Medical Assessment Units and the older patient: a retrospective case-control study

Objective. To evaluate the effect of a Medical Assessment Unit (MAU) on older patients. Methods. Retrospective case-control study of patients 65 years and above admitted to the MAU (study group) and the general medical wards (control group) in Bankstown-Lidcombe Hospital from 1 October 2008 to 31 March 2009 with four mostcommon Diagnosis-Related Groups (DRG) ('falls and gait disorder', 'chronic obstructive pulmonary disease (COPD)', 'other major respiratory diseases and 'cellulitis'). Main outcome measures. Length of stay (LOS) in Emergency Department (ED) and in the hospital, mortality, readmissions within 1 month, and discharge destination. Results. Eighty-nine patients were studied; 47 in the MAU group and 42 in the non-MAU group. The MAU cohort was significantly older (84.1 +/- 7.9 years v. 80.4 +/- 7.8 years, respectively, P = 0.03); and had shorter ED LOS (4.9 +/- 3.0 h v. 6.5 +/- 2.8 h, P = 0.012). Overall hospital LOS did not differ except for patients with 'cellulitis', (5.7 +/- 4.9 days for MAU cohort v. 14.8 +/- 6.8 days for non-MAU cohort, P = 0.022). There was no significant difference in mortality, readmission rate or discharge destination. Conclusions. The MAU can be an effective service model for older patients. More research is required to confirm this and to define the key elements that are essential for its effectiveness.