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Measuring outcomes in care of the elderly
S G Parker1, X Du, M J Bardsley
1Department of Medicine (Geriatrics), University of Newcastle upon Tyne.
Journal of the Royal College of Physicians of London
|September 1, 1994
Summary
Routine outcome measurement in elderly care is feasible for inpatients, showing significant changes in survival and function. However, standard instruments are not responsive enough for day hospital patients, indicating a need for new ambulatory care outcome measures.
Area of Science:
- Geriatrics
- Health Services Research
- Clinical Outcomes Measurement
Background:
- Assessing the feasibility and responsiveness of standard outcome measurement instruments in routine elderly care is crucial.
- Standardized tools are needed to track clinical changes in diverse elderly patient populations.
Purpose of the Study:
- To evaluate the routine implementation of standard outcome measurement instruments in elderly care.
- To determine the responsiveness of these instruments to clinical changes in both inpatient and day hospital settings.
Main Methods:
- An observational study involving 540 inpatients and 340 day hospital patients.
- Routine collection of functional status, cognitive function, and subjective health status data at admission and discharge.
- Integration of data collection into clinical routine with assessment of response rates and data completeness.
Main Results:
- Outcome measurement was successfully integrated into routine care for inpatients.
- Significant changes in survival, physical function (Barthel index), and social status were observed in inpatients.
- Standard instruments, including the Nottingham ADL scale, were not sufficiently responsive for routine use in day hospital patients.
Conclusions:
- Routine outcome measurement using standard instruments is feasible and effective for inpatients in elderly care.
- Current instruments lack responsiveness for measuring clinical change in ambulatory elderly care settings like day hospitals.
- New approaches are required to effectively measure clinical outcomes for older patients in ambulatory care.