Krista M Reich, Jennifer Watt, Bing Li, Jason Jiang, Zahra Goodarzi
{"title":"了解老年住院医疗小组的地方会诊模式：一项横断面研究。","authors":"Krista M Reich, Jennifer Watt, Bing Li, Jason Jiang, Zahra Goodarzi","doi":"10.5770/cgj.28.768","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Geriatric consultation for Comprehensive Geriatric Assessment (CGA) improves outcomes of older adults living with frailty who are hospitalized, but consultation patterns and utilization of inpatient geriatric consultation teams by other hospital-based services are poorly understood.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using linked health administrative data to describe characteristics of older adults (≥ 65 years) who received a CGA while hospitalized between January 1, and December 31, 2019. We identified hospital-based services requesting CGA and the frequency and reasons for referral. We used multivariable logistic regression to estimate the association between patient-level characteristics and receiving a CGA.</p><p><strong>Results: </strong>A total of 29,090 older adults were admitted to hospital; 38.7% were classified as frail and 5.4% (1,563 patients) received at least one CGA. The top three reasons for requesting a CGA were to assess the need for care on an inpatient geriatric rehabilitation unit (43%), and for assessment and management of delirium (27%) and dementia (24%). Referrals were most frequently received from Hospitalists (48%). Frailty was associated with increased odds of receiving a CGA (adjusted odds ratio [aOR] 12.02; 95% confidence interval [CI] 9.67-14.82). A diagnosis of cancer was associated with lower odds of receiving a CGA (aOR 0.75; 95% CI 0.60-0.93).</p><p><strong>Conclusions: </strong>Inpatient geriatric consultation teams support 5.4% of hospitalized older adults. With the rapidly growing aging population, future efforts are needed to explore the optimal delivery of inpatient geriatric services to support its sustainable provision.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"28 1","pages":"41-52"},"PeriodicalIF":1.6000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882203/pdf/","citationCount":"0","resultStr":"{\"title\":\"Understanding Local Consultation Patterns of Inpatient Geriatric Medicine Teams: a Cross-Sectional Study.\",\"authors\":\"Krista M Reich, Jennifer Watt, Bing Li, Jason Jiang, Zahra Goodarzi\",\"doi\":\"10.5770/cgj.28.768\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Geriatric consultation for Comprehensive Geriatric Assessment (CGA) improves outcomes of older adults living with frailty who are hospitalized, but consultation patterns and utilization of inpatient geriatric consultation teams by other hospital-based services are poorly understood.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using linked health administrative data to describe characteristics of older adults (≥ 65 years) who received a CGA while hospitalized between January 1, and December 31, 2019. We identified hospital-based services requesting CGA and the frequency and reasons for referral. We used multivariable logistic regression to estimate the association between patient-level characteristics and receiving a CGA.</p><p><strong>Results: </strong>A total of 29,090 older adults were admitted to hospital; 38.7% were classified as frail and 5.4% (1,563 patients) received at least one CGA. The top three reasons for requesting a CGA were to assess the need for care on an inpatient geriatric rehabilitation unit (43%), and for assessment and management of delirium (27%) and dementia (24%). Referrals were most frequently received from Hospitalists (48%). Frailty was associated with increased odds of receiving a CGA (adjusted odds ratio [aOR] 12.02; 95% confidence interval [CI] 9.67-14.82). A diagnosis of cancer was associated with lower odds of receiving a CGA (aOR 0.75; 95% CI 0.60-0.93).</p><p><strong>Conclusions: </strong>Inpatient geriatric consultation teams support 5.4% of hospitalized older adults. With the rapidly growing aging population, future efforts are needed to explore the optimal delivery of inpatient geriatric services to support its sustainable provision.</p>\",\"PeriodicalId\":56182,\"journal\":{\"name\":\"Canadian Geriatrics Journal\",\"volume\":\"28 1\",\"pages\":\"41-52\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882203/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian Geriatrics Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5770/cgj.28.768\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Geriatrics Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5770/cgj.28.768","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：老年综合评估的老年咨询（CGA）改善了住院的虚弱老年人的预后，但其他医院基础服务的咨询模式和住院老年咨询团队的利用尚不清楚。方法：我们使用相关的健康管理数据进行了一项横断面研究，以描述2019年1月1日至12月31日住院期间接受CGA的老年人（≥65岁）的特征。我们确定了需要CGA的医院服务以及转诊的频率和原因。我们使用多变量逻辑回归来估计患者水平特征与接受CGA之间的关系。结果：共有29,090名老年人住院；38.7%被归类为虚弱，5.4%（1,563例）接受了至少一次CGA。要求CGA的前三个原因是评估住院老年康复病房的护理需求（43%），评估和管理谵妄（27%）和痴呆（24%）。转诊最多的是医院医生（48%）。虚弱与接受CGA的几率增加相关(调整优势比[aOR] 12.02；95%置信区间[CI] 9.67-14.82)。癌症诊断与较低的接受CGA的几率相关(aOR 0.75；95% ci 0.60-0.93)。结论：住院老年会诊团队支持5.4%的住院老年人。随着老龄化人口的迅速增长，未来需要努力探索老年住院服务的最佳提供方式，以支持其可持续提供。
Understanding Local Consultation Patterns of Inpatient Geriatric Medicine Teams: a Cross-Sectional Study.
Background: Geriatric consultation for Comprehensive Geriatric Assessment (CGA) improves outcomes of older adults living with frailty who are hospitalized, but consultation patterns and utilization of inpatient geriatric consultation teams by other hospital-based services are poorly understood.
Methods: We conducted a cross-sectional study using linked health administrative data to describe characteristics of older adults (≥ 65 years) who received a CGA while hospitalized between January 1, and December 31, 2019. We identified hospital-based services requesting CGA and the frequency and reasons for referral. We used multivariable logistic regression to estimate the association between patient-level characteristics and receiving a CGA.
Results: A total of 29,090 older adults were admitted to hospital; 38.7% were classified as frail and 5.4% (1,563 patients) received at least one CGA. The top three reasons for requesting a CGA were to assess the need for care on an inpatient geriatric rehabilitation unit (43%), and for assessment and management of delirium (27%) and dementia (24%). Referrals were most frequently received from Hospitalists (48%). Frailty was associated with increased odds of receiving a CGA (adjusted odds ratio [aOR] 12.02; 95% confidence interval [CI] 9.67-14.82). A diagnosis of cancer was associated with lower odds of receiving a CGA (aOR 0.75; 95% CI 0.60-0.93).
Conclusions: Inpatient geriatric consultation teams support 5.4% of hospitalized older adults. With the rapidly growing aging population, future efforts are needed to explore the optimal delivery of inpatient geriatric services to support its sustainable provision.
期刊介绍：
The Canadian Geriatrics Journal (CGJ) is a peer-reviewed publication that is a home for innovative aging research of a high quality aimed at improving the health and the care provided to older persons residing in Canada and outside our borders. While we gratefully accept submissions from researchers outside our country, we are committed to encouraging aging research by Canadians. The CGJ is targeted to family physicians with training or an interest in the care of older persons, specialists in geriatric medicine, geriatric psychiatrists, and members of other health disciplines with a focus on gerontology.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
