title: Treatment in a Geriatric Day Hospital improve individualized outcome measures using Goal Attainment Scaling.
abstract: Evidence regarding outcomes in the Geriatric Day Hospital (GDH) model of care has been largely inconclusive, possibly due to measurement issues. This prospective cohort study aims to determine whether treatment in a GDH could improve individualized outcome measures using goal attainment scaling (GAS) and whether improvements are maintained 6-months post-discharge.
  
  
  
  A total of 469 outpatients admitted to a Canadian Geriatric Day Hospital, between December 2008 and June 2011, were included in the analysis (81.1 ± 6.7 years, 66.3% females); a smaller cohort of 121 patients received a follow-up phone call 6 months following discharge. Baseline, discharge and 6 month post-discharge observer-rated measures of mobility, cognition, and function were completed using GAS. Traditional psychometric measures were also captured.
  
  
  
  The mean number of goals set was 1.6 (SD 0.8) and patients set goals in the following domains: 88% mobility or falls reduction; 18% optimization of home supports; 17% medication optimization;12% cognition; 8% increasing social engagement; and 5% optimization of function. Total GAS was the most responsive measure to change with 86% of patients improving at discharge; mobility goals were the most likely to be achieved. Six-month GAS scores remained significantly higher than GAS scores on admission. Those who had more goals were more likely to improve during GDH admission (OR 1.49, CI 1.02-2.19) but this association was not seen 6 months after discharge.
  
  
  
  This study demonstrated short- and long-term effectiveness of GDH in helping patients achieve individualized outcome measures using GAS.
authors.affiliation: Division of Geriatric Medicine, Dalhousie University, Veterans' Memorial Building, 5955 Veterans memorial Lane, Halifax, Nova Scotia, B3H2E1, Canada. Paige.Moorhouse@nshealth.ca.|Centre for Health Care of the Elderly, Nova Scotia Health Authority, Veterans' Memorial Building, 5955 Veterans memorial Lane, Halifax, Nova Scotia, B3H2E1, Canada. Paige.Moorhouse@nshealth.ca.
authors.forename: Paige
authors.initials: P
authors.lastname: Moorhouse
authors.affiliation: Division of Geriatric Medicine, Dalhousie University, Veterans' Memorial Building, 5955 Veterans memorial Lane, Halifax, Nova Scotia, B3H2E1, Canada.
authors.forename: Olga
authors.initials: O
authors.lastname: Theou
authors.affiliation: Centre for Health Care of the Elderly, Nova Scotia Health Authority, Veterans' Memorial Building, 5955 Veterans memorial Lane, Halifax, Nova Scotia, B3H2E1, Canada.
authors.forename: Sherri
authors.initials: S
authors.lastname: Fay
authors.affiliation: Centre for Health Care of the Elderly, Nova Scotia Health Authority, Veterans' Memorial Building, 5955 Veterans memorial Lane, Halifax, Nova Scotia, B3H2E1, Canada.
authors.forename: Miranda
authors.initials: M
authors.lastname: McMillan
authors.affiliation: Centre for Health Care of the Elderly, Nova Scotia Health Authority, Veterans' Memorial Building, 5955 Veterans memorial Lane, Halifax, Nova Scotia, B3H2E1, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Moffatt
authors.affiliation: Division of Geriatric Medicine, Dalhousie University, Veterans' Memorial Building, 5955 Veterans memorial Lane, Halifax, Nova Scotia, B3H2E1, Canada.|Centre for Health Care of the Elderly, Nova Scotia Health Authority, Veterans' Memorial Building, 5955 Veterans memorial Lane, Halifax, Nova Scotia, B3H2E1, Canada.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rockwood
mesh_terms: D000203:Activities of Daily Living; D000069537:Adult Day Care Centers; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003631:Day Care, Medical; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010347:Patient Care Planning; D010351:Patient Discharge; D011446:Prospective Studies; D011594:Psychometrics
keywords: Geriatric day hospital; Goal attainment scaling; Mobility