A randomized, controlled trial of outpatient geriatric evaluation and management in a large public hospital

Abstract

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.