A Randomized, Controlled Trial of Outpatient Geriatric Evaluation and Management in a Large Public Hospital

Objective: To study the effect of outpatient geriatric evaluation and management on physical function, mental status, and subjective well‐being. Design: Prospective randomized controlled trial with a 1‐year study period. Setting: Large medical school‐affiliated public hospital in an urban community. Subjects: Patients at least 70 years old admitted to the medicine service were screened, randomized, and completed a 1‐year follow‐up interview. Interventions: Comprehensive geriatric evaluation and an outpatient care management program. Main Outcome Measures: Mental status (SPMSQ), ADL (Katz Index), IADL (Five‐Item OARS Scale), Life satisfaction (LSI‐Z), and self‐perception of health status (physical health section of OARS). Results: No significant differences were found for cognitive status, ADL functioning, life satisfaction, nursing home placement, or mortality. The experimental patients reported significantly higher function in IADL and more favorable self‐perception of health status compared with controls. Conclusion: Outpatient comprehensive geriatric evaluation and management appears to be a useful model for providing care to medically frail elderly patients. 1993 The American Geriatrics Society