Impact of Acute Care for Elders Unit on Patient Outcomes, Hospital Discharge Rates

Study authors determined the likelihood of discharge to home increases for older adults (OAs) when admitted to a dedicated Acute Care for Elders (ACE) unit vs an ACE order set alone for general internal medicine patients.

Through early involvement of allied health providers, elder-friendly care protocols, proactive discharge planning, and changes to the care environment, the ACE unit model of care strives to reduce common complications of hospitalization in OAs.

A dedicated 28-bed medical ACE unit was established in the hospital, but the number of eligible older medical patients often exceeded the number of available beds due to capacity limitations. As a result, some ACE unit-eligible patients were admitted to surgical or medical units for their medical care. 

For this study, 3046 ACE-designated patient admissions, which included 1499 ACE unit and 1547 bed-spaced were analyzed to measure in-hospital mortality and discharge disposition outcomes. Multivariate and univariate comparisons were conducted and in a post-hoc analysis propensity matching was used to adjust for case mix.

For ACE unit patients the mean age of participants was 83.5 years and for bedspaced patients the mean age was 82.6 years.

“In adjusted models, ACE unit patients were more likely to be discharged home (OR 1.28 [1.08–1.50], P = 0.003),” concluded study authors. “In an unadjusted analysis, patients admitted to ACE unit were less likely to die in hospital, but this finding did not persist after adjustment for case mix.”

Reference:
Norman RE, Sinha SK. Patient outcomes related to receiving care on a dedicated acute care for elders (ACE) unit versus with an ACE order set. J Am Geriatr Soc. Published online April 12, 2022. doi:10.1111/jgs.17788