HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Applegate, W B Articles by Elam, J T Search for Related Content PubMed PubMed Citation Articles by Applegate, W B Articles by Elam, J T

Impact of a geriatric assessment unit on subsequent health care charges.

W B Applegate, M J Graney, S T Miller and J T Elam

Department of Preventive Medicine, University of Tennessee, Memphis.

BACKGROUND. In a recent randomized controlled trial assessing the efficacy of an inpatient geriatric assessment unit (GAU), we demonstrated that patients assigned to the unit were less likely than those in the usual care group to be admitted to a nursing home and more likely to remain living in the community. Despite evidence of benefits of GAU care, questions remain about its cost. We examine the impact of GAU treatment on subsequent health care charges. METHODS. Sequential referrals of elderly disabled patients considered at risk for institutionalization or likely to improve with rehabilitation were randomized to the GAU or to usual care. Charge data were collected on utilization of a wide variety of health care services starting at the point of randomization. RESULTS. The group randomized to the GAU experienced significantly higher rehabilitation charges per participant ($10,583 vs $2066, P = .0001), but lower mean nursing home charges ($1798 vs $3426, P = .004). Total health care charges per participant over the 1 year follow-up were greater for the GAU group ($28,406 vs $16,444, P = .004). When charges were adjusted per year of life survived, the GAU group still showed a substantial (but nonsignificant, P = .10) increase in total charges. However, when charges were adjusted per day subsequently spent residing in the community, adjusted total charges were similar between the two groups. CONCLUSIONS. Our results indicated that improved outcomes from GAU care require an investment in rehabilitation that is not totally offset by decreased institutional charges in the following year.

This article has been cited by other articles:

				J. McCusker and J. Verdon Do Geriatric Interventions Reduce Emergency Department Visits? A Systematic Review J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2006; 61(1): 53 - 62. [Abstract] [Full Text] [PDF]

				P. B. d. A. Andreoli, V. d. A. Citero, and J. d. J. Mari A Systematic Review of Studies of the Cost-Effectiveness of Mental Health Consultation-Liaison Interventions in General Hospitals Psychosomatics, December 1, 2003; 44(6): 499 - 507. [Abstract] [Full Text] [PDF]

				D. Wieland, A. E. Stuck, A. L. Siu, J. adams, and L. Z. Rubenstein Meta-Analytic Methods for Health Services Research: An Example from Geriatrics Eval Health Prof, September 1, 1995; 18(3): 252 - 282. [Abstract] [PDF]