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Geriatrician advocates for improvements to primary care to meet the needs of older adults
Date:11/2/2010

"Most of today's primary care does not include these four processes, so patients receive fragmented and inefficient care that is further undermined by a lack of family and community support, " said Wieland, research director of Geriatrics Services at Palmetto Health Richland Hospital. "However, new models of primary care that include these processes have improved health outcomes, and patient and physician satisfaction, and have in some cases lowered the cost of care."

Boult and Wieland identified three models of care that have the greatest potential to improve effectiveness and efficiency of complex primary health care. All three models include a team-based approach to primary care, and they provide many of the same services to complex older patients, beginning with a comprehensive assessment and an evidence-based care plan. All of these models include proactive monitoring and coaching, coordination of care across all sites of care, support of patient's transitions from acute to post-acute settings, and access to community-based agencies.

  • GRACE (Geriatric Resources for Assessment and Care of Elders), a team-based intervention developed by researchers from Indiana University and the Regenstrief Institute. In a large clinical trial, GRACE improved the quality of care, decreased emergency department visits, and lowered hospital admission rates and costs in a group at high risk for hospital admission.
  • PACE (Program of All-inclusive Care for the Elderly), provides comprehensive, interdisciplinary team care to low-income frail elders. Based in an adult day health center, PACE professionals provide (or contract for) primary, specialty, emergency, hospital, home, and long-term care. PACE has been found to increase health screenings, reduce hospital admissions, increase nursing home stays, and reduce mortality among PACE participants at high risk of dying.
  • Guided Care, a multi-disciplinary model of comprehensive primary care
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Contact: Tim Parsons
tmparson@jhsph.edu
410-955-7619
Johns Hopkins University Bloomberg School of Public Health
Source:Eurekalert

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