Acute geriatric intervention increases the number of patients able to live at home. A prospective randomized study.
OBJECTIVE
In a previous publication, we showed that treatment of acutely sick, frail elderly patients in a Geriatric Evaluation and Management Unit (GEMU) reduced mortality considerably when compared with the general Medical Wards (MW). The aim of this presentation was to study the impact of treatment in a GEMU on health care utilization.


METHODS
Acutely sick, frail patients, 75 years or older, who had been admitted as emergencies to the Department of Internal Medicine were randomized either to treatment in the GEMU (n=127) or to continued treatment in the MW (n=127). While usual treatment was given in the MW, the GEMU emphasized interdisciplinary and comprehensive assessment of all relevant disorders, early mobilization/rehabilitation, and discharge planning. After discharge from hospital, no specific follow-up was offered to any of the groups.


RESULTS
Of all subjects, 101 (80%) GEMU and 79 (64%) MW patients were still living in their own homes at three months (p=0.005); at six months the number was 91 (72%) and 74 (60%) (p=0.04) respectively. Median length of index stay was 19 days in the GEMU and 13 days in the MW group (p<0.001). After the initial stay, there were no statistically significant differences in admissions to or time spent in institutions.


CONCLUSIONS
The results indicate the overall positive treatment effect of acutely sick, frail elderly in a GEMU, i.e. patients treated in the GEMU had increased possibilities of living in their own homes, an effect that was mainly related to considerably reduced mortality in the GEMU group.
Saltvedt
Ingvild
I
Section of Geriatrics, Department of Internal Medicine, University Hospital of Trondheim, Trondheim, Norway. Ingvild.Saltvedt@medisin.ntnu.no
Saltnes
Turi
T
Mo
Ellen-Sofie Opdahl
ES
Fayers
Peter
P
Kaasa
Stein
S
Sletvold
Olav
O
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D005853:Geriatrics; D006748:Hospital Departments; D006801:Humans; D007902:Length of Stay; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data; D005791:Patient Care; D011446:Prospective Studies; D012111:Residence Characteristics / Q000706:statistics & numerical data; D016019:Survival Analysis