Who should provide hospital care of elderly people?

Since 1980 Islington Health District has appointed one consultant physician trained in geriatric medicine and three general physicians. The effect of these appointments on health care of the elderly in hospital was studied by means of Hospital Activity Analysis data for 1980-83. There were significant reductions in length of stay and in numbers becoming long stay among elderly patients admitted to the geriatric department. There was little change in these variables for elderly patients in general medical beds. The reduction in length of stay was achieved by the geriatric medicine department despite a lower staff/bed ratio and negative skewing in favour of acute medicine, and without any significant increase in the rates of readmission or mortality within 2 weeks of admission.