Table 2 Top five most reported advices and referrals per setting in at risk intervention patients (n = 404)

Most reported advices and referrals during ED admission

(n = 810 advices in 404 patients)

1. Advice feasibility of returning home (n = 252)

2. Advice discharge destination (in-hospital or -out-of-hospital) if retuning home was not possible (n = 234)

3. Advice pain management (n = 110)

4. Advice referral to social worker on the ED (n = 73)

5. Advice additional medical follow-up for treating physician on ED (e.g. blood test, technical intervention) (n = 69)

Most reported advices and referrals in case the patient is hospitalized

(n = 1560 advices in 404 patients)

1. Advice functional evaluation during hospitalization (n = 342)

2. Advice referral to occupational therapist during hospitalization (n = 188)

3. Advice referral to social worker during hospitalization (n = 195)

4. Advice cognitive evaluation during hospitalization (n = 178)

5. Advice referral to physiotherapist during hospitalization (n = 152)

Most reported post-discharge advices and referrals

(n = 402 advices in 404 patients)

1. Advice for additional professional help at home (n = 161)

2. Advice further cognitive evaluation by healthcare workers at home (n = 29)

3. Advice ambulatory follow-up by other medical discipline after ED discharge (n = 25)

4. Advice for (preventive) application for residential care stay (n = 25)

5. Prescription of aid by physician (e.g. walking aid) (n = 24)