The Implementation of a Geriatrics Co-Management Model of Care Reduces Hospital Length of Stay

(1) Background: Older adults comprise a large proportion of hospitalized patients. Many are frail and require complex care. Geriatrics has developed models of care specific to this inpatient population. Our objective was to demonstrate the effect of a geriatric co-management team on clinical administrative indicators of care in Clinical Teaching Units (CTUs) that have adopted the Age-friendly Hospital (AFH) principles in Brazilian hospitals. (2) Methods: Following 3 months of implementation of the AFH principles in CTUs, two periods of the same 6 months of two consecutive years were compared. (3) Results: The total number of participants in the study was 641 and 743 in 2015 and 2016, respectively. Average length of patient-stay (length of stay: 8.7 +/- 2.7 vs. 5.4 +/- 1.7 days) and number of monthly complaints (44.2 +/- 6.5 vs. 13.5 +/- 2.2) were significantly lower with the co-management model. Number of homecare service referrals/month was also significantly higher (2.5 +/- 1 vs. 38.3 +/- 6.3). The 30-day readmission rates and total hospital costs per patient remained unchanged. (4) Conclusion: The presence of a geriatric co-management team in CTUs is of added benefit to increase the efficiency of the AFH for vulnerable older inpatients with reduced LOS and increased referrals to homecare services without increasing hospital costs.

Automated summary

Implementing an Age-friendly Hospital model in Brazilian hospitals and integrating a geriatric co-management team in Clinical Teaching Units (CTUs) leads to improved efficiency, reduced length of patient-stay, increased referrals to homecare services, without increasing total hospital costs.