IMPACT OF GERIATRIC REHABILITATION FOR FRAIL ELDERS

描述（改编自申请人摘要）：体弱老人

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.