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Coordinated elderly care model proves beneficial

Monday April 22, 2013
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Elderly patients were less likely to experience adverse events and had shorter hospital stays if they were treated in an interdisciplinary, team-based, patient-centered model of acute care, according to a study.

William W. Hung, MD, MPH, of the Mount Sinai School of Medicine in New York City, and colleagues examined the use of the Mobile Acute Care of the Elderly service compared with general medical service.

MACE teams consist of a geriatrics attending physician, a geriatrics fellow, geriatrics nurse coordinator and social worker. Mount Sinaiís website says the program aims "to help patients avoid the hazards of hospitalization that typically result from being bed-bound and physically isolated." The team works to ensure safe, seamless continuity of care from hospital to home, with the goal of discharging patients to their previous living arrangements whenever possible.

Patients were recruited for the study if they were 75 or older and were admitted because of an acute illness to either the MACE service or usual care. Patients were matched for age, diagnosis and ability to ambulate independently. A total of 173 matched pairs of patients were recruited to participate in the study from November 2008 through August 2011.

After adjustment for confounders, patients in the MACE group were less likely to experience adverse events and had shorter hospital stays than patients receiving usual care. Patients in the MACE group were not less likely to have a lower rate of rehospitalization within 30 days than those in the usual-care group, and functional status did not differ between the two groups.

Care Transition Measure scores, a tool for assessing the quality of care during transition from patientsí perspectives, were 7.4 points higher in the MACE group, according to the study results.

The MACE service "has the potential to improve care outcomes among hospitalized older adults," the researchers concluded.

The study was published April 22 on the website of JAMA Internal Medicine (formerly the Archives of Internal Medicine).

Read the study abstract: http://archinte.jamanetwork.com/article.aspx?articleid=1680133.


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