Impact of continued geriatric outpatient management on health outcomes of older veterans.
Although previous trials have proved inpatient-based geriatric assessment to be beneficial, to our knowledge, the effectiveness of outpatient geriatric assessment has not been established.
We examined the effectiveness of an outpatient geriatric evaluation and management (GEM) clinic.
Hospitalized veterans aged 65 years or older with impairment of activities of daily living, chronic disease, polypharmacy, or two or more hospitalizations in the previous year were randomized to an outpatient GEM team clinic (n=60) or usual care (n=68).
At randomization, no significant differences were noted between the groups.
The average age of the patients was 71 years (range, 65 to 93 years).
At 1 year following randomization, GEM clinic patients compared with subjects receiving usual care had significantly improved health perception, took fewer medications despite increased number of diagnoses, reported greater social activity, had improved Center for Epidemiologic Studies-Depression scale scores, and had higher life satisfaction scores.
There was a trend toward improved performance of activities of daily living for GEM clinic patients.
The GEM clinic patients had a 54% lower mortality (6.8% vs 14.9%). Overall, no differences were observed in the total number of hospitalizations between the groups.
The combination of long-term management following comprehensive outpatient assessment significantly improved aspects of health status.
Mots-clés Pascal : Hospitalisation, A domicile, Etats Unis, Traitement, Vieillard, Evaluation performance, Amérique du Nord, Amérique, Homme
Mots-clés Pascal anglais : Hospitalization, At home, United States, Treatment, Elderly, Performance evaluation, North America, America, Human
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0398067
Code Inist : 002B30A03B. Création : 01/03/1996.