The Senior Care Study
- 1 October 1990
- journal article
- research article
- Published by Wiley in Journal of the American Geriatrics Society
- Vol. 38 (10) , 1073-1081
- https://doi.org/10.1111/j.1532-5415.1990.tb01368.x
Abstract
Successful models of inpatient geriatric assessment have often involved long hospital stays, specialized interdisciplinary care, and prolonged follow‐up, which are difficult to achieve within a prospective payment system. A randomized clinical trial was undertaken to evaluate the efficacy (maintenance or improvement in mental, emotional, and physical function) of using a geriatric assessment process in acute hospital care without increasing hospital charges or lengths of stay. Four hundred thirty‐six patients ≥ 75 years of age were randomly allocated to treatment (n = 221) or control (n = 215) conditions. Patients in the treatment group were admitted to a special unit and evaluated on admission by an interdisciplinary team, which developed a care plan. Although primary care was provided by the patient's own physician, the team followed the patients as consultants on the unit in the hospital, and by telephone for 2 months after discharge. The control group was placed on other units and received usual hospital care. The treatment and control groups were similar at study entry. At follow‐up, there were no significant differences between the groups with respect to lengths of stay, hospital charges, mortality, change in physical function, or change in mental function. The treatment group changed more often in measured emotional function (χ2 = 6.213, P = .045). This study indicates that it is feasible to implement consultative interdisciplinary team care in the acute‐care hospital, but that its efficacy may be limited when applied to an unselected group of older patients.This publication has 29 references indexed in Scilit:
- Conceptual and Methodological Problems in Studying the Effects of Interdisciplinary Geriatric TeamsThe Gerontologist, 1988
- Effectiveness of a Geriatric Evaluation UnitNew England Journal of Medicine, 1984
- Consequences of assessment and intervention among elderly people: a three year randomised controlled trial.BMJ, 1984
- A randomized trial of team care following stroke.Stroke, 1984
- Effect of health visitors working with elderly patients in general practice: a randomised controlled trial.BMJ, 1984
- A Research and Service Oriented Multilevel Assessment InstrumentJournal of Gerontology, 1982
- A New Design for Randomized Clinical TrialsNew England Journal of Medicine, 1979
- A Measure of Primary Sociobiological FunctionsInternational Journal of Health Services, 1976
- A Self-Rating Depression ScaleArchives of General Psychiatry, 1965