Acute Care of the Elderly (ACE) Units

Author: Melanie Zuo, M.D. and Nasiya Ahmed, M.D.

Key Points

ACE Units are general medical units specifically for older adults. These units typically have the following components:

  1. First started in 1989 at the University Hospitals of Cleveland
  2. Clinical and cost-effective benefits include:
    1. Fewer medications at discharge
    2. Reduced prevalence and duration of delirium
    3. Decreased length of stay
    4. Decreased re-admission rate
    5. Decreased nursing home placement
    6. Better functional capacity including improved ambulation and ability to perform instruments of daily living
    7. Better pain satisfaction scores
  3. Cost savings are realized by increased discharges to home versus long-term care, decreased length of stay, and decreased readmissions.



Ahmed, N.N. & Pearce, S. E. (2010). Acute Care for the Elderly: A Literature Review. Population Health Management:13 (4): 219-225.

Ahmed, N., Taylor, K., McDaniel, Y., Dyer, C.B. (2012). The role of an acute care for the elderly unit in achieving hospital quality indicators while caring for frail hospitalized elders. Population Health Management: 15(4): 236-240.

Flood, K., MacLennan, P., McGrew, D. , et al.(2013). Effects of an Acute Care for Elders Unit on Costs and 30-Day Readmissions. Journal of the American Medical Association, 173(11):981-987.

Fox, M,T., Sidani, S., Persaud, M., Tregunno, D., Maimets, I., Brooks, D., & O'Brien, K. (2013). Acute Care for Elders Components of Acute Geriatric Unit Care: Systematic Descriptive Review. Journal of the American Geriatrics Society: 61(6): 939–946.

Landefeld, C.S., Palmer, R.M., Kresevic, D.M., Fortnsky, R.H., & Kowal, J. (1995). A Randomized Trial of Care in a Hospital Medical Unit Especially Designed to Improve the Functional Outcomes of Acutely Ill Older Patients. New England Journal of Medicine; 332:1338-1344.