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Working Group Recommendations: Methods for Geriatric Evaluation and Management Research
Author(s) -
Feussner John R.,
Wieland Darryl,
KayserJones Jeanie,
Kramer Andrew,
Saunders William,
Fretwell Marsha
Publication year - 1991
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1991.tb05934.x
Subject(s) - medicine , randomized controlled trial , geriatric care , inpatient care , unit (ring theory) , geriatrics , clinical trial , medical emergency , family medicine , nursing , health care , surgery , psychiatry , mathematics education , mathematics , pathology , economics , economic growth
Methodological issues relating to multi‐site studies of inpatient geriatric evaluation and management units were the focus of this working group's deliberations. The group favored a randomized clinical trial in which the inpatient geriatric evaluation and management unit was coupled with outpatient geriatric care. Inclusion of a broad spectrum of patients stratified according to risk for poor hospital outcomes was proposed in order to obtain information on the types of patients that would be most likely to benefit. The need for a detailed definition and description of care in the unit and of “usual care” was emphasized. Serious concerns were raised about including both VA medical centers and private hospitals in the same trial due to differences in the implementation of such a program. Furthermore, fears of contamination of the control group suggested that hospitals could be randomized either to provide usual care or have a GEM unit. However, this strategy would necessitate that hospitals that have already developed inpatient GEM units would be excluded from the trial and could be costly because of the number of hospitals that would be required.