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Short-term outcomes of seniors aged 80 years and older with acute illness: hospitalist care by geriatricians and other internists compared.

BACKGROUND
Although acute geriatric units have improved the outcomes of hospitalized seniors, it is uncertain as to whether hospitalist care by geriatricians outside of these units confers similar benefit.


OBJECTIVE
To determine whether hospitalist care by geriatricians reduces short-term mortality and readmission, and length of stay (LOS) for seniors aged 80 years and older with acute medical illnesses compared with care by other internists.


DESIGN
Retrospective cohort study using administrative and chart review data on demographic, admission-related, and clinical information of hospital episodes.


SETTING
General internal medicine department of an acute-care hospital in Singapore from 2005 to 2008.


PATIENTS
Seniors aged 80 years and older with specific focus on 2 subgroups with premorbid functional impairment and acute geriatric syndromes.


INTERVENTION
Hospitalist care by geriatricians compared with care by other internists.


MEASURES
Hospital mortality, 30-day mortality or readmission, and LOS.


RESULTS
For 1944 hospital episodes (intervention: 968, control: 976), there was a nonsignificant trend toward lower hospital mortality (15.5% vs 16.9%) but not 30-day mortality or readmission, or LOS for care by geriatricians compared with care by other internists. A marginally stronger trend toward lower hospital mortality for care by geriatricians among those with acute geriatric syndromes (20.2% vs 23.1%) was observed. Similar treatment effects were found after adjustment for demographic, admission-related, and clinical factors.


CONCLUSIONS
For seniors aged 80 years and over with acute medical illness, hospitalist care by geriatricians did not significantly reduce short-term mortality, readmission, or LOS, compared with care by other internists.