Objective: to examine the effectiveness of geriatric evaluation and management for somewhat advanced in life hospitalized patients.Objective: to examine the effectiveness of geriatric evaluation and management for somewhat advanced in life hospitalized patients, combined with post-discharge hearthstone intervention by an interdisciplinary team. Design: randomized controll trial with issue and costs assessed for 12 month after the date of admission. Setting: university-affiliated geriatric hospital and the place of abodes of elderly patients. Subjects: 545 patients with acute illnesses admitted from abode to the geriatric hospital. Interventions: patients were randomly assigned to receive either comprehensive geriatric assessment and postdischarge domicile intervention (intervention), comprehensive geriatric assessment alone (assessment) or usual care (control) Main consequence measures: survival, functional status, rehospitalization, nursing fireside placement and direct costs above 12 months. Results: the intervention assign places to showed a significant reduction in fulness of hospital stay (33.49 days v 407 days in the assessment cluster and 42.7 days in the hinder group; P < 0.05) and rate of immediate nursing place of abode placement (4.4% vs 7.3% and 81%; P < 005) There was no difference in survival, acute care hospital readmissions or just discovered admissions to nursing homes on the other hand the intervention group had significantly shorter hospital readmissions (222 days v 342 days and 357 days; P < 005) and nursing to one's home placements (114.7 days vs 1616 days and 1700 days; P < 005) Direct preciousnesss were lower in the intervention cluster [about DM 7000 (US $4000) by person per year]. Functional capacities were significantly better in the intervention assign places to Conclusions: comprehensive geriatric assessment in combination with post-discharge family intervention does not improve survival, moreover does improve functional status and can cut short the length of the initial hospital stay and of following readmissions. It can reduce the rate of immediate nursing hearth admissions and delay permanent nursing hearthstone placement. It may also substantially mould direct costs of hospitalized patients. COPYRIGHT 1999 Oxford University Press |
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