Long-Term Evaluation of the Ambulatory Geriatric Assessment: A Frailty Intervention Trial (AGe-FIT): Clinical Outcomes and Total Costs After 36 Months
| Autor: | Anne Ekdahl, Jenny Alwin, Magnus Husberg, Amelie Lindh Mazya, Barbro Krevers, Tiny Jaarsma, Anna Milberg, Per Carlsson, Rolf Wiklund, Jeanette Eckerblad, Mitra Unosson |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Frail Elderly law.invention 03 medical and health sciences 0302 clinical medicine total costs of care Randomized controlled trial Ambulatory care law Outcome Assessment Health Care Ambulatory Care Medicine media_common.cataloged_instance Humans Single-Blind Method 030212 general & internal medicine European union hospitalizations Geriatric Assessment General Nursing media_common Aged Geriatrics Aged 80 and over Sweden business.industry Health Policy Comprehensive Geriatric Assessment Hazard ratio outpatient geriatric care General Medicine mortality Confidence interval Concomitant Ambulatory Costs and Cost Analysis Female Geriatrics and Gerontology business 030217 neurology & neurosurgery |
| Zdroj: | Journal of the American Medical Directors Association. 17(3) |
| ISSN: | 1538-9375 |
| Popis: | Objective: To compare the effects of care based on comprehensive geriatric assessment (CGA) as a complement to usual care in an outpatient setting with those of usual care alone. The assessment was performed 36 months after study inclusion. Design: Randomized, controlled, assessor-blinded, single-center trial. Setting: A geriatric ambulatory unit in a municipality in the southeast of Sweden. Participants: Community-dwelling individuals aged � 75 years who had received inpatient hospital care 3o r more times in the past 12 months and had 3or more concomitant medical diagnoses were eligible for study inclusion. Participants were randomized to the intervention group (IG) or control group (CG). Intervention: Participants in the IG received CGA-based care for 24 to 31 months at the geriatric ambulatory unit in addition to usual care. Outcome measures: Mortality, transfer to nursing home, days in hospital, and total costs of health and social care after 36 months. Results: Mean age (SD) of participants was 82.5 (4.9) years. Participants in the IG (n ¼ 208) lived 69 days longer than did those in the CG (n ¼ 174); 27.9% (n ¼ 58) of participants in the IG and 38.5% (n ¼ 67) in the CG died (hazard ratio 1.49, 95% confidence interval 1.05e2.12, P ¼ .026). The mean number of inpatient days was lower in the IG (15.1 [SD 18.4]) than in the CG (21.0 [SD 25.0], P ¼ .01). Mean overall costs during the 36-month period did not differ between the IG and CG (USD 71,905 [SD 85,560] and USD 65,626 [SD 66,338], P ¼ .43). Conclusions: CGA-based care resulted in longer survival and fewer days in hospital, without significantly higher cost, at 3 years after baseline. These findings add to the evidence of CGA’s superiority over usual care in outpatient settings. As CGA-based care leads to important positive outcomes, this method should be used more extensively in the treatment of older people to meet their needs. 2016 AMDA e The Society for Post-Acute and Long-Term Care Medicine. |
| Databáze: | OpenAIRE |
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