[The community activity of a hospital geriatrics service: a practical example of coordination between primary and specialized care].
OBJECTIVE
To describe the management of the geriatric hospital home assessment team to support at primary care in the need of health of geriatric patients.


METHODS
Prospective observational study.


METHODS
5-North health district from Madrid.


METHODS
All patients evaluated at home and the coordination activities between primary care and hospital geriatric service, developed by the geriatric assessment team between january 1997 at december 1999. Inquiry to primary care physicians about the usefulness of geriatric hospital home assessment team.


RESULTS
524 patients was assisted at home by the geriatric assessment team to request primary care (58.4% at all patients attended), 83.24 +/- 7.21 years old (68.1% females), with pluripathology (4.02 +/- 1.86 diagnostics) and polypharmacy (4.95 +/- 2.8), moderate-severe functional disability (Barthel Index < 60 at 65% and Red Cross functional disability > 2 at 74.4%) and frequently cognitive impairment (41.2% with Pfeiffer > 5). The main reasons of primary care to consult was functional impairment (28.4%), medical process assessment (16.2%), geriatric assessment (13.2%), skin ulcers (13.2%) and behavioral disorders (10.8%). 865 telephone call and 178 meeting in health center of primary care for consultation or medical management or for coordinating medical management was attended. 62% of primary care physician inquired to answer back. The belief of 100% answers was about de usefulness of the geriatric assessment team activity, mainly because their specialization on geriatric care (76.7%) and their responsibility of the hospital resources (65.1%).


CONCLUSIONS
The activity of geriatric hospital home assessment team is useful as support of primary care on assessment and management geriatric patients in the community and coordinate hospital and primary care to resolve health problems in this population.
Baztán
J J
JJ
Servicio de Geriatría, Hospital Central Cruz Roja, Madrid. baztanhornillos@retemail.es
Gil
L
L
Andrés
E
E
Vega
E
E
Ruipérez
I
I
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D018575:Home Care Services, Hospital-Based / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010348:Patient Care Team / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D016730:Program Development / Q000379:methods / Q000706:statistics & numerical data; D011446:Prospective Studies; D013030:Spain; D014505:Urban Population / Q000706:statistics & numerical data