Geriatric screening in acute care wards--a novel method of providing care to elderly patients

OBJECTIVE: To assess a nurse-implemented geriatric screening system. DESIGN: Descriptive study. SETTING: University teaching hospital, Hong Kong. PATIENTS: All (5080) elderly patients admitted between 1 January 1996 and 31 December 1996. MAIN OUTCOME MEASURES: Patient characteristics such as disease, prior admission, living quarters, and regular medications; interventions taken; and morbidity and mortality. RESULTS: The most common interventions were referral to a convalescent hospital, patient education, and carer contact. The overall death rate was 8.5% and the diseases with the highest mortality rates were renal failure, liver cirrhosis, and cancer. Approximately one quarter of patients had been admitted to hospital in the previous month. The death rate was higher among women than men (10.8% versus 6.7%, P<0.001; odds ratio=1.68; 95% confidence interval, 1.38-2.05), as was the percentage of those with a history of admission in the previous month (32.8% versus 20.0%, P<0.001; odds ratio=1.95; 95% confidence interval, 1.71-2.21). Patients with multiple pathologies and polypharmacy had a greater frequency of previous 1-month admission compared with those who did not have these features (37.5% versus 20.0%, P<0.001; odds ratio=2.37; 95% confidence interval 2.0-2.7). Patients living in old-age homes had a higher death rate and more previous 1-month admissions than home dwellers, and patients living in private old-age homes had a higher death rate but lower number of previous 1-month admissions than those living in subsidised old-age homes. CONCLUSIONS: This study has collected important data from one form of integrated geriatric practice, which can be used for future service provision.