As the United States population ages and the geriatric population grows, the healthcare system is facing multiple challenges, particularly increasing healthcare utilization. Prior studies have shown that the involvement of geriatricians and other geriatrics-trained healthcare professionals in dedicated geriatrics units or from inpatient consult services may reduce mortality, improve time to discharge, and improve access to health and social services for older patients. 

Over the summer, our project group set out to evaluate whether a geriatrics inpatient consult service, started August 2022 at Pennsylvania Hospital, improves discharge time and readmission rates and affects discharge disposition for older patients. We collected demographic data, including age and sex; discharge data; and readmission data for patients seen by the geriatrics consult service (n = 407) and control patients (n = 495) who did not have consults between August 2022 and May 2024.  

Geriatric patients seen by the inpatient consult service were on average older and disproportionately female compared to the overall geriatric patient population admitted to Pennsylvania Hospital, which may indicate bias in the demographics of patients referred to the service. 

A multivariate multiple linear regression showed that the time to discharge and 0-30-day and 31-60-day readmission rates were not significantly affected by the consult service, BUT the time from admission to consult was a major confounding variable. Patients receiving a consult within 8 days of admission were typically discharged 6-7 days after the consult was completed regardless of how long the primary treatment team waited to place the consult. This suggests that delays in consulting the geriatrics team may delay discharge and that earlier consultation could improve time to discharge. 

In addition, the control group was significantly more likely to die in the hospital than patients seen by the consult service, suggesting the consult service was either reducing overall patient mortality or at least reducing in-hospital mortality by assisting with discharge planning. 

In the future, we can seek to improve the consult balance for male and younger patients as well as try to decrease the time between admission and consultation and explore how these factors will affect outcomes for geriatric patients.