A RANDOMIZED, CONTROLLED TRIAL OF OUTPATIENT GERIATRIC EVALUATION AND MANAGEMENT IN A LARGE PUBLIC HOSPITAL

Objective: To study the effect of outpatient geriatric evaluation and management on physical function, mental status, and subjective well-being. Design: Prospective randomized controlled trial with a 1-year study period. Setting: Large medical school-affiliated public hospital in an urban community. Subjects: Patients at least 70 years old admitted to the medicine service were screened, randomized, and completed a 1-year follow-up interview. Interventions: Comprehensive geriatric evaluation and an outpatient care management program. Main Outcome Measures: Mental status (SPMSQ), ADL (Katz Index), IADL (Five-Item OARS Scale), Life satisfaction (LSI-Z), and self-perception of health status (physical health section of OARS). Results: No significant differences were found for cognitive status, ADL functioning, life satisfaction, nursing home placement, or mortality. The experimental patients reported significantly higher function in IADL and more favorable self-perception of health status compared with controls. Conclusion: Outpatient comprehensive geriatric evaluation and management appears to be a useful model for providing care to medically frail elderly patients.