IMPACT OF GERIATRIC REHABILITATION FOR FRAIL ELDERS

描述（改编自申请人的摘要）：体弱的老年人 提出了一个复杂的和具有挑战性的一套需要的医疗保健， 与一个以急性、医院为特征的医疗保健系统不一致， 基础护理和一个有一个显着的差距机构护理和护理 在家里1993年，宾夕法尼亚大学护理学院试图填补这一空白， 为体弱长者设立老人科日间医院， 老年人评估和康复方案，一个全面的， 跨学科，短期强化康复计划，解决 高危长者的健康、功能及心理问题 因为功能下降而住进疗养院或医院。一个 正在对CARE参与者（n=435）的方案成果进行评估， 首席研究员 拟议的研究将在此基础上展开 通过（1）评估老年康复的贡献进行评价 减少医疗保健服务的使用，特别是医院， 护理院，为体弱老人，通过比较，治疗组为三组 对照组，两个来自NLTCS，一个来自CARE参与者， (2)评估二级数据源的敏感性， 比较具有研究和临床实践实用性的信息B 这些数据与患者水平数据的性能和稳健性 从临床环境中获得。 该分析将采用创新的 对照组方法和生存分析，以评估 用于治疗组患者医疗保健服务，如住院 与其他老年医学研究者相比， 方法论的方法，并大大有助于努力评估的结果，以及- 设计的临床干预措施缺乏必要的对照组， 回答这些问题。 此外，这项研究提供了机会， 评估这些二级数据源（如NLTCS）的敏感性， 制定具有深远影响的功能和结果措施， 调查或

DESCRIPTION (adapted from the applicant's abstract): The frail elderly present a complex and challenging set to needs to the health care that are not-well-aligned with a health care system whose signature is acute, hospital- based care and one that has a notable gap between institutional care and care at home. The Penn School of Nursing sought to fill this gap in care in 1993 by establishing a geriatric day hospital for the frail elderly, the Collaborative Assessment and Rehabilitation for Elders (CARE) Program, a comprehensive, interdisciplinary, short-term intensive rehabilitation program addressing the full range of health, functional, and psychosocial problems for elders at risk for nursing home or hospital admission because of functional decline. An evaluation of program outcomes among CARE participants (n=435) is underway by the Principal Investigator. The proposed study will expand upon this evaluation by (1) assessing the contribution of geriatric rehabilitation services to reductions in health care services use, especially hospitals and nursing homes, for the frail elderly by comparing the treatment group to three control groups, two drawn from the NLTCS and one from CARE participants, and (2) to evaluate the sensitivity of secondary data sources for providing information that has both research and clinical practice utility b comparing the performance and robustness of these data with that of patient-level data obtained from a clinical setting. This analysis will employ innovative control group methodologies and survival analysis to assess the hazard of health care services use, such as hospitalization, for treatment group patient as compared to other geriatric researchers on the effectiveness this methodologic approach, and greatly aid efforts to assess the outcomes of well- designed clinical interventions that lack a comparison group essential to answering these questions. Furthermore, this study offers the opportunity to assess the sensitivity of these secondary data sources, such as the NLTCS, for the development of functional and outcome measures that have far-reaching research purposes.