Minimizing geriatric rehospitalizations: a successful model.
Rehospitalizations may indicate care quality problems. The authors conducted a retrospective cohort study of adults aged 65 years and older, comparing 30-day rehospitalization rates. Rates were compared for comprehensive geriatrics practice patients and for patients receiving usual general medical care. The unadjusted 30-day rehospitalization rate was 18% overall, 21% for geriatrics patients cared for on the geriatrics inpatient service, 22% for geriatrics practice patients on general medical services (GMSs), and 17% for older patients on GMS. Compared with older adults discharged from a GMS, geriatrics patients on the geriatrics service had an adjusted odds ratio for readmission of 1.00 (95% confidence interval = 0.88-1.13). Despite greater frailty, patients cared for in an interdisciplinary geriatrics practice were no more likely to be rehospitalized than adults receiving "usual care," when adjusted for age and disease burden. Incomplete adjustment may account for this finding, which did not confirm the hypothesis that comprehensive geriatrics care would yield fewer rehospitalizations.
Section of Geriatrics, Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, USA. daniel.oates@bmc.org
Daniel J
DJ
Oates
David
D
Kornetsky
Michael R
MR
Winter
Rebecca A
RA
Silliman
Lisa B
LB
Caruso
Matthew E
ME
Sharbaugh
Eric J
EJ
Hardt
Victoria A
VA
Parker
D000368:Aged; D000369:Aged, 80 and over; D001900:Boston; D005260:Female; D006299:Health Services for the Aged / Q000592:standards; D006801:Humans; D008297:Male; D017146:Models, Organizational; D010359:Patient Readmission / Q000592:standards; D017410:Practice Guidelines as Topic / Q000592:standards; D011787:Quality of Health Care / Q000592:standards; D012189:Retrospective Studies