A Community-Based Integrated Healthy Aging Program at a Tertiary Hospital (YASAM) for the Oldest Old Participants May have the Potential to Reduce Emergency Admission: Preliminary Evidence from a Pre-Post-Intervention Study.

BACKGROUND

Frail, oldest old individuals living in the community frequently face obstacles when trying to access outpatient clinics, which results in a higher dependence on emergency departments. This trend highlights the need for improved accessibility and support services for this vulnerable population.

OBJECTIVES

This study aims to investigate the relationship between community-based integrated healthy aging program in tertiary hospital and healthcare utilization among the oldest old adults.

METHODS

A before-after pilot intervention prospective study was conducted between June 2023 and December 2023. The YASAM conducted a comprehensive assessment, including the Mini-Cog, Mini Mental Status Assessment, Mini Nutrition Assessment (short form), and Geriatric Depression (Yesavage) scale, as well as the Time-up and Go test and Stand-Chair tests. Health service utilization, including emergency visits, hospitalizations, and outpatient clinic visits, was documented after and before the index date for the participants.

RESULTS

The study included 312 participants, with a mean age of 85.8 ± 3.9 years. The proportion of individuals with mild cognitive impairment was 55.8 % (n = 159). The percentage of participants with possible sarcopenia was 43.3 % (n = 135), and the percentage of those with moderate or severe frailty was 53.8 % (n = 163). The average visits to the emergency department per month before the index date were lower than after the index date, and this difference was significant (p = 0.01).

CONCLUSIONS

Policymakers should consider expanding community-based integrated healthy aging programs in tertiary hospitals to meet the growing healthcare needs of older adults.

TRIAL REGISTRATION: The trial was prospectively registered at ClinicalTrials.gov. Identifier: NCT05993572 Registered on 15 July 2023.