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Substudy 13 Fact Sheet
The Geriatric Outcome Evaluation Study (GOES) (NA101-13)
University of Victoria
This project is one of fifteen sub-studies of the National Evaluation
of the Cost-Effectiveness of Home Care Project (NA101). In Canada, geriatric
day hospitals have emerged as one of a variety of services available to
older adults, yet there is a paucity of information concerning their effectiveness.
Sub-study 13 explored the utilization of services within a geriatric services
program and examined how a geriatric day hospital (GDH) fits into this
spectrum of services in Victoria, British Columbia. The researchers wished
to determine if patient needs could best be served by such specialized
services within the continuum of care concept, or if they could be substituted
by inpatient and other services.
Data were obtained for all persons admitted to each of the 5 service components
of the geriatric services program: a geriatric outpatient clinic, a geriatric
day hospital, post-acute geriatric inpatient rehabilitation, residential
geriatric rehabilitation for people admitted from the community, and inpatient
psychogeriatric rehabilitation. Measures of clients' mental health, physical
health, daily functioning and bodily pain were administered to family
members involved in providing care at admission, discharge and 4 months
post-discharge. Data on health care utilization and costs of care were
obtained through existing data bases, manual record reviews and reports
of caregivers, and addressed issues related to costs of self-care, informal
care, and formal care.
The project leaders identified the following outcomes:
- Persons admitted to each of the service components differed with
respect to their profile of mental health, physical health, daily functioning,
and bodily pain - in other words, each service did appear to address
a particular need or constellation of needs.
- Within each service, health status appeared to improve when receiving
care, and examination of the sustainability of improved health status
over time supported the present model of care in that little change
in functioning was seen in the post-discharge period.
- Researchers were unable to assess the cost-effectiveness of the various
services to determine if there could be a cost-effective substitution
of services. This was due in part to a restructuring of outpatient programs
during the research period.
The project leaders indicated that their findings are important because,
in their view:
- The results of the study support the notion that a spectrum of care
services is required for geriatric care and that health benefits are
realized and sustained across a broad spectrum of services.
- The data available will be further examined with respect to a variety
of specific topics in the future.
As this project was an evaluation study, please see the "Activities"
HTF Contribution to the Project:
$1,505,000 (divided among the 15 sub-studies)
Language of Report: