In a national difference-in-differences study of 4002 US hospitals, level 2 Age-Friendly Health Systems recognition was associated with lower 30-day mortality for acute myocardial infarction, pneumonia, and stroke, level 1 recognition was associated with lower readmissions only for pneumonia, both levels were associated with modest reductions in Medicare spending per beneficiary, and no determinative associations were found for patient-reported experience.
Level 2 AFHS recognition was associated with lower 30-day mortality for acute myocardial infarction, pneumonia, and stroke.
Level 1 AFHS recognition was associated with lower readmission rates only for pneumonia.
Both level 1 and level 2 AFHS recognition were associated with modest reductions in Medicare spending per beneficiary.
No determinative associations were identified between AFHS recognition and patient-reported experience measures.
The study used a national hospital cohort and a difference-in-differences design to assess AFHS recognition.
Prior evidence on the impact of the AFHS movement on outcomes has been limited.
This study looked at whether US hospitals that earned recognition as an "Age-Friendly Health System" had better results for older patients. These hospitals commit to focusing on four areas of care: what matters to the patient, medications, mental health and thinking (mentation), and mobility. The researchers compared 388 recognized hospitals with 3614 other hospitals, tracking changes over time. Hospitals at the more advanced recognition level (those with at least 3 months of data showing they delivered this care to older patients) had lower 30-day death rates after heart attack, pneumonia, and stroke. Hospitals at the earlier level (having a plan to implement the approach) had lower readmission rates only for pneumonia. Both levels were linked with small reductions in Medicare spending per patient. No clear differences were found in how patients rated their experiences. This research suggests that age-friendly care programs may be associated with better outcomes for some conditions and modestly lower spending. Because the study compares hospitals rather than randomly assigning them, it shows associations and cannot prove that the recognition or the care model caused the improvements.
Rosenberg M, Holmgren A, Israelit G, Eckstrom E, Adler-Milstein J. (2026). Age-Friendly Health System Recognition and Its Association with Improved Clinical Outcome Measures.. NEJM catalyst innovations in care delivery. https://doi.org/10.1056/CAT.26.0307