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  • Ekerstad, Niklas,1969-Linköpings universitet,Avdelningen för hälso- och sjukvårdsanalys,Medicinska fakulteten,NU NAL Uddevalla Hospital Grp, Sweden (author)

Is the acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care?

  • Article/chapterEnglish2017

Publisher, publication year, extent ...

  • DOVE MEDICAL PRESS LTD,2017

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/248170
  • https://gup.ub.gu.se/publication/248170URI
  • https://doi.org/10.2147/CIA.S124003DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:134815264URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-133878URI

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  • Language:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agencies|Health Care Subcommittee, Region Vastra Gotaland; Department of Research and Development, NU Hospital Group; Fyrbodal Research and Development Council, Region Vastra Gotaland, Sweden
  • Objective: The aim of this study was to investigate whether the acute care of frail elderly patients in a comprehensive geriatric assessment (CGA) unit is superior to the care in a conventional acute medical care unit. Design: This is a clinical, prospective, randomized, controlled, one-center intervention study. Setting: This study was conducted in a large county hospital in western Sweden. Participants: The study included 408 frail elderly patients, aged ≥75 years, in need of acute in-hospital treatment. The patients were allocated to the intervention group (n=206) or control group (n=202). Mean age of the patients was 85.7 years, and 56% were female. Intervention: This organizational form of care is characterized by a structured, systematic interdisciplinary CGA-based care at an acute elderly care unit. Measurements: The primary outcome was the change in health-related quality of life (HRQoL) 3 months after discharge from hospital, measured by the Health Utilities Index-3 (HUI-3). Secondary outcomes were all-cause mortality, rehospitalizations, and hospital care costs. Results: After adjustment by regression analysis, patients in the intervention group were less likely to present with decline in HRQoL after 3 months for the following dimensions: vision (odds ratio [OR] =0.33, 95% confidence interval [CI] =0.14–0.79), ambulation (OR =0.19, 95% CI =0.1–0.37), dexterity (OR =0.38, 95% CI =0.19–0.75), emotion (OR =0.43, 95% CI =0.22–0.84), cognition (OR = 0.076, 95% CI =0.033–0.18) and pain (OR =0.28, 95% CI =0.15–0.50). Treatment in a CGA unit was independently associated with lower 3-month mortality adjusted by Cox regression analysis (hazard ratio [HR] =0.55, 95% CI =0.32–0.96), and the two groups did not differ significantly in terms of hospital care costs (P>0.05). Conclusion: Patients in an acute CGA unit were less likely to present with decline in HRQoL after 3 months, and the care in a CGA unit was also independently associated with lower mortality, at no higher cost.

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  • Karlson, Björn W.,1953Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,University of Gothenburg, Sweden(Swepub:gu)xkabjo (author)
  • Dahlin-Ivanoff, Synneve,1950Gothenburg University,Göteborgs universitet,Centrum för åldrande och hälsa (AgeCap),Institutionen för neurovetenskap och fysiologi, sektionen för hälsa och rehabilitering,Centre for Ageing and Health (Agecap),Institute of Neuroscience and Physiology, Department of Health and Rehabilitation,University of Gothenburg, Sweden(Swepub:gu)xdahsy (author)
  • Landahl, StenGothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,University of Gothenburg, Sweden(Swepub:gu)xlstek (author)
  • Andersson, DavidLinköpings universitet,Nationalekonomi,Filosofiska fakulteten(Swepub:liu)davan75 (author)
  • Heintz, EKarolinska Institutet,Karolinska Institute, Sweden (author)
  • Husberg, MagnusLinköpings universitet,Avdelningen för hälso- och sjukvårdsanalys,Medicinska fakulteten(Swepub:liu)maghu85 (author)
  • Alwin, JennyLinköpings universitet,Avdelningen för hälso- och sjukvårdsanalys,Medicinska fakulteten(Swepub:liu)jenal62 (author)
  • Linköpings universitetAvdelningen för hälso- och sjukvårdsanalys (creator_code:org_t)

Related titles

  • In:Clinical Interventions in Aging: DOVE MEDICAL PRESS LTD121178-19981176-9092

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