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Outpatient geriatric evaluation and management

C Boult1, L Boult, L Morishita

  • 1Department of Family Practice and Community Health, University of Minnesota Medical School, Minneapolis 55414-3034, USA.

Journal of the American Geriatrics Society
|March 26, 1998
PubMed
Summary
This summary is machine-generated.

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This outpatient geriatric evaluation and management (GEM) model effectively supports high-risk seniors, offering intensive care for six months with high patient and physician satisfaction at a reasonable cost.

Area of Science:

  • Geriatrics
  • Health Services Research
  • Internal Medicine

Background:

  • High-risk community-dwelling older adults are prone to hospital readmissions.
  • Effective management models are needed to improve care for this population.

Purpose of the Study:

  • To describe the development and operation of a practical outpatient geriatric evaluation and management (GEM) model.
  • To assess the outcomes and satisfaction associated with this GEM model for high-risk older adults.

Main Methods:

  • A cohort of 248 community-dwelling Medicare beneficiaries aged 70+ with high readmission probability received outpatient GEM.
  • Interdisciplinary teams provided comprehensive assessment, primary care, and case management over six months.
  • Patient and primary physician satisfaction, program completion, and costs were evaluated.

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Main Results:

  • Patients averaged 78.7 years, took 5.0 medications, and had functional limitations.
  • The six-month GEM program involved 7.4 clinic visits, weekly phone contact, and referrals.
  • Program completion was high (94.4%), with 66.7% completing advance directives.
  • Patient and physician satisfaction were high, with an average personnel cost of $1540 per patient.

Conclusions:

  • The outpatient GEM model provides intensive, targeted care for high-risk older adults over six months.
  • This model is cost-effective and achieves high satisfaction among patients and their physicians.