Wieland D, Rubenstein L Z
Department of Medicine, University of South Carolina School of Medicine, Columbia, USA.
Aging (Milano). 1996 Oct;8(5):297-310. doi: 10.1007/BF03339586.
Evidence indicates that institution-based programs for interdisciplinary geriatric evaluation and management (GEMs) improve outcomes of care, but results vary considerably between studies. Targeting (i.e., selective admission of frail elderly patient subgroups who are thought particularly to benefit) has been advocated as a means to improve the cost-effectiveness of GEM programs, and results from meta-analysis give this concept some support. Our review has several objectives: 1) describing approaches to GEM targeting and development of selection criteria; 2) assessing evidence from randomized trials concerning effects of targeting on outcome; and 3) suggesting an agenda for further research and development on GEM targeting.
有证据表明，基于机构的跨学科老年评估与管理项目（GEMs）能改善护理结果，但不同研究的结果差异很大。针对性（即选择性收治被认为特别受益的体弱老年患者亚组）已被提倡作为提高GEM项目成本效益的一种手段，荟萃分析的结果为这一概念提供了一些支持。我们的综述有几个目标：1）描述GEM针对性的方法和选择标准的制定；2）评估来自随机试验的关于针对性对结果影响的证据；3）提出关于GEM针对性的进一步研究和发展议程。
