Effectiveness of a Finnish geriatric inpatient assessment. Two-year follow up of a randomized clinical trial on community-dwelling patients

Abstract

Objective: To determine whether need for services could be reduced and functional status and satisfaction improved by assessing and rehabilitating aged patients on a geriatric inpatient ward.

Design: A randomized clinical trial with a two-year follow-up.

Setting: Geriatric unit with 8 beds in a Finnish central hospital.

Patients: 312 selected community-dwelling patients were assigned to the intervention group (N = 104) and the control group (N = 208).

Interventions: The intervention patients were individually assessed and rehabilitated in a geriatric ward. The control group received usual home care.

Main outcome measures: Services, institutionalization, mortality, ADL, IADL and satisfaction.

Results: At one year, the intervention group had fewer days in health centre hospitals than controls (13.7 vs. 22.7), but only the intervention group had the geriatric inpatient stay (16.5 days). No significant differences were found for cumulative institutionalization or mortality over 24 months. At three months, the intervention group experienced a more positive change than controls in continence (P < 0.05), housekeeping (P < 0.05) and satisfaction (P < 0.01).

Conclusion: The effectiveness of comprehensive geriatric inpatient assessment and rehabilitation on community-dwelling patients is mild. More targeting and more follow-up interventions are needed.