Introduction and background: Comprehensive geriatric assessment (CGA) is considered a good method for diagnosing frail older people, deferring disability and providing adequate care. Since it is more expensive than a regular clinic, it should be used efficiently.
Study goals: To ascertain whether CGA is provided to the appropriate population and identify changes pre- and six months post-CGA in intervention and control groups.
Study design: Two surveys--one retrospective including atd 580 older people receiving CGA in Maccabi Healthcare Services in 2007 (data from Maccabi's database), the other a prospective semi-experimental survey, with a representative sample of 211 older people, receiving CGA in 2008, and 166 matching patients who had not received CGA (both groups interviewed twice within a six-month intervaL).
Findings: A total of 59% of CGA people were women, average age 79 years. Geriatric symptoms: 42% with functional disability, 63% Limited in out-of-home functions (e.g., shopping), 52%--cognitive decline, 33%--suspected depression, 41%--repeated falls, 35%--urinary incontinence. Morbidity data included: 55% suffered from heart disease, 29% diabetes, 18% malignancies, taking 7.8 medications on average. There was an improvement in health-related quality-of-life and use of services by patients receiving CGA, while this remained unchanged in the control group, with no change in the geriatric symptoms of both groups.
Implications for policy: CGA clinics receive referrals with multiple geriatric symptoms. It is important to expand them and to formulate structured criteria to identify target populations and disseminate the criteria to physicians, in order to increase referral of suitable patients.