An Interdisciplinary Geriatric Consultation Service: A Controlled Trial

Abstract

Structure and function of a newly created interdisciplinary geriatric consultation team (GCT) are described. GCT was introduced on a single medical unit, where consultations were given to 46 consecutive patients aged 75 yr and over. GCT patients had, on average, 5.5 illnesses and were receiving 3.7 medications. Anemia (50%), hypoalbuminemia (65%) and elevated blood urea nitrogen (BUN) (58%) were frequent. Functional assessment showed frequent dependence on others for assistance with ambulation (59%), transfers (54%) and dressing (52%); cognitive impairment was found in 52% and clinical depression in 11% of the patients. In comparison with control units, GCT increased use of physical therapy by 357%, occupational therapy by 390% and speech therapy by 300% without increasing length of stay. In comparison with control subjects, GCT patients had no decrease in hospital readmission rates (43%) over 10.5 mo. of follow-up. A GCT in an acute-care hospital promotes geriatrics, teaches interdisciplinary teamwork, improves awareness of functional problems of patients and increases use of rehabilitative services, but does not decrease the high rate of readmission of hospitalized geriatric patients.