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Building a Framework for Care of Older Patients in an Academic Setting: High Risk Geriatrics Ambulatory Care Program

BACKGROUND: Traditional models of geriatric medicine and health system reimbursement structure often force ambulatory care teams to function as high-volume delivery programs, thereby dis-servicing our most vulnerable and frail older patients. This “high cost and high needs” labeled demographic requi...

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Autores principales: Chow, Stephanie, Chun, Audrey, Munoz, Lizette, Fani, Shamsi, Morrison, Rolfe Sean, MacKenzie, Blair, Lavayen, Susana, Hung, William
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7742621/
http://dx.doi.org/10.1093/geroni/igaa057.1684
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author Chow, Stephanie
Chun, Audrey
Munoz, Lizette
Fani, Shamsi
Morrison, Rolfe Sean
MacKenzie, Blair
Lavayen, Susana
Hung, William
author_facet Chow, Stephanie
Chun, Audrey
Munoz, Lizette
Fani, Shamsi
Morrison, Rolfe Sean
MacKenzie, Blair
Lavayen, Susana
Hung, William
author_sort Chow, Stephanie
collection PubMed
description BACKGROUND: Traditional models of geriatric medicine and health system reimbursement structure often force ambulatory care teams to function as high-volume delivery programs, thereby dis-servicing our most vulnerable and frail older patients. This “high cost and high needs” labeled demographic requires uniquely adapted plans from medical and social work providers. METHODS: To better examine opportunities for improved framework for geriatric ambulatory care, the Acute Life Interventions, Goals & Needs (ALIGN) Program has launched several inter-professional pilot programs, each with intention to explore components of health care service to older patients, and feasibility of implementation in other health care systems. Three current models include the ALIGN Program itself, a telemedicine community paramedicine program, and a geriatric surgery co-management program. RESULTS: Preliminary results are forthcoming, with initial promising findings. For the first 126 patients enrolled, mean emergency room (ED) visits 6 months prior to ALIGN enrollment were 1.7 visits per person, reduced to 0.7 ED visits/person 6 months post-graduation from the program, and 126 fewer ED visits. Mean hospitalization 6 months prior to enrollment was 0.32 per person, whereas 6 months post-graduation was 0.2 hospitalizations/person, totaling 40.32 hospitalizations saved. Mean length of stay in the hospital 6 months prior to ALIGN enrollment for the 22 patients admitted was 7.7 days, reduced to 7.3 days post-graduation, and 32 fewer hospital days in the small subset of patients requiring hospitalization despite program interventions. CONCLUSION: The ALIGN Program’s multi-professional and flexible modularity highlights promising innovative frameworks for ambulatory geriatrics care, warranting further exploration and collaboration.
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spelling pubmed-77426212020-12-21 Building a Framework for Care of Older Patients in an Academic Setting: High Risk Geriatrics Ambulatory Care Program Chow, Stephanie Chun, Audrey Munoz, Lizette Fani, Shamsi Morrison, Rolfe Sean MacKenzie, Blair Lavayen, Susana Hung, William Innov Aging Abstracts BACKGROUND: Traditional models of geriatric medicine and health system reimbursement structure often force ambulatory care teams to function as high-volume delivery programs, thereby dis-servicing our most vulnerable and frail older patients. This “high cost and high needs” labeled demographic requires uniquely adapted plans from medical and social work providers. METHODS: To better examine opportunities for improved framework for geriatric ambulatory care, the Acute Life Interventions, Goals & Needs (ALIGN) Program has launched several inter-professional pilot programs, each with intention to explore components of health care service to older patients, and feasibility of implementation in other health care systems. Three current models include the ALIGN Program itself, a telemedicine community paramedicine program, and a geriatric surgery co-management program. RESULTS: Preliminary results are forthcoming, with initial promising findings. For the first 126 patients enrolled, mean emergency room (ED) visits 6 months prior to ALIGN enrollment were 1.7 visits per person, reduced to 0.7 ED visits/person 6 months post-graduation from the program, and 126 fewer ED visits. Mean hospitalization 6 months prior to enrollment was 0.32 per person, whereas 6 months post-graduation was 0.2 hospitalizations/person, totaling 40.32 hospitalizations saved. Mean length of stay in the hospital 6 months prior to ALIGN enrollment for the 22 patients admitted was 7.7 days, reduced to 7.3 days post-graduation, and 32 fewer hospital days in the small subset of patients requiring hospitalization despite program interventions. CONCLUSION: The ALIGN Program’s multi-professional and flexible modularity highlights promising innovative frameworks for ambulatory geriatrics care, warranting further exploration and collaboration. Oxford University Press 2020-12-16 /pmc/articles/PMC7742621/ http://dx.doi.org/10.1093/geroni/igaa057.1684 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Chow, Stephanie
Chun, Audrey
Munoz, Lizette
Fani, Shamsi
Morrison, Rolfe Sean
MacKenzie, Blair
Lavayen, Susana
Hung, William
Building a Framework for Care of Older Patients in an Academic Setting: High Risk Geriatrics Ambulatory Care Program
title Building a Framework for Care of Older Patients in an Academic Setting: High Risk Geriatrics Ambulatory Care Program
title_full Building a Framework for Care of Older Patients in an Academic Setting: High Risk Geriatrics Ambulatory Care Program
title_fullStr Building a Framework for Care of Older Patients in an Academic Setting: High Risk Geriatrics Ambulatory Care Program
title_full_unstemmed Building a Framework for Care of Older Patients in an Academic Setting: High Risk Geriatrics Ambulatory Care Program
title_short Building a Framework for Care of Older Patients in an Academic Setting: High Risk Geriatrics Ambulatory Care Program
title_sort building a framework for care of older patients in an academic setting: high risk geriatrics ambulatory care program
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7742621/
http://dx.doi.org/10.1093/geroni/igaa057.1684
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