Short-term outcomes of seniors aged 80 years and older with acute illness: Hospitalist care by geriatricians and other internists compared.
J Hosp Med. 2014 Jul 15;
Authors: Ding YY, Sun Y, Tay JC, Chong WF
Abstract
BACKGROUND: Although acute geriatric units have improved the outcomes of hospitalized seniors, it is uncertain as to whether hospitalist care by geriatricians outside of these units confers similar benefit.
OBJECTIVE: To determine whether hospitalist care by geriatricians reduces short-term mortality and readmission, and length of stay (LOS) for seniors aged 80 years and older with acute medical illnesses compared with care by other internists.
DESIGN: Retrospective cohort study using administrative and chart review data on demographic, admission-related, and clinical information of hospital episodes.
SETTING: General internal medicine department of an acute-care hospital in Singapore from 2005 to 2008.
PATIENTS: Seniors aged 80 years and older with specific focus on 2 subgroups with premorbid functional impairment and acute geriatric syndromes.
INTERVENTION: Hospitalist care by geriatricians compared with care by other internists.
MEASURES: Hospital mortality, 30-day mortality or readmission, and LOS.
RESULTS: For 1944 hospital episodes (intervention: 968, control: 976), there was a nonsignificant trend toward lower hospital mortality (15.5% vs 16.9%) but not 30-day mortality or readmission, or LOS for care by geriatricians compared with care by other internists. A marginally stronger trend toward lower hospital mortality for care by geriatricians among those with acute geriatric syndromes (20.2% vs 23.1%) was observed. Similar treatment effects were found after adjustment for demographic, admission-related, and clinical factors.
CONCLUSIONS: For seniors aged 80 years and over with acute medical illness, hospitalist care by geriatricians did not significantly reduce short-term mortality, readmission, or LOS, compared with care by other internists. Journal of Hospital Medicine 2014. © 2014 Society of Hospital Medicine.
PMID: 25044377 [PubMed - as supplied by publisher]