Demographic characteristics and clinical benefits of outpatient geriatric evaluation and management service in Taiwan

Lin, Ming Hsien; Liu, Chien‐Liang; Peng, Li Ning; Chen, Yi Tsun; Chen, Liang Kung

doi:10.1016/j.archger.2011.04.016

Cited by 10 publications

(20 citation statements)

References 30 publications

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“…14 Although the clinical benefits of outpatient GEM have been reported extensively, 8,15,16 little is known about the clinical benefits of outpatient GEM services located in a community-based primary care center. GEM services are usually provided in hospital settings and are less likely to be provided independently in the communities.…”

Section: Discussionmentioning

confidence: 99%

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Living alone as a red flag sign of falls among older people in rural Taiwan

Lee

Cheng

Liu

et al. 2011

Journal of Clinical Gerontology and Geriatrics

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a b s t r a c tBackground/Purpose: Fall is a common geriatric syndrome and is associated with physical injuries, fear of falling, limitation of activities of daily living, and increased medical expenditure. Although risk factors of falls have been explored extensively, little is known about the impact of solitary living on falls in the elderly. The main purpose of this study was to evaluate the impact of solitary living on risk of fall among older people who visited the outpatient geriatric services in rural Taiwan. Methods: From September 2009 to August 2010, all patients who visited the primary careebased outpatient geriatric services were invited for study. For all participants, comprehensive geriatric assessment was performed by a well-trained research nurse. Common risk factors of falls were collected in addition to solitary living, such as polypharmacy (more than four drugs), visual impairment, hearing impairment, age, gender, and cognitive impairment. Results: Overall, 173 (mean age ¼ 78.8 AE 6.8 years, men ¼ 73.4%) patients were enrolled, and 42 (24.2%) of them reported falls in the past year. Two-thirds of fall events occurred outdoors and mainly (66.7%) during walking. Two-thirds of falls were associated with injuries, and half of the patients reported reduced activities of daily living because of fear of falling. Compared with nonfallers, fallers were significantly more likely to live alone (28.6% vs. 14%, p ¼ 0.031), but age (79.0 AE 7.2 years vs. 78.8 AE 6.8 years, p ¼ 0.89); gender (66.7% vs. 76.7%, p ¼ 0.197); polypharmacy (47.6% vs. 39.8%, p ¼ 0.378); use of psycotropic agents (4.8% vs. 0.8%, p ¼ 0.096); visual impairment (35.7% vs. 35.7%, p ¼ 0.995); hearing impairment (21.4% vs. 23.4%, p ¼ 0.79); and cognitive impairment (21.4% vs. 12.5%, p ¼ 0.158) were not statistically significant. Conclusions: In rural Taiwan, solitary living is an important risk factor of falls among patients who visited primary careebased outpatient geriatric services. Further prospective study is needed to evaluate the impact of solitary living on risk of falls, and improvement of outdoor environment is also of great importance to reduce fall-related injuries.

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Section: Discussionmentioning

confidence: 99%

“…During the study period, 173 patients (mean age ¼ 78 8. AE 6.8 years, men ¼ 73.4%) were enrolled, and 42 (24.2%) of them reported recent falls within a year.…”

mentioning

confidence: 99%

Living alone as a red flag sign of falls among older people in rural Taiwan

Lee

Cheng

Liu

et al. 2011

Journal of Clinical Gerontology and Geriatrics

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“…On average, the number of ambulatory care visits by elderly people in Taiwan was 26.8 per year, while the average was 15 visits among all age groups and was raised concern recently by NHI. Nearly all elderly people utilized ambulatory care services and one-half of them had more than 24 visits annually, a number that was much higher than those in the United States and other Organization for Economic Co-operation and Development countries [3].…”

Section: Introductionmentioning

confidence: 99%

Utilization of health care services by elderly people with National Health Insurance in Taiwan: The heterogeneous health profile approach

2012

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“…It also improves the quality of care and promotes long-term clinical outcomes by finding the atypical presentations of older patients, and hidden health or social problems [67,68]. Mo andMak (1985 and1991) mentioned that according to Ajzen's theory of planned behavior [69,70], the Chinese population that has mental health problems commonly underuses professional mental health services because of cultural values and the associated stigmatization [71].…”

Section: Discussionmentioning

confidence: 98%