Implementation status of comprehensive geriatric assessment among older inpatients: A nationwide retrospective study

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY Geriatrics & Gerontology International Pub Date : 2024-08-06 DOI:10.1111/ggi.14953

Tatsuya Hosoi, Hayato Yamana, Shoya Matsumoto, Hiroki Matsui, Kiyohide Fushimi, Masahiro Akishita, Hideo Yasunaga, Sumito Ogawa

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Abstract

Aim

The importance of comprehensive geriatric assessment (CGA) is increasing in aging societies worldwide. However, there are few comprehensive studies on CGA, resulting in a limited understanding of its implementation rate, temporal changes and factors associated with its implementation. We aimed to investigate the implementation status of CGA and its regional variance in Japan.

Methods

Using the Diagnosis Procedure Combination database, we investigated CGA trends, and identified the patient, hospital and regional factors associated with its implementation. We identified patients aged ≥65 years who were admitted for the first time between 2016 and 2020 with a diagnosis of stroke, heart failure, pneumonia, bone fracture or colorectal cancer. We examined the CGA implementation rate according to patient and hospital characteristics. We also investigated temporal changes and tendencies to carry out CGA in different prefectures.

Results

A total of 1 974 817 patients were analyzed, of whom 570 696 (28.9%) underwent CGA. The implementation trend increased steadily from 25.3% in fiscal year 2016 to 33.4% in fiscal year 2019. The implementation rate also increased with patient age (30.3% in patients aged ≥95 years). Regional variations in its implementation status were observed, with a higher tendency to be implemented in areas near major metropolitan regions. A trend toward carrying out CGA for colorectal cancer, but not for other diseases, has been observed in eastern Japan.

Conclusion

Although CGA is increasingly carried out, considerable regional differences remain in its implementation status. Initiatives to reduce variations are necessary. Geriatr Gerontol Int 2024; 24: 904–911.

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老年住院患者中老年病综合评估的实施情况：全国范围内的回顾性研究。

目的：在全球老龄化社会中，老年综合评估（CGA）的重要性与日俱增。然而，有关 CGA 的综合性研究很少，因此对其实施率、时间变化以及实施相关因素的了解有限。我们的目的是调查 CGA 在日本的实施情况及其地区差异：我们利用诊断程序组合数据库调查了 CGA 的趋势，并确定了与实施 CGA 相关的患者、医院和地区因素。我们确定了在 2016 年至 2020 年期间首次入院并诊断为中风、心力衰竭、肺炎、骨折或结直肠癌的年龄≥65 岁的患者。我们根据患者和医院的特征研究了 CGA 的实施率。我们还调查了不同都道府县开展 CGA 的时间变化和趋势：结果：共分析了 1 974 817 名患者，其中 570 696 人（28.9%）接受了 CGA。实施率从 2016 财年的 25.3% 稳步上升至 2019 财年的 33.4%。实施率也随着患者年龄的增长而增加（≥95 岁患者的实施率为 30.3%）。实施情况存在地区差异，大都市附近地区的实施率更高。在日本东部地区，结直肠癌患者有实施 CGA 的趋势，而其他疾病患者则没有：结论：尽管 CGA 的实施越来越多，但其实施状况仍存在相当大的地区差异。结论：虽然 CGA 的开展越来越多，但其实施情况仍存在相当大的地区差异，有必要采取措施减少差异。Geriatr Gerontol Int 2024; --：-----.

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来源期刊

Geriatrics & Gerontology International 医学-老年医学

CiteScore

5.50

自引率

6.10%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Geriatrics & Gerontology International is the official Journal of the Japan Geriatrics Society, reflecting the growing importance of the subject area in developed economies and their particular significance to a country like Japan with a large aging population. Geriatrics & Gerontology International is now an international publication with contributions from around the world and published four times per year.