This study determines whether proactive screening of hospitalised patients can identify unrecognised comorbid psychiatric conditions, and whether comprehensive assessment and psychogeriatric intervention (UPBEAT) can improve care while reducing inpatient use. The comparator was usual care for medical and surgical patients. The perspective adopted was that of the funders of hospital-based care. UPBEAT achieved an overall saving compared with usual care. UPBEAT appeared to accelerate the transition from inpatient to outpatient care for acute non-psychiatric admissions.