Abstract

BackgroundPeople aged ≥ 65 years comprise around 1 in 5 emergency department (ED) presentations. Many of these presentations occur due to complications associated with chronic diseases and frailty. This review aims to provide a comprehensive understanding of available research regarding models of care for frail older people presenting to the ED.MethodsThe Joanna Briggs Institute scoping review framework will be used to guide this review. Literature searches will be conducted in the following electronic databases (from January 2009 onwards): CINAHL via EBSCOhost, Ovid MEDLINE, Embase, SocINDEX. Grey literature will be identified through searching Google Scholar. This review will consider primary research studies (including observational and interventional studies) published in English on models of care for frail older people (aged ≥ 65) presenting to the ED. Two researchers will independently screen all citations, full-text articles, and abstract data. Potential disagreements will be resolved through discussion with a third researcher. Data extracted from included studies will include the following: author(s), year of publication, country, research design and aim, time frame of the study, study population and sample size, data collection methods, definition of frailty, model of care, and key findings that pertain to the ability to inform this review. The strength of the body of evidence will be assessed using the National Health and Medical Research Council level of evidence hierarchy body of evidence matrix. Data will be presented in a tabular format and accompanied by a narrative that describes the characteristics of the body of literature.DiscussionDespite the increased number of ED presentations for frail older people, there has been no synthesis of the sources of evidence of model of care for frail older people in the setting of emergency care. The results of this scoping review will provide an overview of different models of care and help inform future research in the development of models of care for frail older persons, tailored to the healthcare system in the emergency context.Systematic review registrationThis scoping review has been registered in the Open Science Framework (osf.io/h2t94).

Highlights

  • People aged ≥ 65 years comprise around 1 in 5 emergency department (ED) presentations

  • We will include original research that investigates model(s) of care for frail older people presenting to the ED

  • The main goal of this scoping review is to map the existing research evidence with regards to models of care for frail older people presenting to the ED and provide a narrative summary of the extracted data reflected in our review question

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Summary

Introduction

People aged ≥ 65 years comprise around 1 in 5 emergency department (ED) presentations. Many of these presentations occur due to complications associated with chronic diseases and frailty. People aged 65 and over comprised 22% of the eight million ED presentations made in 2017–2018 in Australia [6]. These presentations made by older adults often result from complications associated with certain diseases and frailty [1, 2, 4, 7]. Appropriate screening for early identification of frailty in patients and care delivery can help to reduce the complications and morbidity associated with frailty

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