Evaluating the effectiveness of the integrated Geriatric Emergency Medicine Short Stay Unit model of care: a retrospective cohort study

Objectives: To evaluate the clinical effectiveness and cost-effectiveness of the integrated Geriatric Emergency Medicine (iGEM) Short Stay Unit (SSU) model in the management of patients presenting from residential aged care facilities (RACF) to the Emergency Department (ED). Methods: This is a retrospective cohort study comparing patients admitted to the iGEM SSU in July 2024 (Cohort Ia) with matched contemporaneous (Cohort Ib) and historical (May 2024, July 2023) controls who met iGEM criteria but were managed under standard ED pathways. Inclusion criteria comprised geriatric RACF patients presenting with stable, low-acuity conditions such as uncomplicated infections, minor trauma, dehydration, or requiring transfusions suitable for short-stay management. Results: A total of 531 geriatric patients from RACFs were included. A progressive improvement in service efficiency was observed with the iGEM SSU model. The average ED length of stay decreased from 18.3 h in July 2023 (Cohort III) to 6.5 h in July 2024 (Cohort Ia), accompanied by a reduction in inpatient admission rates (51% to 5.3%) and overall hospital LOS (8.1 days to 1.7 days). Quality outcomes also improved, with lower readmission and complication rates observed in cohort Ia compared with earlier standard-care cohorts, supporting the model's clinical efficiency. Conclusions: The iGEM SSU model was associated with greater efficiency, reduced inpatient admissions, shorter hospital length of stay, and potential cost savings compared to standard geriatric emergency care in this retrospective case–control study. These findings suggest that iGEM may help to alleviate ED pressures and optimise hospital resource utilisation without compromising patient safety.