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• W1968449251 abstract "Editorials4 November 2003Establishing Benchmarks for Quality Care for an Aging Population: Caring for Vulnerable Older AdultsLinda P. Fried, MD, MPHLinda P. Fried, MD, MPHFrom The Johns Hopkins Medical Institutions Baltimore, MD 21205.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-9-200311040-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail We are experiencing a demographic revolution, the aging of the United States and populations worldwide. Soon 20% of the U.S. population will be older than 65 years of age, and people will be living one third of their lives after retirement. Those 85 years of age and older are the most rapidly increasing segment of our population and contribute to the large subset of older adults that are highly vulnerable to adverse health outcomes, including disability, dependency, and death. Among the 95% of people 65 years and older living in the community, approximately one third can be considered highly vulnerable ...References1. Reuben DB, Borok GM, Wolde-Tsadik G, Ershoff DH, Fishman LK, Ambrosini VL, . A randomized trial of comprehensive geriatric assessment in the care of hospitalized patients. N Engl J Med. 1995;332:1345-50. [PMID: 7715645] CrossrefMedlineGoogle Scholar2. Stuck AE, Aronow HU, Steiner A, Alessi CA, Bula CJ, Gold MN, . A trial of annual in-home comprehensive geriatric assessments for elderly people living in the community. N Engl J Med. 1995;333:1184-9. [PMID: 7565974] CrossrefMedlineGoogle Scholar3. Boult C, Boult LB, Morishita L, Dowd B, Kane RL, Urdangarin CF. A randomized clinical trial of outpatient geriatric evaluation and management. J Am Geriatr Soc. 2001;49:351-9. [PMID: 11347776] CrossrefMedlineGoogle Scholar4. Cohen HJ, Feussner JR, Weinberger M, Carnes M, Hamdy RC, Hsieh F, . A controlled trial of inpatient and outpatient geriatric evaluation and management. N Engl J Med. 2002;346:905-12. [PMID: 11907291] CrossrefMedlineGoogle Scholar5. Landefeld CS, Palmer RM, Kresevic DM, Fortinsky RH, Kowal J. A randomized trial of care in a hospital medical unit especially designed to improve the functional outcomes of acutely ill older patients. N Engl J Med. 1995;332:1338-44. [PMID: 7715644] CrossrefMedlineGoogle Scholar6. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. Journal of Gerontology: Medical Sciences. 2004 [In press]. Google Scholar7. Tsevat J, Dawson NV, Wu AW, Lynn J, Soukup JR, Cook EF, . Health values of hospitalized patients 80 years or older. HELP Investigators. Hospitalized Elderly Longitudinal Project. JAMA. 1998;279:371-5. [PMID: 9459470] CrossrefMedlineGoogle Scholar8. Wenger NS, Solomon DH, Roth CP, MacLean CH, Saliba D, Kamberg CJ, . The quality of medical care provided to vulnerable community-dwelling older patients. Ann Intern Med. 2003;139:740-7. LinkGoogle Scholar9. Sloss EM, Solomon DH, Shekelle PG, Young RT, Saliba D, MacLean CH, . Selecting target conditions for quality of care improvement in vulnerable older adults. J Am Geriatr Soc. 2000;48:363-9. [PMID: 10798460] CrossrefMedlineGoogle Scholar10. Shekelle PG, MacLean CH, Morton SC, Wenger NS. Assessing care of vulnerable elders: methods for developing quality indicators. Ann Intern Med. 2001;135:647-52. [PMID: 11601947] LinkGoogle Scholar11. ACOVE Investigators. ACOVE quality indicators. Ann Intern Med. 2001;135:653-67. [PMID: 11601948] LinkGoogle Scholar12. Saliba D, Elliott M, Rubenstein LZ, Solomon DH, Young RT, Kamberg CJ, . The Vulnerable Elders Survey: a tool for identifying vulnerable older people in the community. J Am Geriatr Soc. 2001;49:1691-9. [PMID: 11844005] CrossrefMedlineGoogle Scholar13. Jencks SF, Cuerdon T, Burwen DR, Fleming B, Houck PM, Kussmaul AE, . Quality of medical care delivered to Medicare beneficiaries: A profile at state and national levels. JAMA. 2000;284:1670-6. [PMID: 11015797] CrossrefMedlineGoogle Scholar14. Besdine RW. Improving health care quality by reimbursement policy. J Am Geriatr Soc. 1998;46:788-90. [PMID: 9625201] CrossrefMedlineGoogle Scholar15. Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Milbank Q. 1996;74:511-44. [PMID: 8941260] CrossrefMedlineGoogle Scholar16. Riley MW, Riley JW. Age integration and the lives of older people. Gerontologist. 1994;34:110-5. [PMID: 8150298] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From The Johns Hopkins Medical Institutions Baltimore, MD 21205.Grant Support: By Robert Wood Johnson Partnership for Solutions.Disclosures: None disclosed.Corresponding Author: Linda P. Fried, MD, MPH, 2024 East Monument Street, Suite 2-700, Baltimore, MD 21205; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Quality of Medical Care Provided to Vulnerable Community-Dwelling Older Patients Neil S. Wenger , David H. Solomon , Carol P. Roth , Catherine H. MacLean , Debra Saliba , Caren J. Kamberg , Laurence Z. Rubenstein , Roy T. Young , Elizabeth M. Sloss , Rachel Louie , John Adams , John T. Chang , Patricia J. Venus , John F. Schnelle , and Paul G. Shekelle Metrics Cited ByWhat physicians reason about during admission case reviewEffect of Continuity of Care on Quality of Life in Older Adults With Chronic Diseases: A Meta-AnalysisComparison of Cognitive Task-Directed Motor Control Ability in Younger and Older SubjectsNursing Home Residents Versus Researcher: Establishing Their Needs While Finding Your WayComplex health problems among the oldest old in Sweden: increased prevalence rates between 1992 and 2002 and stable rates thereafterPerceived social support following myocardial infarction and long-term development of frailtyProfile of elderly with multiple physician visits: Advocacy for tailored comprehensive geriatric assessment use in clinics“It’s Somebody else’s responsibility”- perceptions of general practitioners, heart failure nurses, care home staff, and residents towards heart failure diagnosis and management for older people in long-term care: a qualitative interview studyDesempenho cognitivo e fragilidade em idosos clientes de operadora de saúdeAccess to heart failure care post emergency department visit: Do we meet established benchmarks and does it matter?Developing a Unified List of Physicians’ Reasoning Tasks During Clinical EncountersHigh prevalence of undetected heart failure in long-term care residents: findings from the Heart Failure in Care Homes (HFinCH) studyApathy as Marker of Frail StatusImpact of androgen deprivation on physical well-being in patients with prostate cancerImproving Identification and Documentation of Pressure Ulcers at an Urban Academic HospitalComorbidity and clinical features in elderly patients with dementia: Differences according to dementia severityUse of the folinic acid/5-fluorouracil/irinotecan (FOLFIRI 1) regimen in elderly patients as a first-line treatment for metastatic colorectal cancer: a Phase II studyComprehensive geriatric assessment in female elderly patients with alzheimer disease and other types of dementiaIncidence of Disability Among Preretirement Adults: The Impact of Depression 4 November 2003Volume 139, Issue 9Page: 784-786KeywordsAgingDisabilitiesElderlyFallsGeriatric careGeriatricsHealth care qualityPreventive medicineQuality indicatorsQuality of life ePublished: 4 November 2003 Issue Published: 4 November 2003 CopyrightCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ..." @default.
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