As the aging population in the U.S. increases, treatment of the elderly becomes a primary issue in the administration and implementation of health care services. This paper looks at a study on the assessment of hospitalized frail elderly patients and evaluates the impact of a comprehensive geriatric assessment intervention that is started before hospital discharge and is continued at home (Siu et al. 76-82).
The study looked at patients over the age of 65 who had either unstable medical problems, recent functional limitations, or potentially reversible geriatric clinical problems. Three hundred and fifty four such patients were randomly assigned to either the intervention group or a control group. Information on survival, readmission, nursing home placement, medication use, and health status was collected at 30 and 60 days after hospital discharge.
Though many models have been advanced and tested for implementing comprehensive geriatric assessment over the years in inpatient hospital settings, other hospital units, ambulatory offices and clinics, the home, and in combinations of these settings, using a variety of target patient populations, structure and personnel involved in the process, duration and intensity of assessments, and the degree of clinical control by the team conducting the assessments, the efficacy of comprehensive geriatric assessments has been debatable according to the authors of the study. They also found that the different forms of comprehensive geriatric assessments also differed in their effects on outcomes. Improved survival and placement have been observed for such assessments conducted in designated evaluation and management units or in long-term home programs, but favorable effects were not observed for assessments performed on either hospital inpatients or patients seen in an ambulatory setting.
The authors suggest several reasons for these uneven outcomes. One factor is a limited supply ...