Postdischarge geriatric assessment of hospitalized frail elderly patients

Albert L. Siu, Richard L Kravitz, Emmett Keeler, Karen Hemmerling, Raynard Kington, James W. Davis, Anne Mitchell, Tanya M. Burton, Hal Morgenstern, Mark H. Beers, David B. Reuben

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Background: The diffusion of comprehensive geriatric assessment services has been rather limited in North America partly because of reimbursement and organizational constraints. Objective: To evaluate the impact of a comprehensive geriatric assessment intervention for frail older patients thai is started before hospital discharge and is continued at home. Methods: Patients older than 65 years were selected who had either unstable medical problems, recent functional limitations, or potentially reversible geriatric clinical problems. Patients (n=354) were randomly assigned to either the intervention group or a control group. Information on survival, readmissions, nursing home placement, medication use, and health status was collected at 30 and 60 days after hospital discharge. Results: No differences were observed between the two treatment groups in survival, hospital readmission, or nursing home placement by 60 days. Alter adjustment for baseline characteristics, no significant differences were observed between the two groups on measures of physical functioning, social functioning, role limitations, health perceptions, pain, mental health, energy and/or fatigue, health change, or overall well-being. Conclusions: Although efficacy has been demonstrated for some forms of comprehensive geriatric assessment, the types of services that are easier to establish (inpatient consultation services and ambulatory, assessment) have not been shown to improve outcomes. Our results indicate that outcomes are unaffected by a limited form of comprehensive geriatric assessment begun in the hospital and completed at home. Further efforts are needed to develop and to evaluate realistic approaches to comprehensive geriatric assessment.

Original languageEnglish (US)
Pages (from-to)76-81
Number of pages6
JournalArchives of Internal Medicine
Volume156
Issue number1
DOIs
StatePublished - Jan 8 1996

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Geriatric Assessment
Frail Elderly
Nursing Homes
Mental Fatigue
Patient Readmission
Pain Perception
Survival
Health
North America
Geriatrics
Health Status
Inpatients
Mental Health
Referral and Consultation
Control Groups

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Siu, A. L., Kravitz, R. L., Keeler, E., Hemmerling, K., Kington, R., Davis, J. W., ... Reuben, D. B. (1996). Postdischarge geriatric assessment of hospitalized frail elderly patients. Archives of Internal Medicine, 156(1), 76-81. https://doi.org/10.1001/archinte.156.1.76

Postdischarge geriatric assessment of hospitalized frail elderly patients. / Siu, Albert L.; Kravitz, Richard L; Keeler, Emmett; Hemmerling, Karen; Kington, Raynard; Davis, James W.; Mitchell, Anne; Burton, Tanya M.; Morgenstern, Hal; Beers, Mark H.; Reuben, David B.

In: Archives of Internal Medicine, Vol. 156, No. 1, 08.01.1996, p. 76-81.

Research output: Contribution to journalArticle

Siu, AL, Kravitz, RL, Keeler, E, Hemmerling, K, Kington, R, Davis, JW, Mitchell, A, Burton, TM, Morgenstern, H, Beers, MH & Reuben, DB 1996, 'Postdischarge geriatric assessment of hospitalized frail elderly patients', Archives of Internal Medicine, vol. 156, no. 1, pp. 76-81. https://doi.org/10.1001/archinte.156.1.76
Siu, Albert L. ; Kravitz, Richard L ; Keeler, Emmett ; Hemmerling, Karen ; Kington, Raynard ; Davis, James W. ; Mitchell, Anne ; Burton, Tanya M. ; Morgenstern, Hal ; Beers, Mark H. ; Reuben, David B. / Postdischarge geriatric assessment of hospitalized frail elderly patients. In: Archives of Internal Medicine. 1996 ; Vol. 156, No. 1. pp. 76-81.
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