Adding services for older people in EDs could save €2.4 billion, research finds

Early assessment and intervention by dedicated teams of health and social care professionals could lead to shorter stays in hospital

A report published on Tuesday looked at the impact of introducing a dedicated team of health and social care professionals to focus on 'timely assessment and intervention' among patients aged 65 and over. Photograph: iStock

Introducing a dedicated healthcare team for older patients in emergency departments (ED) across Ireland could save the health service up to €2.4 billion a year and improve patients’ quality of life, new research suggests

Trinity College Dublin, in collaboration with University of Limerick, published a paper on Tuesday that looked at the impact of introducing a dedicated team of health and social care professionals (HSCPs) to focus on “timely assessment and intervention” among patients aged 65 and over.

In the research, which was published in the journal Plos One, the HSCP team included an occupational therapist, physiotherapist and social worker.

The study of 353 older adults showed early assessment and intervention by the HSCP team reduced ED length of stay and the risk of hospital readmissions, as well as improving patient satisfaction.


Crowding in emergency departments is a growing problem in Ireland and internationally and, coupled with long waiting times, affects healthcare outcomes and patient satisfaction.

The clinical findings of the trial suggested several older adults can be safely discharged from the ED following early assessment and intervention by a HSCP team, avoiding costly inpatient stays in hospital.

The researchers said this data, analysed with the estimated direct cost of HSCP, as well as costs to the Irish Health Service for inpatient admissions, shows how adding this team to existing usual care in ED creates a potential national saving of €2.4 billion.

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These cost savings are largely driven by the timely discharge of older adults from the ED, meaning – if adopted nationally – the service would aim to get patients home as soon as possible, the research said.

Prof Dominic Trépel, from the School of Medicine and Global Brain Health Institute (GBHI) at Trinity, said about 23 per cent of people presenting to the ED are “low-acuity” patients, meaning they don’t have a “huge amount of major concerns”.

“Sometimes, what happens is decision-makers admit these older patients because they’re afraid of missing something. But if you have this integrated care team, you know maybe the patient is a bit wobbly on their feet, in which case the OT can help with that,” he said.

“This can help prevent unnecessary hospital admissions. If you can avoid just one night, you’re doing well. But this can prevent several. The cost of admitting someone for a night is astronomical.”

The research concluded that the economic evaluation shows HSCP should be adopted as part of treatment in Irish EDS, as “not doing so results in overspending of €6,128 every time a low-acuity patients visits the ED”.

Shauna Bowers

Shauna Bowers

Shauna Bowers is Health Correspondent of The Irish Times