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|Issue 61||March 2013|
Evidence Brief: Effect of Geriatricians on Outcomes of Inpatient and Outpatient Care
Projections are that 43% of all Veterans older than 65 will be enrolled in VA by 2013, up from 31% in 2003. Moreover, 20% of Veterans older than 85 years of age received VA healthcare in 2003, and this is expected to rise to 51% by 2013. Older Veterans are more likely to have multiple chronic illnesses and age-related disability, take multiple medications, and to get their healthcare from several clinicians. All of these factors increase the chances for miscommunication and fragmented care that can result in negative consequences for older Veterans, such as adverse drug events or reduced function.
Recently, investigators at the VA Evidence-Based Synthesis Program located in Portland, Oregon summarized available research literature — published from 1985 through March 2012 — on the effects of including geriatricians in inpatient and outpatient care. This evidence brief was produced in response to a time-sensitive request from the Office of Geriatrics and Extended Care and the Healthcare Delivery Committee of VA's National Leadership Council. Evidence briefs differ from a full systematic review in several ways. The scope of work is more narrowly defined: briefs present a concise, high-level review of scientific literature drawing from existing high-quality reviews and are conducted within one to three months.
Evidence on the Effect of Geriatricians on Inpatient Care
Three good-quality systematic reviews attempted to identify components of care that are essential for positive outcomes. These attempts found either no difference (e.g., outcomes were not better in studies where geriatric care was targeted to patients based on criteria other than age alone) or reported that the impact of different components of the intervention, including the specific contribution of the geriatrician, were difficult to isolate from published descriptions of the studies.
Evidence on the Effect of Geriatricians on Outpatient Care
A Cyberseminar session on this ESP Report was held on Wednesday, March 20, 2013 from 11:00am to 12:15pm (ET). View archive here.
This report is a product of VA/HSR&D's Quality Enhancement Research Initiative's (QUERI) Evidence-Based Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers -- and to disseminate these reports throughout VA.
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This Management eBrief is a product of the HSR&D Evidence Synthesis Program (ESP). ESP is currently soliciting review topics from the broader VA community. Nominations will be accepted electronically using the online Topic Submission Form. If your topic is selected for a synthesis, you will be contacted by an ESP Center to refine the questions and determine a timeline for the report.
This Management e-Brief is provided to inform you about recent HSR&D findings that may be of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. If you have any questions or comments about this Brief, please email CIDER. The Center for Information Dissemination and Education Resources (CIDER) is a VA HSR&D Resource Center charged with disseminating important HSR&D findings and information to policy makers, managers, clinicians, and researchers working to improve the health and care of Veterans.
This report is a product of the HSR&D Evidence-Based Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers - and to disseminate these reports throughout VA.
See all reports online.