Service Evaluation of New Physiotherapy Referrals to a Geriatric Day Hospital

Abstract Background The Geriatric Day Hospital (GDH) physiotherapy service at our urban university hospital is part of a multidisciplinary team delivering Comprehensive Geriatric Assessment (CGA) for older adults. This service evaluation examined all new physiotherapy referrals to the GDH from 2nd September to 20th December 2024. Methods A retrospective chart review was conducted, collecting data on demographics, referral reasons, waiting times, falls risk factors, functional measures (Gait Speed, Five Times Sit-to-Stand), physiotherapy interventions, number of sessions, discharge destinations and ED readmission within 4 weeks of discharge. Results The evaluation encompassed 102 patients. The mean age was 81.6 years; 58.8% were female. Patients averaged seven comorbidities, and 82.4% were prescribed ≥5 regular medications. Over half (52%) used a mobility aid, 68% had a history of falls, and 51% reported a fear of falling. Most (74%) had at least mild frailty (CFS ≥4). The majority of referrals were for mobility-related concerns: mobility assessment (46.1%), post-fall assessment (16.7%), and combined assessment (6.9%). The average wait time for physiotherapy was 26.4 days (range: 0–124). All patients received physiotherapy, typically over two sessions. Structured exercise programs were provided to 88.2%, with common interventions including mobility advice and home exercise prescriptions. Functional improvements were observed: mean gait speed increased from 0.79 to 0.83 m/s (p < 0.001), and the Sit-to-Stand test improved from 29.8 to 24.2 seconds (p = 0.003). Longer wait times were significantly associated with smaller gait speed gains (r = -0.25, p = 0.019), suggesting earlier access may enhance outcomes. At discharge, 41.2% were referred to additional services, including community rehab, community exercise programs, and social prescribing. Only 13.7% had unplanned hospital admissions within four weeks post-discharge. Conclusion This evaluation highlights the effectiveness of physiotherapy at our GDH in improving functional outcomes for frail older adults and underscores the need for timely access to care.