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A randomized, controlled trial of outpatient geriatric evaluation and management in a large public hospital
C D Rubin1, M T Sizemore, P A Loftis
1Dept. of Internal Medicine, Univ. of Texas Southwestern Medical Ctr., Dallas 75235-8889.
Objective:
To study the effect of outpatient geriatric evaluation and management on physical function, mental status, and subjective well-being.
Design:
Prospective randomized controlled trial with a 1-year study period.
Setting:
Large medical school-affiliated public hospital in an urban community.
Subjects:
Patients at least 70 years old admitted to the medicine service were screened, randomized, and completed a 1-year follow-up interview.
Interventions:
Comprehensive geriatric evaluation and an outpatient care management program.
Main Outcome Measures:
Mental status (SPMSQ), ADL (Katz Index), IADL (Five-Item OARS Scale), Life satisfaction (LSI-Z), and self-perception of health status (physical health section of OARS).
Results:
No significant differences were found for cognitive status, ADL functioning, life satisfaction, nursing home placement, or mortality. The experimental patients reported significantly higher function in IADL and more favorable self-perception of health status compared with controls.
Conclusion:
Outpatient comprehensive geriatric evaluation and management appears to be a useful model for providing care to medically frail elderly patients.