Extending geriatric care beyond traditional settings: lessons from a mobile assessment program

Area of Science:

• Geriatric Medicine
• Public Health
• Healthcare Accessibility

Background:

• Aging populations face barriers to essential care due to changing living conditions and reduced self-advocacy.
• Mobile Geriatric Teams (MGTs) provide in-home assessments, potentially reaching underdiagnosed elderly individuals.
• Barriers to routine healthcare access disproportionately affect older adults.

Purpose of the Study:

• Evaluate the clinical impact and reach of Mobile Geriatric Teams (MGTs) in Israel.
• Assess MGT-initiated Comprehensive Geriatric Assessments and compare outcomes with standard care.
• Determine the effectiveness of MGTs in reaching specific elderly subpopulations.

Main Methods:

• Retrospective, data-based proof-of-concept study of MGT implementation (2020-2023).
• Data collected 3 and 6 months post-MGT appointment.
• Comparative analysis using chi-square, Fisher's exact, Wilcoxon rank-sum tests, and matched logistic regression.

Main Results:

• MGTs assessed 4,348 individuals, reaching older males and those with lower socioeconomic status.
• MGT group showed fewer diagnoses of cognitive impairment and depression, but more orthostatic hypotension and fall risk assessments.
• The MGT intervention correlated with increased primary care visits in the district, unlike the comparison group.

Conclusions:

• MGTs effectively reach elderly subpopulations who may not seek traditional geriatric assessments.
• Findings underscore MGTs' role in enhancing accessibility and equity in geriatric care.
• MGTs address unmet healthcare needs in populations with limited self-advocacy.