Abstracts

Abstract

Aims:To describe the types of hospital and out-ofhospital services provided by public geriatric medicine departments in Australia and New Zealand, and to explore head of department (HOD) views on issues in current and future service provision. Methods: An electronic survey was sent to HODs of public geriatric medicine. Results: Seventy-four (88%) of 84 identified HODs completed the survey. Sixty-nine (93%) departments provide an inpatient service and 40 (54%) provide an acute inpatient service, with highly variable admission policies. Sixty-two (84%) departments have an associated inpatient general medicine department, and fifty-six (90%) of these admit older patients with acute geriatric issues. Fifty-nine (80%) departments provide inpatient rehabilitation services. Thirty-eight (51%) have beds dedicated to behavioural symptoms of dementia and/or delirium. Sixty-eight (92%) provide a proactive orthogeriatric service. In terms of outpatient and community care, seventy-two (99%) departments have outpatient clinics, 57 (77%) can provide telehealth and 66 (89%) perform home visits. Forty-five (61%) provide an inreach/outreach service to nursing homes. The most frequent gaps identified by HODs were acute geriatrics, surgical liaison services, a designated dementia/ delirium behavioural management unit, geriatricians in emergency departments, outreach/inreach to residential care and shared care with some medical specialties. Increasing staff numbers and government policy change were the most frequently identified ways to address these gaps. Conclusions: Geriatric medicine service provision is highly variable across Australia and New Zealand. Our data will help in further discussion and research about what services should be provided by public geriatric medicine departments and how this could be achieved.A longitudinal study of frailty, quality of life and dialysis in older patients with advanced chronic kidney disease