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The effect of geriatrics evaluation and management on nursing home use and health care costs: results from a randomized trial.

Publication ,  Journal Article
Phibbs, CS; Holty, J-EC; Goldstein, MK; Garber, AM; Wang, Y; Feussner, JR; Cohen, HJ
Published in: Med Care
January 2006

BACKGROUND: The Geriatric Evaluation and Management study was developed to assess the impact of a comprehensive geriatric assessment service on the care of the elderly. OBJECTIVES: We sought to evaluate the cost and clinical impact of inpatient units and outpatient clinics for geriatric evaluation and management. RESEARCH DESIGN: We undertook a prospective, randomized, controlled trial using a 2x2 factorial design, with 1-year follow-up. SUBJECTS: A total of 1388 participants hospitalized on either a medical or surgical ward at 11 participating Veterans Affairs medical centers were randomized to receive either inpatient geriatric unit (GEMU) or usual inpatient care (UCIP), followed by either outpatient care from a geriatric clinic (GEMC) versus usual outpatient care (UCOP). MEASURES: We measured health care utilization and costs. RESULTS: Patients assigned to the GEMU had a significantly decreased rate of nursing home placement (odds ratio=0.65; P=0.001). Neither the GEMU nor GEMC had any statistically significant improvement effects on survival and only modest effects on health status. There were statistically insignificant mean cost savings of $1027 (P=0.29) per patient for the GEMU and $1665 (P=0.69) per patient for the GEMC. CONCLUSIONS: Inpatient or outpatient geriatric evaluation and management units didn't increase the costs of care. Although there was no effect on survival and only modest effects on SF-36 scores at 1-year follow-up, there was a statistically significant reduction in nursing home admissions for patients treated in the GEMU.

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Published In

Med Care

DOI

ISSN

0025-7079

Publication Date

January 2006

Volume

44

Issue

1

Start / End Page

91 / 95

Location

United States

Related Subject Headings

  • United States Department of Veterans Affairs
  • United States
  • Prospective Studies
  • Outcome Assessment, Health Care
  • Nursing Homes
  • Humans
  • Health Policy & Services
  • Health Care Costs
  • Geriatric Assessment
  • Cost-Benefit Analysis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Phibbs, C. S., Holty, J.-E., Goldstein, M. K., Garber, A. M., Wang, Y., Feussner, J. R., & Cohen, H. J. (2006). The effect of geriatrics evaluation and management on nursing home use and health care costs: results from a randomized trial. Med Care, 44(1), 91–95. https://doi.org/10.1097/01.mlr.0000188981.06522.e0
Phibbs, Ciaran S., Jon-Erik C. Holty, Mary K. Goldstein, Alan M. Garber, Yajie Wang, John R. Feussner, and Harvey J. Cohen. “The effect of geriatrics evaluation and management on nursing home use and health care costs: results from a randomized trial.Med Care 44, no. 1 (January 2006): 91–95. https://doi.org/10.1097/01.mlr.0000188981.06522.e0.
Phibbs CS, Holty J-EC, Goldstein MK, Garber AM, Wang Y, Feussner JR, et al. The effect of geriatrics evaluation and management on nursing home use and health care costs: results from a randomized trial. Med Care. 2006 Jan;44(1):91–5.
Phibbs, Ciaran S., et al. “The effect of geriatrics evaluation and management on nursing home use and health care costs: results from a randomized trial.Med Care, vol. 44, no. 1, Jan. 2006, pp. 91–95. Pubmed, doi:10.1097/01.mlr.0000188981.06522.e0.
Phibbs CS, Holty J-EC, Goldstein MK, Garber AM, Wang Y, Feussner JR, Cohen HJ. The effect of geriatrics evaluation and management on nursing home use and health care costs: results from a randomized trial. Med Care. 2006 Jan;44(1):91–95.

Published In

Med Care

DOI

ISSN

0025-7079

Publication Date

January 2006

Volume

44

Issue

1

Start / End Page

91 / 95

Location

United States

Related Subject Headings

  • United States Department of Veterans Affairs
  • United States
  • Prospective Studies
  • Outcome Assessment, Health Care
  • Nursing Homes
  • Humans
  • Health Policy & Services
  • Health Care Costs
  • Geriatric Assessment
  • Cost-Benefit Analysis