Background: There is ongoing controversy whether patients show better functional outcomes when care is provided in acute geriatric (AG) or internal medicine (IM) departments.
Objective: This study compared the recovery of acutely ill patients concerning activities of daily living (ADL) and instrumental activities of daily living (IADL).
Material and methods: A total of 274 patients (≥70 years old, 67 in AG, 207 in IM) were included consecutively (AG intervention) or data were obtained (IM comparison) in a Swiss hospital with 2 locations. The ADL/IADL data were collected 14 days before admission (t1, retrospectively), on admission (t2), at discharge (t3), and 30 days after admission (t4). This study consisted of a prospective study with a longitudinal quasi-experimental design.
Results: The AG patients had a significantly higher probability to gain independence in mobility (between t2/t3, P = 0.008), grooming of the lower body (between t2/t3, P = 0.037) and defecation (between t2/t4, P < 0.001). The IM patients were significantly more independent in IADL at t4 (all P < 0.05) except for meal preparation. The odds for nursing home admission in AG with dependency at t1 were significantly lower in every ADL (all P < 0.05) and with shopping in IADL (P = 0.008).
Conclusion: This study shows a positive effect of AG compared to IM in self-care with a lower probability for nursing home admission. There is need for further education and research to improve outcomes in older hospitalized patients.
Keywords: Activities of daily living; Aged; Early rehabiliation; Instrumental activities of daily living; Physical function.