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Some Hospitals Give Poor Care to Elderly

July 29th, 2011

This is a frightening bit of research:  According to a study published in the June 2011 issue of the Journal of the American College of Surgeons, in a comparison of the care provided to patients who had emergency surgery, centers that provided high quality care for young patients did not necessarily provide good care for older patients.

According to an article in ScienceDaily, this is because hospitals lack programs to meet the special health needs of people over age 65.

“This suggests that some hospitals put into place something unique that better addresses the needs of elderly patients,” said Dr. [Avery Nathens, trauma director at St. Michael’s Hospital in Toronto]. “What’s put into place, however, is not quite clear.”

This should be an important part of evaluating hospital performance, the same way hospitals are rated on infection control and death rates. Especially since a large portion of our population will soon be in this high-risk age group. I, for one, would like to know that my loved ones would be well-cared-for in a hospital, regardless of their age.

Other research has shown that older patients undergoing elective surgery have improved outcomes if they are offered consultation and pre-surgical testing to reduce the risk of heart attacks and strokes, aggressive medical management, and referrals to clinics that perform high volumes of the most complex procedures. But in the event of emergency surgery, these safety measures aren’t possible.

What can be done? Hospitals that do provide good care to older patients offer consultations and collaboration with geriatricians.

In St. Michael’s Trauma Program, a geriatrician sees every patient over 60 who experiences a major injury and makes recommendations regarding their care and treatment. This program — the first of its kind in Canada — has shown significant benefits, with fewer consultation requests to internal medicine and psychiatry, meaning more efficient care, and a reduction in delirium, which can be common among elderly hospital patients, costly, preventable, and associated with higher morbidity and mortality. Most importantly, fewer elderly patients are being discharged from the hospital to long-term care facilities than before the partnership with geriatrics began in 2007.

In addition, all patients over 65 are given a risk of fall assessment and a frailty assessment before being sent home.

This would be a great options, except that there are very few geriatricians in the United States and Canada. In Canada, there is 1 geriatrician for every 20,000 people over age 65. With a shortage like that, the quality of care for older patients isn’t likely to change soon.

To read the full story in ScienceDaily, click here:  Not All Hospitals Treat Elderly the Same

To read the original journal article, click here:  Variation of Quality of Care