Objective: To evaluate the effectiveness of intermediate care (IC) for frail older patients managed by comprehensive geriatric assessment (CGA) and to provide a baseline profile of functional gain during IC services. Method: This is a prospective cohort study conducted in a community hospital. Elderly patients with post acute conditions were recruited and received interdisciplinary integrated care. CGA data were collected within 72 hours of admission and upon discharge so as to compare effectiveness of daily living, cognition, nutrition, emotion, pain control and ambulation. Results: Data of 137 recruited patients were collected during the period from April 2008 to March 2009; 27 of them were excluded due to incomplete data or unplanned readmission to acute ward. Mean age of the 110 eligible patients was 84.4±5.4 years old. Overall, clinical improvement was significant in various dimensions, including cognition (Mini-Mental State Examination from 18.0±6.8 to 20.9±6.8, p<.001), physical function (Barthel Index from 48.1±24.3 to 77.8±25.6, p<.001; Lawton-Brody Instrumental Activities of Daily Living from 1.9±1.7 to 3.7±2.5, p<.001), depression (Geriatric Depression Scale from 3.0±2.5 to 1.4±1.5, p<.001), ambulation (timed up-and-go test from 45.7±23.7 to 30.9±20.5, p<.001), nutrition (Mini Nutritional Assessment from 15.7±3.9 to 18.4±3.0, p<.001, Body Mass Index from 21.6±3.3 to 21.8±3.2, P=.001), and pain control (3.4±3.1 to 1.2±1.7, p<.001). Conclusion: A short-term inpatient physical re-enablement program conducted by an interdisciplinary geriatric team in a community hospital can successfully improve the physical and mental function, mood, ambulation, nutritional conditions, and pain control of postacute patients. Further studies are needed to evaluate long- term clinical outcomes.
Objective: To evaluate the effectiveness of intermediate care (IC) for frail older patients managed by comprehensive geriatric assessment (CGA) and to provide a baseline profile of functional gain during IC services. Method: This is a prospective cohort study conducted in a community hospital. Elderly patients with post acute conditions were recruited and received interdisciplinary integrated care. CGA data were collected within 72 hours of admission and upon discharge so as to compare effectiveness of daily living, cognition, nutrition, emotion, pain control and ambulation. Results: Data of 137 recruited patients were collected during the period from April 2008 to March 2009; 27 of them were excluded due to incomplete data or unplanned readmission to acute ward. Mean age of the 110 eligible patients was 84.4±5.4 years old. Overall, clinical improvement was significant in various dimensions, including cognition (Mini-Mental State Examination from 18.0±6.8 to 20.9±6.8, p<.001), physical function (Barthel Index from 48.1±24.3 to 77.8±25.6, p<.001; Lawton-Brody Instrumental Activities of Daily Living from 1.9±1.7 to 3.7±2.5, p<.001), depression (Geriatric Depression Scale from 3.0±2.5 to 1.4±1.5, p<.001), ambulation (timed up-and-go test from 45.7±23.7 to 30.9±20.5, p<.001), nutrition (Mini Nutritional Assessment from 15.7±3.9 to 18.4±3.0, p<.001, Body Mass Index from 21.6±3.3 to 21.8±3.2, P=.001), and pain control (3.4±3.1 to 1.2±1.7, p<.001). Conclusion: A short-term inpatient physical re-enablement program conducted by an interdisciplinary geriatric team in a community hospital can successfully improve the physical and mental function, mood, ambulation, nutritional conditions, and pain control of postacute patients. Further studies are needed to evaluate long- term clinical outcomes.
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