A Randomized Clinical Trial of Outpatient Geriatric Evaluation and Management
| Autor: | Cristina Urdangarin, Lynne Morishita, Chad Boult, Robert L. Kane, Bryan E Dowd, Lisa Boult |
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| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty Activities of daily living Population law.invention Randomized controlled trial law Outpatients medicine Humans Functional ability education Geriatric Assessment Aged Patient Care Team Geriatrics education.field_of_study business.industry Odds ratio Community hospital Clinical trial Outcome and Process Assessment Health Care Physical therapy Female Geriatrics and Gerontology business |
| Zdroj: | Journal of the American Geriatrics Society. 49:351-359 |
| ISSN: | 1532-5415 0002-8614 |
| Popis: | OBJECTIVES: To measure the effects of outpatient geriatric evaluation and management (GEM) on high-risk older persons' functional ability and use of health services. DESIGN: Randomized clinical trial. SETTING: Ambulatory clinic in a community hospital. PARTICIPANTS: A population-based sample of community-dwelling Medicare beneficiaries age 70 and older who were at high risk for hospital admission in the future (N = 568). INTERVENTION: Comprehensive assessment followed by interdisciplinary primary care. MEASUREMENTS: Functional ability, restricted activity days, bed disability days, depressive symptoms, mortality, Medicare payments, and use of health services. Interviewers were blinded to participants' group status. RESULTS: Intention-to-treat analysis showed that the experimental participants were significantly less likely than the controls to lose functional ability (adjusted odds ratio (aOR) = 0.67, 95% confidence interval (CI) = 0.47-0.99), to experience increased health-related restrictions in their daily activities (aOR = 0.60, 95% CI = 0.37-0.96), to have possible depression (aOR = 0.44, 95% CI = 0.20-0.94), or to use home healthcare services (aOR = 0.60, 95% CI = 0.37-0.92) during the 12 to 18 months after randomization. Mortality, use of most health services, and total Medicare payments did not differ significantly between the two groups. The intervention cost $1,350 per person. CONCLUSION: Targeted outpatient GEM slows functional decline. |
| Databáze: | OpenAIRE |
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