Geriatric assessment programs in the United States. Their growing role and impact

Geriatric assessment programs have become a growing component of the health care delivery system for the elderly in the United States. They generally provide interdisciplinary assessment, treatment planning, case management, and often rehabilitation for frail elderly persons and are especially important for persons suspected of needing long-term institutional care. Their development here stems from long experience with geriatric assessment in the United Kingdom and increasing evidence of their effectiveness in North American settings. Among their demonstrated benefits are better diagnostic accuracy and treatment planning, more appropriate placement decisions with less referral to nursing homes, and improved patient functional status, general well-being, and survival. This article provides, in addition to an overview of geriatric assessment programs and their effectiveness, practical guidelines for their establishment in the hospital setting.