Health and Medical Care for the Elderly and Aged Population: The State of the Evidence†

Bloom, Bernard S.; Soper, Keith A.

doi:10.1111/j.1532-5415.1980.tb01118.x

Cited by 15 publications

(10 citation statements)

References 22 publications

(20 reference statements)

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“…One survey found that only seven out of about 1000 met criteria of adequate design and execution 12. The only trial in the literature comparable to ours had similar problems with patient attrition but did attain its sample size 5.…”

Section: Discussionmentioning

confidence: 53%

Evaluation of a palliative care service: problems and pitfalls

McWhinney

Bass

Donner

1994

BMJ

220

205

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Section: Discussionmentioning

confidence: 53%

Evaluation of a palliative care service: problems and pitfalls

McWhinney

Bass

Donner

1994

BMJ

220

205

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“…The grouping together of elderly patients under the care of a specialized team of geriatrics professionals allows for the development of a comprehensive, individualized regimen of treatment 1–5 . However, health administrators must be cognizant that specialized units of this type may consume a significant portion of hospital resources for the benefit of relatively few patients 6 . Moreover, care providers and researchers are faced with a wide variety of estimates of patient improvements in differing types of geriatric care settings 7 .…”

mentioning

confidence: 99%

“…It is therefore important to critically analyze geriatric assessment units with respect to the potential each type has for improving patient care outcomes. Justification for these specialized units has generally been based on descriptive studies of discharge placement, functional status, decreased length of stay, and increased bed turnover 5–7 …”

mentioning

confidence: 99%

A Comparison of Placement Outcomes of Geriatric Cohorts Receiving Care in a Geriatric Assessment Unit and on General Medicine Floors

Teasdale

Shuman

Snow

et al. 1983

J American Geriatrics Society

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To assess whether care in a geriatric assessment unit using a multidisciplinary team approach with rehabilitative emphasis impacted on patient placement outcomes, a historical prospective study was initiated using records of geriatric assessment unit patients admitted during a one-year period (n = 62). A second, diagnostically similar general medicine unit cohort was also sampled (n = 62). Placement outcomes of the two groups were compared. All study patients were 75 years of age or older, stratified by source of admission, and controlled for comparability using diagnostic grouping. The geriatric assessment unit admitted 92 per cent of its patients from home; the general medicine unit, 82 per cent. As a result of expanded rehabilitative, respite, and terminal care promoted by the geriatric assessment unit staff, mean length of stay was 36 days, whereas it was 13 days in the general medicine unit (P less than 0.001). There was no significant difference between the two units with respect to hospital deaths, post-hospitalization discharges to home or nursing homes, or patient locations (home versus nursing home) six months after admission. Although improvements in patient independence may have been achieved through the efforts of a multidisciplinary team approach utilizing the geriatric assessment unit, they were not sufficient to significantly increase the proportion of patients placed at home. Superiority in placement outcome may be demonstrated only by geriatric assessment unit use of selective admission criteria.

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“…Our purpose is not to suggest that researchers are consciously avoiding the elderly, and we recognize the many difficulties inherent in studying elderly subjects 9,18,19 . The multiple diseases, disabilities, and polypharmacy that characterize the health status of many older people complicate research methodology with many potentially confounding variables.…”

Section: Discussionmentioning

confidence: 99%

Survey of the Age Structure of “Age‐Relevant” Articles in Four General Medical Journals

Clarfield

Friedman

1985

J American Geriatrics Society

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The authors analyzed clinical research articles (1980 to 1982) in four general medical journals: New England Journal of Medicine, Annals of Internal Medicine, Journal of the American Medical Association, and British Medical Journal. Of the 1943 articles surveyed, 38.2% were judged to be clinically "relevant" to the elderly. "Relevant" articles were further analyzed to determine whether they contained enough older subjects to enable the reader to draw any inferences about the particular disease or diagnostic or treatment modality studied. Criteria for "age sufficiency" included: mean age of study group (means) greater than or equal to 60 years; if means was less than 60 years, two SD or the range included at least one patient aged 70 years; and greater than or equal to 20% of the study group was older than 60 years. Overall, slightly more than 50% of clinically relevant articles had too few older subjects by the authors' quite liberal age criteria. No statistically significant differences were found among the four journals. Of the age-relevant articles, 25.5% had a mean age of sample studied of greater than or equal to 60 years, 10.9% of greater than or equal to 65 years, 5.6% of greater than or equal to 70 years, and 2.3% of greater than or equal to 75 years. The average age of all subjects studied for three conditions commonly found among the elderly was calculated: coronary artery disease (51.7 years); hypertension (49.8 years); and cancer (52.9 years). The authors concluded that many of the original articles of these four journals did not include (for 1980 to 1982) enough older subjects in their study samples to enable readers to draw any valid inferences about the older population itself.

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Health and Medical Care for the Elderly and Aged Population: The State of the Evidence†

Cited by 15 publications

References 22 publications

Evaluation of a palliative care service: problems and pitfalls

Evaluation of a palliative care service: problems and pitfalls

A Comparison of Placement Outcomes of Geriatric Cohorts Receiving Care in a Geriatric Assessment Unit and on General Medicine Floors

Survey of the Age Structure of “Age‐Relevant” Articles in Four General Medical Journals

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