A comparison of placement outcomes of geriatric cohorts receiving care in a geriatric assessment unit and on general medicine floors.

Abstract

To assess whether care in a geriatric assessment unit using a multidisciplinary team approach with rehabilitative emphasis impacted on patient placement outcomes, a historical prospective study was initiated using records of geriatric assessment unit patients admitted during a one-year period (n = 62). A second, diagnostically similar general medicine unit cohort was also sampled (n = 62). Placement outcomes of the two groups were compared. All study patients were 75 years of age or older, stratified by source of admission, and controlled for comparability using diagnostic grouping. The geriatric assessment unit admitted 92 per cent of its patients from home; the general medicine unit, 82 per cent. As a result of expanded rehabilitative, respite, and terminal care promoted by the geriatric assessment unit staff, mean length of stay was 36 days, whereas it was 13 days in the general medicine unit (P less than 0.001). There was no significant difference between the two units with respect to hospital deaths, post-hospitalization discharges to home or nursing homes, or patient locations (home versus nursing home) six months after admission. Although improvements in patient independence may have been achieved through the efforts of a multidisciplinary team approach utilizing the geriatric assessment unit, they were not sufficient to significantly increase the proportion of patients placed at home. Superiority in placement outcome may be demonstrated only by geriatric assessment unit use of selective admission criteria.