00 hours) and night-time (00:00-08:00 hours). Comparisons were made across these time intervals. March was selected to represent an average admission period, minimizing seasonal variability.

RESULTS

A total of 844 (55.2%) female and 685 (44.8%) male patients with a mean age of 69.7 ± 7.5 years were included in the study. Among these patients, 44.7% (683) visited the geriatrics (08:00-16:00 hours) outpatient clinic, 36.4% (556) presented to the emergency department during evening hours (16:00-00:00 hours) and 19% (290) sought care at night (00:00-08:00 hours). Consultation was requested for 7.3% (111) of patients. The majority of patients (n = 1426, 97%) were discharged with outpatient management, whereas 2.6% (38) required hospitalization, 0.3% (4) were referred to a more comprehensive facility and 0.1% (2) chose to leave the hospital against medical advice after providing written consent to refuse treatment. The most common reasons for referrals to the geriatrics outpatient clinic are non-traumatic musculoskeletal problems (ICD code M79 and its extensions), upper respiratory tract infections (ICD code J00-J06 and its extensions), vertigo (ICD code R42) and urinary system infections (ICD code N30 and its extensions). When we compare the patients who visited the geriatric outpatient clinic on the same day with those in other time slots, we found that the time elapsed from initial arrival to seeing the physician was shorter for patients visiting the geriatric clinic (P < 0.001), the rate of admission to short-stay unit was lower (P < 0.001), and the length of stay in the short-stay unit was also shorter (0.038).

CONCLUSION

Establishing a separate geriatric outpatient clinic for older patients reduces waiting times. Geriatr Gerontol Int 2025; 25: 1247-1252.