Evolution of a geriatric evaluation clinic

Multidisciplinary geriatric evaluation units are being established in hospitals and, to a lesser extent, as outpatient clinics. This paper presents results of a chart audit of 332 patients seen from 1978 to 1982 at a university based geriatric outpatient evaluation unit. The relationships of clinic staffing to types of referrals and other aspects of clinic operation are investigated. During the time under study, the proportion of patients whose problems were medical rather than psychiatric or social increased. Presenting problems varied by referral source. Family and self referrals were most likely to identify a medical presenting problem, while physician and community agency referrals were most likely to identify a psychiatric problem. Patients frequently received diagnoses in areas of function other than those identified as the presenting problems. For example, medical clinicians made at least one psychiatric diagnoses for 86 per cent of patients they evaluated. Important questions about the potential contribution of such geriatrics clinics to health care of the elderly remain to be answered.