Dedicated Teams Keep Older Adults Out of Hospital

Research led by Dr. Stephanie Chow of Mount Sinai Hospital in New York City indicates that health care programs that target the needs of older patients can reduce unnecessary visits to the emergency department, reports Medscape . The researchers assessed a model in which two clinicians, a social worker, and a care coordinator provided services for seniors at risk for hospitalization. Under the model, known as the Geriatrics Preventable Admissions Care Team (GERIPACT), the group made house calls to patients diagnosed with everything from stroke to myocardial infarction to cancer and were dealing with different doctors and new therapeutic regimens. The intervention typically lasts about 60 days, after which the patient returns to primary care. During regular meetings, the doctor and nurse practitioner ensure that the medical issues are taken care of, and the social worker and care coordinator "make sure that things like health insurance, transportation, meals, housing, and caregivers are in place, and that the caregivers are well supported," Chow says. For individuals who had been hospitalized, a geriatric pharmacist performs medication reconciliation for each patient at discharge. The researchers reviewed the use of health care resources by 78 patients six months before and six months after the GERIPACT intervention, finding that there were 14 fewer visits to the emergency department after the intervention than before and 16 fewer hospitalizations. Chow says, "Our hope is that the GERIPACT model will help primary care doctors, many of whom do not do geriatrics."