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Impact of Geriatric Consultation Services for Elderly Patients Admitted to Acute Care Hospitals

Published online by Cambridge University Press:  29 November 2010

David B. Hogan
Affiliation:
Department of Medicine, Dalhousie University

Abstract

Geriatric consultation programs have been developed to service elderly patients in a number of acute care hospitals. Evaluation studies examining their utility have shown variable results. Suggested explanations for these inconsistent findings include differing study designs, various service delivery strategies, differing outcome measurements, and site-specific factors. The evidence suggests that the critical variable may well be the methods utilized in patient recruitment. Further work is required in a number of areas such as: (1) development of optimal targeting strategies, (2) determination of appropriate service composition and function, (3) study of how these programs interact with other components of a comprehensive geriatric program, (4) documentation of the long-term (1 year) impact on assessed patients, and (5) evaluation of the institutional impacts of these programs.

Résumé

Certains centres hospitaliers de soins à courte durée ont mis sur pied des programmes de consultation gériatrique destinés à l'intention des patients âgés. Des études évaluatives explorant l'utilité de ces programmes ont produit des résultats variés. Ces résultats inconsistants pourraient être causés par la différence au niveau de la conception des études de recherche, les différentes stratégies utilisées, les différentes façons d'analyser les résultats, et finalement certains facteurs propres à l'institution même. De toute évidence, la variable critique serait celle qui porte sur les méthodes utilisées pour recruter les patients. Des études plus poussées devraient être mises au point dans le but de (1) développer des stratégies cibles optimales, (2) déterminer la composition appropriée de service et fonction (3) étudier l'interaction entre ces programmes et les autres éléments d'un programme gériatrique d'envergure, (4) documenter l'effet à long terme (une année) sur les patients évalués et (5) évaluer l'impact institutionnel de ces programmes.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 1990

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References

(1)Rubenstein, LZ: Documenting impacts of geriatric consultation. J Am Ger Soc 1987, 35:829.CrossRefGoogle ScholarPubMed
(2)Goldman, L, Lee, T, Rudd, P: Ten commandments for effective consultations. JAMA 1983, 143:17531755.Google ScholarPubMed
(3)Pupa, LE, Coventry, JA, Hanley, JF, Carpenter, JL: Factors affecting compliance for general medicine consultations to non-internists. AM J Med 1986, 81:508514.CrossRefGoogle ScholarPubMed
(4)Merle, GJ, Wietz, HH: The medical consultant. Med Clin N A 1987, 71:353355.CrossRefGoogle Scholar
(5)Schmitt, MH, Farrell, MP, Heinemann, GD: Conceptual and methodological problems in studying the effects of interdisciplinary geriatric teams. The Gerontologist 1988, 20:753764.CrossRefGoogle Scholar
(6)Burley, LE, Currie, CT, Smith, RG, Williamson, J: Contribution from geriatric medicine within acute medical wards. Brit Med J 1979, 2:30.CrossRefGoogle ScholarPubMed
(7)Campion, EW, Jette, A, Berkman, B: An interdisciplinary geriatric consultation service - a controlled trial. J Am Ger Soc 1983, 31:792.CrossRefGoogle ScholarPubMed
(8)Blumenfield, S, Morris, J, Sherman, FT: The geriatric team in the acute care hospital. J Am Ger Soc 1982, 30:660664.CrossRefGoogle Scholar
(9)Lichenstein, H, Winograd, CH: Geriatric consultation. J Am Ger Soc 1984, 32:356.CrossRefGoogle Scholar
(10)Barker, WH, Williams, TF, Zimmer, JG, et al: Geriatric consultation teams in acute hospitals. J Am Ger Soc 1985, 33:422.CrossRefGoogle ScholarPubMed
(11)Katz, PR, Dube, DH, Calkins, E: Use of astructured functional assessment format in geriatric consultative service. J Am Ger Soc 1985, 33:681.CrossRefGoogle Scholar
(12)Gayton, D, Wood-Dauphinee, S, de Lormier M, et al: Trial of a geriatric consultation team in an acute care hospital. J Am Ger Soc 1987, 35:726.CrossRefGoogle Scholar
(13)Hogan, DB, Fox, RA, Badley, BWD, Mann OE: Effect of a geriatric consultation service on management of patients in an acute care hospital. CMAJ 1987, 136:713.Google Scholar
(14)Saltz, EC, McVey, LJ, Becker, PM, et al: Impact of a geriatric consultation team on discharge placement and repeat hospitalization. The Gerontologist 1988, 28:344350.CrossRefGoogle Scholar
(15)Allen, CM, Becker, PM, McVey, LJ, et al: A randomized, controlled clinical trial of a geriatric consultation team, compliance with recommendations. JAMA 1986, 255:2617.CrossRefGoogle ScholarPubMed
(16)Becker, PM, McVey, LJ, Saltz, CC, et al: Hospital-acquired complications in a randomized controlled trial of a geriatric consultation team. JAMA 1987, 257:2313.CrossRefGoogle Scholar
(17)McVey, LJ, Becker, PM, Saltz, CC, Feussner, JR, Cohen, HJ: Effect of a geriatric consultation team on functional states of elderly hospitalized patients. Ann Int Med 1989,110:7084.CrossRefGoogle Scholar