Geriatric Emergency Care, Hospitalization, and Mortality Among Older Adults in the United States

Geriatric Emergency Departments (GEDs) -- accredited units that integrate geriatric-trained staff, age-friendly protocols, and post-visit care coordination -- have expanded rapidly across the United States. This paper provides the first nationally representative estimates of GED effects on hospitalization and mortality among Medicare beneficiaries. Linking data from the Health and Retirement Study to Medicare claims, we find that older adults treated at a GED were 9.7 percentage points less likely to be hospitalized and 6.1 percentage points less likely to die within 30 days, compared to those treated at a non-GED emergency department. Placebo tests and sensitivity analyses support causal interpretation. However, treatment effect heterogeneity analysis reveals that gains are concentrated among non-Hispanic white patients and adults under age 80; Black and Hispanic older adults exhibit no statistically significant benefit, consistent with persistent disparities in post-discharge care access and social support. These findings suggest that GED accreditation improves downstream health outcomes at scale, but that structural inequities outside the emergency department attenuate benefits for minority patients.