Evidence map›Paper›PMID 39482258›Full record

ArticleJournal of the American Geriatrics Society2025

Patterns of referral to interprofessional services among frail older adults presenting to emergency departments in Canada.

Amanda A Nova, George A Heckman, Navjot Gill-Chawla, Amy Miles, Andrew P Costa, Samir K Sinha, Micaela Jantzi, John P Hirdes, Paul C Hébert

Abstract read
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In one paragraph

Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Addressing Frailty in the Emergency Department: Early Outcomes of a Geriatric Rapid Access Clinic.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026
    Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Amanda A NovaSchool of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.ORCID 0000-0002-5064-079X
George A HeckmanSchool of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.ORCID 0000-0003-3847-3287
Navjot Gill-ChawlaSchool of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
Amy MilesDivision of Geriatric Medicine, McMaster University, Waterloo, Ontario, Canada.
Andrew P CostaDepartment of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Samir K SinhaDivision of Geriatric Medicine, Department of Medicine, Sinai Health and the University Health Network, Toronto, Ontario, Canada.
Micaela JantziSchool of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
John P HirdesSchool of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
Paul C HébertBruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada.

Funding

Canadian Frailty Network SIG(Fall)2014-2014F-31CIHR
6 · The paper itself

Abstract

backgroundGeriatric Emergency Department (ED) Guidelines recommend optimizing transitions of care for older patients with complex needs. In this study, we investigated referral patterns to interprofessional services, including occupational therapy, physiotherapy, dietician, social work, home care, and specialized geriatric services, among older adults presenting to the ED with high-risk characteristics.

methodsWe recruited community-dwelling older adults presenting to 10 EDs across Ontario, Quebec, and Newfoundland, Canada, from April 2017 to July 2018. To observe processes of care in the ED, we deployed a two-stage high-risk case-finding and focused comprehensive assessment process based on the interRAI ED-Screener and ED Contact Assessment to identify and characterize older adults at high risk. We analyzed the secondary data using descriptive statistics and logistic regression.

resultsWe screened 5265 individuals with the ED Screener, further assessed 1479 with the ED Contact Assessment, and analyzed data from a subset of 1055 community-dwelling older adults assessed with the ED Contact Assessment. Participants in our study sample had a mean age of 83 years, 58% were female, and many had a complex burden of cognitive and functional impairment and social needs. Over half of this high-needs sample were referred to general home care services (62.7%), occupational therapy (59.3%), and physiotherapy services (55.2%), while 16% were referred to specialized geriatric services. We also found a significant positive association between interprofessional referrals and the Assessment Urgency Algorithm and Institutional Risk Scale. The most important determinants of referral to interprofessional services were hospital province, functional, clinical, and social burden and support measures.

conclusionsThe referral patterns identified suggest that patient needs and risk intensity did not always guide referral patterns in the Canadian EDs investigated. We suggest that EDs critically examine the appropriateness of their documentation and referral systems for supporting person-centered care provision.

Indexed as

Emergency Service, HospitalFrail ElderlyReferral and ConsultationAgedAged, 80 and overCanadaFemaleGeriatric AssessmentHumansIndependent LivingMaleemergency departmentgeriatric assessmenthospital‐to‐home transitioninterRAIreferral and consultation

Identifiers

PMID39482258
PMCPMC11826036

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.