title: Delirium and transition to a nursing home of hospitalized older adults: a controlled trial of assessing the interdisciplinary team-based "geriatric" care and care coordination by non-geriatrics specialist physicians.
abstract: OBJECTIVE
  To examine whether a team-based inpatient "geriatric" care model provided by non-geriatrics specialist physicians was associated with changes in the occurrence of delirium and transition to a nursing home.
  
  
  METHODS
  We carried out an intervention (interdisciplinary; ITD group) control (usual care group) study comparing the outcomes of hospitalized older adults cared for by non-geriatrics specialist physicians. Compared with the usual care group, the ITD intervention group provided additional value: geriatric care and care coordination by leading daily ITD team meetings.
  
  
  RESULTS
  After adjusting for patient demographics and clinical characteristics, the probability of transition to a nursing home in the ITD intervention group was significantly lower (odds ratio 0.52; 95% confidence intervals, 0.16-0.94; P = 0.008) than that in the usual care group. However, there was no significant difference in the predicted probabilities of delirium between the ITD intervention and usual care groups.
  
  
  CONCLUSIONS
  As compared with the usual care group, a significantly lower probability of transition to a nursing home was observed in the ITD intervention group, but the probabilities of delirium between the ITD intervention and usual care groups did not differ significantly.
authors: Cleveland Clinic Health System, Cleveland, Ohio, USA. yoojiw@trinity-health.org
authors: Ji Won
authors: JW
authors: Yoo
authors: Shunichi
authors: S
authors: Nakagawa
authors: Sulgi
authors: S
authors: Kim
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D019090:Case Management; D016022:Case-Control Studies; D057189:Checklist; D003071:Cognition / Q000502:physiology; D003693:Delirium / Q000517:prevention & control*; D003933:Diagnosis; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D005853:Geriatrics / Q000193:education; D006760:Hospitalization; D006801:Humans; D008297:Male; D059065:Medication Reconciliation; D008511:Medicine; D008609:Mental Status Schedule; D009735:Nursing Homes; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D010360:Patient Transfer; D012111:Residence Characteristics; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology