The current landscape of Acute Care for Elders units in the United States

被引:15
作者
Rogers, Stephanie E. [1 ]
Flood, Kellie L. [2 ]
Kuang, Qiao Yu [1 ]
Harrison, James D. [3 ]
Malone, Michael L. [4 ]
Cremer, Julia [1 ]
Palmer, Robert M. [5 ]
机构
[1] Univ Calif San Francisco, Dept Med, Div Geriatr, 505 Parnassus Ave,Box 0131, San Francisco, CA 94143 USA
[2] Univ Alabama Birmingham, Dept Med, Div Gerontol Geriatr & Palliat Care, Birmingham, AL 35294 USA
[3] Univ Calif San Francisco, Div Hosp Med, Dept Med, San Francisco, CA 94143 USA
[4] Advocate Aurora Hlth, Aurora Senior Serv & Aurora UW Med Grp, Milwaukee, WI USA
[5] Eastern Virginia Med Sch, Dept Internal Med, Norfolk, VA 23501 USA
关键词
ACE units; Acute Care for Elders units; Age-Friendly Health Systems; geriatrics models of care; hospitalized older adults; FUNCTIONAL OUTCOMES; MEDICAL UNIT; TRIAL; ACE;
D O I
10.1111/jgs.17892
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background The clinical benefits of Acute Care for Elders (ACE) units have been established for over 25 years. However, how widely disseminated ACE units are in the United States and the degree of fidelity to the key elements of this model of care are unknown. Our objective was to identify all existing ACE units in the United States and to obtain detailed information about variations in implementation. Methods The strategy to identify current ACE units began with online searches and snowball sampling using contacts from professional societies and workgroups. Next, a request for information regarding the existence of ACE units was sent to the remaining US hospitals listed in a national hospital database. An online survey was sent to identified ACE unit contacts to capture information on implementation characteristics and the five key elements of ACE units. Results There were 3692 hospitals in the database with responses from 2055 (56%) hospitals reporting the presence or absence of an ACE unit. We identified 68 hospitals (3.3%) with an existing or previous ACE unit. Of these 68 hospitals, 50 (74%) completed the survey and reported that 43 ACE units were currently open and 7 had been closed. Of the 43 currently open ACE units, most are affiliated with an academic hospital and there is variable implementation of each of the five key ACE elements (from 69% to 98%). Conclusions Among the 50 hospitals to complete the survey, 43 current ACE units were identified, with variable fidelity to the key elements. Estimates of prevalence of ACE units and fidelity to key elements are limited by nonresponses to the national survey request by nearly half of hospitals.
引用
收藏
页码:3012 / 3020
页数:9
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