[Quality assurance in geriatric rehabilitation hospital treatment. Long-term medical and functional outcome].
Clinical geriatric therapy has shown to be beneficial and cost-effective. However, little is known about its long-term results. Based on GEMIDAS (Geriatric Minimal Data Set), a multicenter-Database of the German Federal Association of 140 Clinical Geriatric Institutions, we conducted a one-year-follow-up pilot study focusing on medical and functional results, including needs of technical aids and nursing. Mortality was 16% at 1 year. Two thirds of the deceased had died during the first half year, many with severe stroke. Among the 840 survivors, 81.1% lived in their private housing, 14.5% in nursing homes, 4.4% were actually hospitalized. 37.3% suffered from recurrent diseases such as stroke (5.2%), bone fractures (4.5%), heart attacks (2.1%), severe infections (1.1%), needing hospitalization in 31.9%, repeatedly in 6.9% of the survivors. Technical aids were regularly used in about 80%. Personal help was often necessary and was provided by relatives (66.9%), professional nursing (39.8%), neighbors (5.7%), only 6% of the patients needed no help. The initial functional gain (mean Barthel-Index from 53.4 to 72.3 points) diminished to 59.6 points during follow-up, with similar patterns for most of the single Barthel-items. Our results confirm the initial benefit and clearly show a significant long-term effect of clinical geriatric rehabilitation. For stabilization and further functional improvement, specific and continuous rehabilitation efforts seem to be crucial.
Vogel
W
W
Braun
B
B
D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000401:mortality / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D005858:Germany; D006801:Humans; D008297:Male; D009313:National Health Programs / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*; D016896:Treatment Outcome