Effectiveness of a Finnish geriatric inpatient assessment. Two-year follow up of a randomized clinical trial on community-dwelling patients.

OBJECTIVE

To determine whether need for services could be reduced and functional status and satisfaction improved by assessing and rehabilitating aged patients on a geriatric inpatient ward.

DESIGN

A randomized clinical trial with a two-year follow-up.

SETTING

Geriatric unit with 8 beds in a Finnish central hospital.

PATIENTS

312 selected community-dwelling patients were assigned to the intervention group (N = 104) and the control group (N = 208).

INTERVENTIONS

The intervention patients were individually assessed and rehabilitated in a geriatric ward. The control group received usual home care.

MAIN OUTCOME MEASURES

Services, institutionalization, mortality, ADL, IADL and satisfaction.

RESULTS

At one year, the intervention group had fewer days in health centre hospitals than controls (13.7 vs. 22.7), but only the intervention group had the geriatric inpatient stay (16.5 days). No significant differences were found for cumulative institutionalization or mortality over 24 months. At three months, the intervention group experienced a more positive change than controls in continence (P < 0.05), housekeeping (P < 0.05) and satisfaction (P < 0.01).

CONCLUSION

The effectiveness of comprehensive geriatric inpatient assessment and rehabilitation on community-dwelling patients is mild. More targeting and more follow-up interventions are needed.