A randomized trial of geriatric liaison intervention in elderly medical inpatients.
OBJECTIVE
The aim of this study was to examine the effect of psychogeriatric intervention in a group of elderly medical inpatients over 75 years of age. In addition to usual care, intervention consisted of multidisciplinary joint treatment by a psychogeriatric team. The main purpose of intervention was to obtain the optimal level of physical functioning.


METHODS
In a prospective randomized trial the effect of the intervention (N = 140) compared with usual care (N = 97) was estimated for physical functioning, length of stay, and nursing home placement within 12 months of discharge.


RESULTS
Substantially more patients assigned to the intervention group improved in their physical functioning, and fewer became worse. The mean length of stay was 5 days shorter for the intervention group. There were more readmissions to hospital in the usual care group (29.9%) compared with the intervention group (17.4%). Of the patients assigned to the intervention treatment, 18% were admitted to a nursing home. In the usual care group this was 27%. The effects of intervention remained statistically significant for all the outcome variables after controlling for possible confounding baseline characteristics.


CONCLUSIONS
The intervention we studied had clinically relevant effects on important outcome variables. Psychiatric co-morbidity was an important risk factor for the outcome of the patients in our study. By combining elements from a psychiatric and geriatric consultation service with elements from a unit-driven service, we were able to improve health care for the elderly in our hospital in a feasible and cost-effective way.
Slaets
J P
JP
Department of Geriatric Medicine, Leyenburg Hospital, The Hague, The Netherlands. slaets@pi.net
Kauffmann
R H
RH
Duivenvoorden
H J
HJ
Pelemans
W
W
Schudel
W J
WJ
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006707:Homes for the Aged; D006801:Humans; D007902:Length of Stay; D008297:Male; D009426:Netherlands; D009735:Nursing Homes; D010348:Patient Care Team; D011446:Prospective Studies; D011602:Psychophysiologic Disorders / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome