Effects of a geriatric inpatient unit on elderly home care patients: a controlled trial.

Abstract

This was the first controlled trial to test the value of bringing elderly community-dwelling home care program patients into a hospital geriatric assessment unit. Elderly community-dwelling patients (N = 312; mean age = 78 years) who belonged to a supervised home-care population were randomized into intervention (N = 104) and control groups (N = 208). Patients in the intervention group underwent a comprehensive multidisciplinary geriatric assessment in an inpatient geriatric assessment unit (mean length of stay, 16.5 days). Controls continued with usual home care. At baseline, the two groups were comparable. By three months, the intervention group had more positive changes in general health, continence, housekeeping and satisfaction with care. However, by 12 months, these differences were no longer statistically significant. During the follow-up year, the intervention group had fewer days in health center hospitals. However, since controls had no initial days in the geriatric unit, there was no net difference in cumulative institutional days. We conclude that the benefits of this assessment approach were relatively mild and apparently temporary. More studies of alternative assessment schemes are needed, and different targeting models should be studied.