TORONTO Nov. 28, 2012 – Seniors hospitalized for a serious event such as illness or injury have fewer falls, less functional decline and earlier discharge with lower costs of care if they are treated in an acute geriatric care unit where staff focus on early intervention for functional decline, according to a recent study by York University researchers.
The study, “Effectiveness of Acute Geriatric Unit Care using ACE Components: A Systematic Review and Meta-Analysis”, published in the Journal of the American Geriatrics Society, is the first of its kind to measure the combined effectiveness of an innovative function-focused approach to older adults' acute hospital care in comparison to standard nursing and medical care.
“It is known that older adults face a higher risk of functional decline, falls, pressure ulcers and delirium when hospitalized, which is associated with increased hospital costs, institutionalization and death,” says the study’s lead author, Mary Fox, professor in York’s School of Nursing. “However, these poor outcomes are more often not related to their illness, but to other things, like not getting up and walking around while in the hospital, or receiving treatments, such as drugs and catheters, which make it difficult to move around. There are things that fall through the cracks when an acute illness or injury is being intensely treated and stabilized. Focusing on preserving older people’s functioning early, while the acute illness or injury is being treated, is crucial in helping to circumvent these risks.”
Acute geriatric units are those with at least one Acute Care for Elders (ACE) component, either patient-centred care, frequent medical review, early rehabilitation, early discharge planning or prepared environment. The goal of ACE components is to prevent hospital-acquired complications and functional deterioration associated with common hospital treatments, procedures and care practices for older adults.
Fox and her team conducted a systematic review and meta-analysis of 13 trials involving 6,839 acutely ill or injured octogenarians, finding that not only did acute geriatric care units speed up recovery time and minimize functional decline and nursing home discharges, but they also resulted in shorter lengths of hospital stay and lower costs of care.
“It demonstrated that this approach has significant beneficial effects in improving both patient- and system-level outcomes over usual care,” says Fox. “As older adults account for 50 per cent of Canadian hospital expenditures, this cost difference may represent a significant future source of financial savings to Canada's health-care system, while improving patient outcomes.”
York nursing Professors Malini Persaud, Deborah Tregunno and Ellen Schraa, along with York librarian IIo-Katryn Maimets, were co-authors of the study, which included a team of researchers from York and the University of Toronto. Funding was provided through the Canadian Institutes of Health Research and a York University Faculty of Health Junior Faculty Award.
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