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
Journal of Emergency Medicine, cilt.72, ss.112-120, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 72
- Basım Tarihi: 2025
- Doi Numarası: 10.1016/j.jemermed.2024.12.009
- Dergi Adı: Journal of Emergency Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
- Sayfa Sayıları: ss.112-120
- Anahtar Kelimeler: comprehensive assessment, emergency admission, healthy aging, home-care, older adults
- Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet
Özet
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.