A 30-Minute Comprehensive Geriatric Assessment Can Sharply Cut Hospital Readmissions

A team at Bundang Seoul National University Hospital can assess an older patient’s walking speed, balance, grip strength, body composition, cognition, medication use, nutrition, depression and fall risk in about 30 minutes. The hospital uses the process, known as Comprehensive Geriatric Assessment, or CGA, to build treatment and long-term care plans around the patient rather than a single disease.

Kim Kwang-il, director of the hospital’s Geriatric Medical Center, summarizes the challenge as “raise it and lower it.” The clinical value and institutional standing of CGA need to rise, he says, while its cost structure must come down through digital technology and redesigned work.

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Raise it and lower it.

CGA grew from work by British physician Marjory Warren in the 1930s. She systematically assessed older patients in chronic-disease hospitals and showed that many people considered close to death could return home after treatment and rehabilitation. Bundang Seoul National University Hospital opened in 2003 with a mission to help develop a national model of geriatric medicine. It began outpatient and inpatient CGA services in 2004.

The hospital’s standard team includes a dedicated nurse, dietitian and clinical pharmacist. In 2025, it performed about 1,500 assessments, including roughly 1,000 before surgery and 500 for internal-medicine outpatients and inpatients. Results are shared with specialists in geriatrics, endocrinology, psychiatry and rehabilitation, who develop treatment plans through multidisciplinary consultation.

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Comprehensive assessment is both a diagnosis and the starting point for intervention.

A recent 10-hospital study led by Kim and supported by the National Evidence-based Healthcare Collaborating Agency found that CGA-based intervention increased the rate of older patients living healthily at home three months later by about 40% compared with usual care. Kim says the model remains difficult to fund because it requires staff and upfront investment, while Korea has not agreed how to count savings in nursing hospitals, care facilities and caregiving.

He proposes linking incentives to hospitals that maintain a qualifying assessment and intervention system, rather than paying a small fee for each assessment. He also wants the model extended to ordinary hospitals, where assigning four staff members is often impossible. Bundang has introduced motion-capture equipment for some physical measurements and is developing a five-year AI-based system that could analyze cognition, mood, medication use, grip strength and walking after patients interact with a chatbot and perform simple movements at home.

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Hospitals that properly operate comprehensive assessment teams and those that do not show a major difference in the quality of geriatric care.