The care provided in acute geriatric units leads to better outcomes for older people than conventional hospital care, researchers claim today.
Dr Leocadio Rodriguez-Manas and colleagues from Getafe University Hospital in Madrid, Spain, explain that hospital care for people over 65 years of age requires comprehensive assessment by multidisciplinary teams to guage risk of functional decline, which is the main determinant of quality of life, cost of care, and prognosis.
They systematically reviewed 11 studies on the effect of acute geriatric units compared with conventional hospital care. The five randomised trials indicated an 18 per cent lower risk of functional decline at discharge and a 30 per cent higher chance of returning home. There was no difference in mortality rates.
Overall, the remaining studies showed similar results, the team reports on the website of the British Medical Journal. They write: "Since admission to hospital is a risk factor for case fatality, functional decline, and admission to a nursing home, any intervention that helps reduce this risk is potentially important."
They add that the 18 per cent reduction in functional decline associated with acute geriatric units is comparable with that found in an earlier study of similar patients who received multidisciplinary care.
Future studies should examine whether the reduction in functional decline persists in the medium-term after discharge, they write. Ideally the studies would be randomised and use larger sample sizes.
"In conclusion, acute geriatric units reduce functional decline at discharge and increase the probability of living at home at discharge and at three months after discharge without increasing case fatality or the costs of hospital care," they write.
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