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Geriatric outreach service avoids unnecessary ED presentations

An outreach service running out of Bankstown-Lidcombe hospital in Sydney is saving the NSW government $2 million a year and reducing pressure on its emergency department.

According to the Australian Institute of Health and Welfare, there are approximately 270,559 people aged 65 and over in aged care, and these residents make up between 20 and 40 per cent of all emergency department presentations.

Figures from Bankstown-Lidcombe hospital show that cohort makes up 25–30 per cent of all patients on its geriatric wards.

For geriatrician Frank Liu this can be problematic, as these older patient presentations often wait longer, take longer to be assessed and are likely to be more complex. And, more often than not, these ED referrals can be avoided, Liu believes.

To ease the strain, Liu started the Geriatric Outreach Service, whereby a geriatrician or nurse would be called to treat a resident at their nursing home.

Since its inception in 2013, ambulance presentations from the 12 nursing homes in the Bankstown area reduced by 10 per cent and there was a 26 per cent reduction of referrals to ED from RACFs.

The service has been shown to make a total average saving of $2953 for each individual treated and, according to Liu, nearly $2 million in savings for the state.

The service has now been taken up in the Sutherland and St George areas of Sydney and Liu believes that, apart from the cost savings, patient outcomes are also improving. Avoiding unnecessary ED admissions can help prevent complications such as patient delirium.

“Patients get to stay in their own home to receive medical treatment and are cared for, rather than being in hospital,” Liu said

"Our services have reduced about 200 admissions yearly for Bankstown Hospital, which saved about $2 million per year. We will expand this service for the weekend cover if there is additional funding from our hospital."

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