Purpose To examine the effect of predictive factors on institutionalization among older patients. Methods The participants were older (aged 75 years or older) home-dwelling citizens evaluated at Urgent Geriatric Outpatient Clinic (UrGeriC) for the first time between the 1st of September 2013 and the 1st of September 2014 (n = 1300). They were followed up for institutionalization for 3 years. Death was used as a competing risk in Cox regression analyses. Results The mean age of the participants was 85.1 years (standard deviation [SD] 5.5, range 75–103 years), and 74% were female. The rates of institutionalization and mortality were 29.9% and 46.1%, respectively. The mean age for institutionalization was 86.1 (SD 5.6) years. According to multivariate Cox regression analyses, the use of home care (hazard ratio 2.43, 95% confidence interval 1.80–3.27, p < 0.001), dementia (2.38, 1.90–2.99, p < 0.001), higher age (≥ 95 vs. 75–84; 1.65, 1.03–2.62, p = 0.036), and falls during the previous 12 months (≥ 2 vs. no falls; 1.54, 1.10–2.16, p = 0.012) significantly predicted institutionalization during the 3-year follow-up. Conclusion Cognitive and/or functional impairment mainly predicted institutionalization among older patients of UrGeriC having health problems and acute difficulties in managing at home.

Background Up to 20% of older patients admitted to Emergency Department (ED) are readmitted within 30 days after being discharged. Geriatric assessment in ED has shown to be associated with preferable discharge rates and reduction of readmission rates in older patients. Methods Subjects of this prospective study were ≥75-year-old home-dwelling citizens (N = 1234) who underwent comprehensive geriatric assessment (CGA) during their first visit in Urgent Geriatric Outpatient Clinic (UrGeriC); 535 were discharged and, of those, 110 had a revisit to UrGeriC or an admission to ED within 30 days after index visit. Results Of those 535 discharged patients, 110 (21%) had a revisit to UrGeriC (42 patients, 38%) or an admission to ED (68 patient, 62%) within 30 days after the index visit in UrGeriC. The most common reason for the index visit, as well as for the following visit was nonspecific complaint. Over half of those who were admitted to ED during the office hours and almost all of those who were admitted out of the office hours could have been treated in UrGeriC instead of ED. Conclusions According to our study, it seems that 20% of older patients seek urgent medical help within 30 days after the index visit even after a multidimensional CGA. Frontline geriatric services are needed to better respond to the complex needs of rapidly increasing proportion of frail older patients presenting to ED.