title: The impact of geriatric consultation on the care of the elders in community clinics.
abstract: The aim of this retrospective study was to describe and evaluate the impact of a new model used in caring for the elders in the community, based on geriatrician consultation, initiated by their general physician (GP) and conducted by both in five urban primary care clinics. Five hundred and forty-two elderly patients were referred to a geriatric consultant during a 41-month period. The patients' demographic, functional, cognitive medical status, reasons for referral and recommendations were recorded. Implementation by the GP of the geriatrician's recommendations was analyzed with the number of visits during the 6-month follow up. Patients were referred mainly for affective, cognitive, medical problems, functional decline and gait disturbances in 39.7%, 30.4%, 24.4%, 18.6% and 12.7% of cases, respectively. The referrals to the geriatrician increased from 133 in 2004 to 207 in 2006 (p=0.01), while the visits to the GP decreased from 10.9 to 10.2 during 6-month period following the geriatric consultation (p<0.01). No decline was found in the other elderly patients. In most cases, the GP implemented the geriatrician's advice (p<0.01). Geriatrician consultations and recommendations in the primary care clinic were well accepted by the GP, thereby reducing the number of visits.
authors.affiliation: Department of Geriatrics, Rabin Medical Center, Beilinson Campus, Sackler School of Medicine, Tel Aviv University, Petach Tikvah 49100, Israel; Beit Rivka Geriatric Rehabilitation Hospital, Sackler School of Medicine, Tel Aviv University, Petach Tikvah 49100, Israel.
authors.forename: Vered
authors.initials: V
authors.lastname: Hermush
authors.affiliation: Beit Rivka Geriatric Rehabilitation Hospital, Sackler School of Medicine, Tel Aviv University, Petach Tikvah 49100, Israel.
authors.forename: Daniel
authors.initials: D
authors.lastname: Daliot
authors.affiliation: Department of Geriatrics, Rabin Medical Center, Beilinson Campus, Sackler School of Medicine, Tel Aviv University, Petach Tikvah 49100, Israel.
authors.forename: Avraham
authors.initials: A
authors.lastname: Weiss
authors.affiliation: Beit Rivka Geriatric Rehabilitation Hospital, Sackler School of Medicine, Tel Aviv University, Petach Tikvah 49100, Israel.
authors.forename: Shai
authors.initials: S
authors.lastname: Brill
authors.affiliation: Department of Geriatrics, Rabin Medical Center, Beilinson Campus, Sackler School of Medicine, Tel Aviv University, Petach Tikvah 49100, Israel. Electronic address: beloy@clalit.org.il.
authors.forename: Yichayaou
authors.initials: Y
authors.lastname: Beloosesky
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D003153:Community Health Services; D003266:Continuity of Patient Care; D005260:Female; D005500:Follow-Up Studies; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012017:Referral and Consultation; D012189:Retrospective Studies