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Analysis

Use Geriatric Assessment to Predict Hospital and Long-Term Care Utilization

By Christopher Cheney  
   April 08, 2019

New research shows how specific impairments can determine the likelihood of increased healthcare services utilization among older cancer patients.

For older cancer patients, geriatric assessments can predict hospitalization rates and long-term care utilization as well as guide interventions, new research indicates.

The country's aging population is having a profound impact on the healthcare sector, according to the American Hospital Association. For example, more than 60% of baby boomers are expected to have multiple chronic conditions after reaching retirement age, more than one-third of boomers are expected to be obese, and about a quarter of boomers are expected to have diabetes.

The recent research, which was published in Journal of Oncology Practice, found that geriatric assessments could be a key component of reducing healthcare utilization by older cancer patients.

"Our findings suggest the importance of a geriatric assessment in predicting adverse healthcare use including the frequency of hospitalizations and long-term care use. Geriatric assessment-focused interventions should be targeted toward high-risk patients to reduce long-term adverse healthcare use in this vulnerable population," the researchers wrote.

Researchers examined data collected from 125 cancer patients who underwent geriatric assessments. They found specific impairments were associated with hospital and long-term care utilization.

"Prefrail/frail status, instrumental activities of daily living impairment, and limitations in climbing stairs were associated with increased hospitalizations. Prefrail/frail status, instrumental activities of daily living impairment, presence of falls, prolonged Timed Up and Go, and limitations in climbing stairs were associated with long-term care use," the researchers wrote.

Deploying interventions
 

Conducting geriatric assessments in older cancer patients can target areas for intervention, the researchers wrote.

"Our results demonstrate that impairments predominately in the physical function and functional status domains of the geriatric assessment are particularly related to increased healthcare use. This suggests interventions focused on these impairments may be important for improving outcomes. Impairments in instrumental activities of daily living and limitations in climbing stairs or walking short distances are great examples of the types of interventions that occupational therapists and physical therapists treat."

The lead author of the research, Assistant Professor Grant Williams, MD, at the University of Alabama at Birmingham, told HealthLeaders there are several other promising interventions in addition to occupational and physical therapy.

  • Nutrition
     
  • Comorbidity management
     
  • Treatment of behavioral health conditions such as anxiety and depression
     
  • Social work assistance for older patients with limited social supports
     
  • Medication management

"There are several trials in process that are looking at how geriatric assessment-directed interventions can improve outcomes and we are eagerly awaiting the results," Williams said.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


KEY TAKEAWAYS

The country's aging population is placing significant burdens on the healthcare sector.

Geriatric assessments can help guide the targeting of interventions for older cancer patients.

For older cancer patients who are found at risk of hospitalization or long-term care utilization, interventions include occupational and physical therapy.

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