Research Centre, Institut universitaire de gériatrie de Montréal, 4565 Chemin Queen-Mary, Montréal (QC), H3W 1W5, Canada.
BMC Geriatr. 2010 Jun 22;10:41. doi: 10.1186/1471-2318-10-41.
The increasing number of hospitalized elderly persons has greatly challenged decision makers to reorganize services so as to meet the needs of this clientele. Established progressively over the last 30 years, the short-term Geriatric Assessment Unit (GAU) is a specialized care program, now implemented in all the general hospital centres in Quebec. Within the scope of a broader reflection upon the appropriate care delivery for elderly patients in our demographic context, there is a need to revisit the role of GAU within the hospital and the continuum of care. The objective of this project is to describe the range of activities offered by Quebec GAU and the resources available to them.
In 2004, 64 managers of 71 GAU answered a mail questionnaire which included 119 items covering their unit's operation and resources in 2002-2003. The clinical and administrative characteristics of the clientele admitted during this period were obtained from the provincial database Med-Echo. The results were presented according to the geographical location of GAU, their size, their university academic affiliation, the composition of their medical staff, and their clinical care profile.
Overall, GAU programs admitted 9% of all patients aged 65 years and older in the surveyed year. GAU patients presented one or more geriatric syndromes, including dementia. Based on their clientele, three distinct clinical care profiles of GAU were identified. Only 19% of GAU were focused on geriatric assessment and acute care management; 23% mainly offered rehabilitation care, and the others offered a mix of both types. Thus, there was a significant heterogeneity in GAU's operation.
The GAU is at the cutting edge of geriatric services in hospital centres. Given the scarcity of these resources, it would be appropriate to better target the clientele that may benefit from them. Standardizing and promoting GAU's primary role in acute care must be reinforced. In order to meet the needs of the frail elderly not admitted in GAU, alternative care models centered on prevention of functional decline must be applied throughout all hospital wards.
住院老年人数量的增加给决策者带来了巨大的挑战，需要重新组织服务以满足这一人群的需求。短期老年评估单元（GAU）是一个专业护理项目，在过去 30 年中逐步建立，现在已在魁北克所有综合医院中心实施。在更广泛地反思我们人口结构中老年人适当护理的提供的背景下，有必要重新审视 GAU 在医院和护理连续体中的作用。本项目的目的是描述魁北克 GAU 提供的活动范围及其可用资源。
2004 年，71 个 GAU 的 64 名经理回答了一份邮件问卷，其中包括 119 个项目，涵盖了他们单位在 2002-2003 年的运营和资源。在此期间收治的患者的临床和管理特征从省级数据库 Med-Echo 中获得。结果根据 GAU 的地理位置、规模、大学学术隶属关系、医务人员构成及其临床护理概况进行呈现。
总体而言，GAU 项目收治了调查年度所有 65 岁及以上患者的 9%。GAU 患者患有一种或多种老年综合征，包括痴呆症。根据其患者群体，确定了 GAU 的三种不同临床护理概况。只有 19%的 GAU 专注于老年评估和急性护理管理；23%主要提供康复护理，其余的则提供两者的混合护理。因此，GAU 的运作存在显著的异质性。
GAU 是医院中心老年服务的前沿。鉴于这些资源的稀缺性，最好将目标对准可能从中受益的患者群体。应加强 GAU 在急性护理方面的主要作用的标准化和推广。为了满足未入住 GAU 的体弱老年人的需求，必须在所有病房推广以预防功能下降为中心的替代护理模式。
