Baseline characteristics and outcome data.
| Parameter | Pre-COPE (September 2013) | Post-COPE (September 2014) | |
|---|---|---|---|
| Part A: All medical admissions >75 years, | 398 | 413 | |
| Patient characteristics | p value | ||
| Age, median (range) | 85 (75–101) | 84 (75–101) | |
| Male, % (n) | 32.7 (130) | 39.5 (163) | 0.04 |
| Mean non-elective hospital admissions in last 12 months | 1.40 | 1.44 | 0.56 |
| History of falls, % (n) | 32.7 (130) | 34.1 (141) | 0.66 |
| Confusion/delirium, % (n) | 19.8 (79) | 20.3 (84) | 0.86 |
| Dementia, % (n) | 16.6 (66) | 19.4 (80) | 0.30 |
| Patient from a care home/IMC *, % (n) | 15.3 (61) | 18.4 (76) | 0.24 |
| Any of four criteria above ‘COPE criteria’, % (n) | 54.5 (217) | 54.5 (225) | 0.99 |
| Outcome data | RR, (95% CI), p value | ||
| Inpatient deaths, % (n) | 8.0 (32) | 9.0 (37) | 1.11 (0.71–1.75), 0.64 |
| Seen by geriatric medicine team, % (n) | 19.3 (77) | 33.4 (138) | 1.72 (1.36–2.20), <0.001 |
| Mean time until geriatric review, days | 0.85 | 0.48 | p<0.001 |
| Evidence of CGA, % (n) | 8.8 (35) | 29.3 (121) | 3.33 (2.35–4.73), <0.001 |
| Evidence of MDT meeting, % (n) | 5.5 (22) | 19.6 (81) | 3.55 (2.26–5.57), <0.001 |
| Mean length of stay, days | 7.37 | 6.87 | p = 0.19 |
| Direct discharge from EAU, % (n) | 35.2 (140) | 43.3 (179) | 1.23 (1.03–1.46), 0.02 |
| New discharge to higher level of care, % (n) | 9.3 (34) | 8.0 (30) | 0.86 (0.54–1.37), 0.53 |
| Follow up with community teams, % (n) | 8.5 (31) | 12.5 (47) | 1.48 (0.96–2.27), 0.08 |
| 7-day readmission rates, % (n) | 7.7 (28) | 8.2 (31) | 1.08 (0.66–1.76), 0.76 |
| 30-day readmission rates, % (n) | 18.9 (69) | 18.1 (68) | 0.96 (0.71–1.30), 0.79 |
| 30-day mortality, % (n) | 6 (22) | 4.6 (19) | 0.84 (0.46–1.53), 0.57 |
| Part B Patients with ≥1 markers of frailty **, | 217 | 225 | |
| Patient characteristics | p value | ||
| Male, % (n) | 32.2 (70) | 37.3 (84) | 0.26 |
| Mean non-elective hospital admissions in last 12 months | 1.50 | 1.58 | 0.66 |
| Outcome data | RR, (95% CI), p value | ||
| Inpatient deaths, % (n) | 7.4 (16) | 10.7 (24) | 1.45 (0.79–2.65), 0.23 |
| Seen by geriatric medicine team, % (n) | 27.2 (59) | 47.6 (107) | 1.75 (1.35–2.26), <0.001 |
| Mean time until geriatric review, days | 0.88 | 0.49 | p = 0.001 |
| Evidence of CGA, % (n) | 13.4 (29) | 40.9 (92) | 3.06 (2.11–4.44), <0.001 |
| Evidence of MDT meeting, % (n) | 7.8 (17) | 29.3 (66) | 3.74 (2.27–6.17), <0.001 |
| Mean length of stay, days | 9.53 | 6.76 | p = 0.02 |
| Direct discharge from EAU, % (n) | 29.0 (63) | 42.2 (94) | 1.44 (1.11–1.86), 0.006 |
| New discharge to higher level of care, % (n) | 16.4 (33) | 10.0 (20) | 0.61 (0.36–1.01), 0.06 |
| Follow up with community teams, % (n) | 7.5 (15) | 16.9 (34) | 2.27 (1.28–4.03), 0.005 |
| 7-day readmission rates, % (n) | 9.0 (18) | 9.0 (18) | RR 1 |
| 30-day readmission rates, % (n) | 21.4 (43) | 20.9 (42) | 0.98 (0.67–1.42), 0.9 |
| 30-day mortality, % (n) | 8.0 (16) | 3.0 (6) | 0.38 (0.15–0.94), 0.04 |
↵*Residential home/nursing home or intermediate care; **History of falls, dementia, delirium or from a care home/immediate care (as above). CGA = comprehensive geriatric assessment; CI = confidence interval; COPE = comprehensive older person's evaluation; EAU = emergency assessment unit; MDT = multidisciplinary team; RR = relative risk.