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Prospective care of elderly patients in family practice part 2: is screening worthwhile?

In 1980-1981, the elderly accounted for 48% of patient days in general hospitals in Canada and 72% of those using long-term care facilities. This use is disproportionately generated by those 85 years of age and older and by patients in areas where beds are more readily available and community support services relatively absent. The author critically reviews the literature and describes the efficacy and efficiency of screening and case-finding programs for the elderly. The best evidence from four randomized trials indicates that screening and case-finding is effective in reducing disability, promoting independence, and improving morale and functional capacity, while reducing the use of hospital beds.