The influence of integrated geriatric outpatient clinics on the health care utilization of older people
Abstract Background The number of people aged greater than 65 years is growing in many countries. Taiwan will be a superaged society in 2026, and health care utilization will increase considerably. Our study aimed to evaluate the efficacy of the geriatric integrated outpatient clinic model for reduc...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | BMC Geriatrics |
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| Online Access: | http://link.springer.com/article/10.1186/s12877-020-01782-7 |
| _version_ | 1818300902537166848 |
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| author | Yu-Ju Wei Cheng-Fang Hsieh Yu-Ting Huang Ming-Shyan Huang Tzu-Jung Fang |
| author_facet | Yu-Ju Wei Cheng-Fang Hsieh Yu-Ting Huang Ming-Shyan Huang Tzu-Jung Fang |
| author_sort | Yu-Ju Wei |
| collection | DOAJ |
| description | Abstract Background The number of people aged greater than 65 years is growing in many countries. Taiwan will be a superaged society in 2026, and health care utilization will increase considerably. Our study aimed to evaluate the efficacy of the geriatric integrated outpatient clinic model for reducing health care utilization by older people. Methods This was a retrospective case-control study. Patients aged greater than 65 years seen at the geriatric outpatient clinic (Geri-OPD) and non-geriatric outpatient clinic (non-Geri-OPD) at a single medical centre were age and sex matched. Data on the number of outpatient clinic visits, emergency department visits, hospitalizations and medical expenditures were collected during the first and second years. A subgroup analysis by Charlson comorbidity index (CCI) and older age (age≧80 years) was performed, and the results were compared between the Geri-OPD and non-Geri-OPD groups. Results A total of 6723 patients were included (3796 women and 2927 men). The mean age was 80.42 ± 6.39 years. There were 1291 (19.2%) patients in the Geri-OPD group and 5432 (80.8%) patients in the non-Geri-OPD group. After one year of regular follow-up, the Geri-OPD patients showed a significant reduction in the types of drugs included in each prescription (5.62 ± 10.85) and the number of clinic visits per year (18.18 ± 48.85) (P < 0.01). After a two-year follow-up, the number of clinic visits, emergency department visits, and hospitalizations and the annual medical costs were still decreased in the Geri-OPD patients. The Geri-OPD patients had more comorbidities and a higher rate of health care utilization than the non-Geri-OPD patients. In the subgroup analysis, patients with more comorbidities (CCI≧2) and an older age (≧80 years) in the Geri-OPD group showed a significant reduction in health care utilization. The Geri-OPD patients also showed a significant decrease in medical utilization in the second year compared with the non-Geri-POD patients. Conclusion The Geri-OPD reduced medical costs, the number of drugs prescribed, and the frequency of outpatient clinic visits, emergency department visits and hospitalizations in older patients with complicated conditions. The effect was even better in the second year. |
| first_indexed | 2024-12-13T05:14:30Z |
| format | Article |
| id | doaj.art-b9c0c79988f3426284684961fe62cb94 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-13T05:14:30Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-b9c0c79988f3426284684961fe62cb942022-12-21T23:58:27ZengBMCBMC Geriatrics1471-23182020-10-0120111210.1186/s12877-020-01782-7The influence of integrated geriatric outpatient clinics on the health care utilization of older peopleYu-Ju Wei0Cheng-Fang Hsieh1Yu-Ting Huang2Ming-Shyan Huang3Tzu-Jung Fang4Division of Geriatrics and Gerontology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDivision of Geriatrics and Gerontology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDivision of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityE-Da Cancer HospitalDivision of Geriatrics and Gerontology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityAbstract Background The number of people aged greater than 65 years is growing in many countries. Taiwan will be a superaged society in 2026, and health care utilization will increase considerably. Our study aimed to evaluate the efficacy of the geriatric integrated outpatient clinic model for reducing health care utilization by older people. Methods This was a retrospective case-control study. Patients aged greater than 65 years seen at the geriatric outpatient clinic (Geri-OPD) and non-geriatric outpatient clinic (non-Geri-OPD) at a single medical centre were age and sex matched. Data on the number of outpatient clinic visits, emergency department visits, hospitalizations and medical expenditures were collected during the first and second years. A subgroup analysis by Charlson comorbidity index (CCI) and older age (age≧80 years) was performed, and the results were compared between the Geri-OPD and non-Geri-OPD groups. Results A total of 6723 patients were included (3796 women and 2927 men). The mean age was 80.42 ± 6.39 years. There were 1291 (19.2%) patients in the Geri-OPD group and 5432 (80.8%) patients in the non-Geri-OPD group. After one year of regular follow-up, the Geri-OPD patients showed a significant reduction in the types of drugs included in each prescription (5.62 ± 10.85) and the number of clinic visits per year (18.18 ± 48.85) (P < 0.01). After a two-year follow-up, the number of clinic visits, emergency department visits, and hospitalizations and the annual medical costs were still decreased in the Geri-OPD patients. The Geri-OPD patients had more comorbidities and a higher rate of health care utilization than the non-Geri-OPD patients. In the subgroup analysis, patients with more comorbidities (CCI≧2) and an older age (≧80 years) in the Geri-OPD group showed a significant reduction in health care utilization. The Geri-OPD patients also showed a significant decrease in medical utilization in the second year compared with the non-Geri-POD patients. Conclusion The Geri-OPD reduced medical costs, the number of drugs prescribed, and the frequency of outpatient clinic visits, emergency department visits and hospitalizations in older patients with complicated conditions. The effect was even better in the second year.http://link.springer.com/article/10.1186/s12877-020-01782-7Geriatric integrated outpatient clinicOlder peopleHealth care utilizationComprehensive geriatric assessment |
| spellingShingle | Yu-Ju Wei Cheng-Fang Hsieh Yu-Ting Huang Ming-Shyan Huang Tzu-Jung Fang The influence of integrated geriatric outpatient clinics on the health care utilization of older people BMC Geriatrics Geriatric integrated outpatient clinic Older people Health care utilization Comprehensive geriatric assessment |
| title | The influence of integrated geriatric outpatient clinics on the health care utilization of older people |
| title_full | The influence of integrated geriatric outpatient clinics on the health care utilization of older people |
| title_fullStr | The influence of integrated geriatric outpatient clinics on the health care utilization of older people |
| title_full_unstemmed | The influence of integrated geriatric outpatient clinics on the health care utilization of older people |
| title_short | The influence of integrated geriatric outpatient clinics on the health care utilization of older people |
| title_sort | influence of integrated geriatric outpatient clinics on the health care utilization of older people |
| topic | Geriatric integrated outpatient clinic Older people Health care utilization Comprehensive geriatric assessment |
| url | http://link.springer.com/article/10.1186/s12877-020-01782-7 |
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