Geriatric consultation services-are wards more effective than teams?

Area of Science:

• Gerontology
• Hospital Medicine
• Health Services Research

Background:

• Comprehensive geriatric assessment (CGA) is vital for frail older adults in acute care.
• Geriatric consultation teams are one model for delivering CGA.
• Ward-based CGA is effective for functional status, but team-based models need more evidence.

Purpose of the Study:

• To evaluate the effectiveness of team-based comprehensive geriatric assessment compared to ward-based models.
• To determine outcomes beyond mortality for medium-term follow-up in hospital settings.

Main Methods:

• A recent study published in BMC Medicine by Deschodt and colleagues investigated CGA models.
• The study compared outcomes of team-based versus ward-based CGA.
• Focus was on medium-term outcomes for vulnerable and frail older patients.

Main Results:

• Team-based geriatric consultation models remain unproven for most outcomes beyond medium-term mortality.
• Ward-based CGA has established effectiveness for improving functional status.
• Evidence for team-based models is limited to mortality benefits.

Conclusions:

• Current evidence does not support the widespread use of team-based geriatric consultation models for all outcomes.
• Ward-based comprehensive geriatric assessment models are more effective for improving functional status.
• Clinical practice should prioritize directing older patients with complex needs to ward-based multidisciplinary CGA.