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Minimizing geriatric rehospitalizations: a successful model.

Daniel J Oates¹, David Kornetsky, Michael R Winter

¹Section of Geriatrics, Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, USA. daniel.oates@bmc.org

American Journal of Medical Quality : the Official Journal of the American College of Medical Quality

|June 12, 2012

Summary

Comprehensive geriatrics care did not reduce 30-day rehospitalization rates in older adults compared to usual general medical care. Further adjustment may be needed to confirm these findings on geriatric patient outcomes.

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Area of Science:

Geriatric Medicine
Healthcare Quality Improvement
Patient Outcomes

Background:

Rehospitalizations are potential indicators of healthcare quality issues.
Older adults often experience higher rates of rehospitalization.
Geriatrics-focused care models aim to improve outcomes for elderly patients.

Purpose of the Study:

To compare 30-day rehospitalization rates between older adults receiving comprehensive geriatrics care and those receiving usual general medical care.
To investigate whether specialized geriatric services reduce readmission rates.

Main Methods:

Retrospective cohort study design.
Inclusion of adults aged 65 years and older.
Comparison of 30-day rehospitalization rates between distinct care groups.

Main Results:

The overall unadjusted 30-day rehospitalization rate was 18%.
Geriatrics patients on the geriatrics service had an adjusted odds ratio of 1.00 for readmission compared to general medical service patients.
Patients in an interdisciplinary geriatrics practice showed no increased likelihood of rehospitalization compared to usual care, despite greater frailty.

Conclusions:

Comprehensive geriatrics care did not demonstrate a reduction in 30-day rehospitalizations compared to usual care in this cohort.
Potential for incomplete adjustment in statistical models may explain the lack of observed benefit.
Further research is warranted to fully understand the impact of specialized geriatric care on hospital readmission rates.