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Ideas and Opinions |4 February 2014

When Frail Elderly Adults Get Sick: Alternatives to Hospitalization

Muriel R. Gillick, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • From Harvard Pilgrim Health Care Institute/Harvard Medical School, Boston, Massachusetts.

    Potential Conflicts of Interest: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-1793.

    Requests for Single Reprints: Muriel R. Gillick, MD, Department of Population Medicine, Harvard Pilgrim Health Care Institute/Harvard Medical School, 133 Brookline Avenue, 6th Floor, Boston, MA 02215; e-mail, muriel_gillick@hphc.org.

    Author Contributions: Conception and design: M.R. Gillick.

    Drafting of the article: M.R. Gillick.

    Critical revision of the article for important intellectual content: M.R. Gillick.

    Final approval of the article: M.R. Gillick.

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FULL TEXT
Providing high-quality, cost-effective medical care to the sickest, oldest, and frailest patients remains a formidable challenge. The 18 million people older than 65 years with chronic conditions and limitations in their ability to carry out basic daily activities make up 6% of the noninstitutionalized U.S. population but consume 25% of total health care spending (1). The lion's share of these resources go to hospital care: 63% of Medicare patients with 6 or more chronic conditions are hospitalized each year (vs. 13% of those with 2 to 3 chronic conditions) and account for 70% of Medicare 30-day rehospitalizations (2). Although the hospital offers sophisticated and often life-prolonging diagnostic and treatment methods, it can also be a dangerous environment for frail elderly patients. Providing safe and excellent care for this population will probably require developing viable alternatives to hospitalization.
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Gillick MR. When Frail Elderly Adults Get Sick: Alternatives to Hospitalization. Ann Intern Med. ;160:201–202. doi: 10.7326/M13-1793

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Published: Ann Intern Med. 2014;160(3):201-202.

DOI: 10.7326/M13-1793

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