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Effects of hospitalist-directed interdisciplinary medicine floor service on hospital outcomes for seniors with acute medical illness.
Geriatr Gerontol Int. 2014 Jan;14(1):71-7
Authors: Yoo JW, Seol H, Kim SJ, Yang JM, Ryu WS, Min TD, Choi JB, Kwon M, Kim S
Abstract
AIM: To examine whether a hospitalist-directed interdisciplinary (ITD) team in an internal medicine residency program enhances the hospital and clinical outcomes for seniors with acute medical illness.
METHODS: Seniors admitted to a USA teaching hospital medical floor-teaching services were allocated to the ITD (n = 379) and usual care teams (n = 383). Compared with the usual care team, the ITD team physicians carried out daily "geriatric" assessment and management, and led ITD team meetings.
RESULTS: The mean probability of functional decline on hospital discharge in the ITD team (25%; 95% CI 19-30%) was significantly lower than that in the usual care team (36%; 95% CI 30-43%; OR 0.35; 95% CI 0.10-0.92; P < 0.001). The mean probability of delirium in the ITD team (26%; 95% CI 20-32%) was significantly lower than that in the usual care team (34%; 95% CI 28-41%; OR 0.48; 95% CI 0.16-0.97; P = 0.03). The mean probability of transition to an institution in the ITD team (18%; 95% CI 13-23%) was significantly lower than that in the usual care team (26%; 95% CI 19-32%; OR 0.41; 95% CI 0.14-0.95; P = 0.01).
CONCLUSIONS: Hospitalist-directed ITD team care is associated with reductions of functional decline, delirium and transition to an institution for seniors with acute medical illness.
PMID: 23531144 [PubMed - indexed for MEDLINE]