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Targeting the hospitalized elderly for geriatric consultation
C H Winograd1, M B Gerety, E Brown
1Department of Medicine, Stanford University School of Medicine.
Journal of the American Geriatrics Society
|December 1, 1988
Summary
Most hospitalized elderly patients are too well for geriatric consultation. Standardized criteria can efficiently target frail elderly patients needing geriatric intervention, improving care focus.
Area of Science:
- Gerontology
- Geriatric Medicine
- Health Services Research
Background:
- Hospitalized elderly populations often require specialized care.
- Geriatric consultation aims to improve outcomes for frail older adults.
- Efficiently identifying appropriate candidates for geriatric services is crucial.
Purpose of the Study:
- To determine the proportion of hospitalized elderly patients suitable for geriatric consultation.
- To develop and evaluate criteria for targeting frail elderly patients.
- To assess the efficiency of age-based targeting for geriatric services.
Main Methods:
- Screened 451 elderly patients (aged 65+) admitted to medical/surgical services.
- Applied standardized criteria to assess frailty and suitability for geriatric consultation.
- Excluded patients based on administrative criteria (62%) and clinical judgment (too independent/impaired).
Main Results:
- Only 24% of clinically screened patients were appropriate for geriatric consultation.
- 64% were deemed 'too independent' and 12% 'too impaired' to benefit.
- Over 42% of patients aged 76+ were considered 'too independent'.
Conclusions:
- A majority of hospitalized elderly patients may not benefit from general geriatric consultation.
- Age alone is an inefficient targeting method for geriatric services.
- Developed criteria offer an inexpensive and effective way to target patients most in need of geriatric expertise.