Community geriatric assessment services for reducing rehospitalizations of residential-care residents: retrospective survival and cost analyses

Background: Repeated hospitalizations among older adults living in residential care homes can potentially be ameliorated through comprehensive geriatric assessment, but evidence is limited. This study evaluated a comprehensive geriatric assessment program in Hong Kong that provides community geriatric assessment services (CGAS) to residents in residential care homes, focusing on (i) its association with hospital readmissions and (ii) its cost relative to potential savings in readmission costs.
Methods: Longitudinal demographic and clinical records (2014-11-01 to 2016-12-31) of 138 older adults were retrospectively analyzed. A survival analysis with a marginal structural model examined the association between CGAS and readmission risk, controlling for age, gender, calendar year of entering the care home, length of previous hospital stay, and morbidity/comorbidity. A scenario-based cost analysis estimated the cost of CGAS and compared it with the potential reduction in readmission costs modeled on the observed associations.
Results: Receiving CGAS was associated with at least 33% lower hazard of readmission (p < 0.01). Comorbidities were also major risk factors for repeated hospital admissions. At the individual level, while CGAS cost 2,868 HKD per person annually, it was associated with savings of 12,895 HKD per person in readmission cost.
Conclusions: The provision of CGAS was associated with a lower risk of hospital readmissions and potential economic benefits among residents in residential care homes.
Public interest summary: Older adults living in residential care homes frequently experience repeated hospital admissions, exacerbating their health conditions and imposing a substantial burden on healthcare systems. To tackle this issue, implementing comprehensive geriatric assessments may be beneficial. Nevertheless, evidence specific to older adults residing in residential care homes remains limited. The present study focused on assessing a comprehensive geriatric assessment program in Hong Kong, which offers community geriatric assessment services (CGAS) to older adults living in residential care homes. Our findings revealed that the provision of CGAS was associated with a lower hazard of hospital readmissions, as well as potential economic benefits. These results warrant further evaluation of the role and scalability of such outreach geriatric assessment programs within continuous care for older adults.
© 2026 Fellowship of Postgraduate Medicine.