| Methods |
‐ RCT of an acute care elders unit (ACE) compared to usual care units.
‐ randomised using computer generated random numbers
‐ Setting: USA, community teaching hospital.
‐ Funding: Summa Health System Foundation. |
| Participants |
‐ 1531 of 6609 eligible patients.
‐ Mean age 80 years, 60% female, none from institutions.
‐ Inclusion criteria: community dwelling persons aged 70 or older admitted to a medicine or family practice service.
‐ Exclusion criteria: transferred from a nursing facility or another hospital, required specialty unit admission, were admitted electively, had a length of stay of less than 2 days or had been previously enrolled in the study.
Reason for admission: acute dyspnoea or pulmonary problem (24.1%), change in mental status or neurological abnormality (20.1%), gastrointestinal (18.75%), fever, pneumonia or infection (13.98%), diabetes mellitus, failure to thrive or other problem (11.56%), congestive heart failure, chest pain or cardiac problem (11.50%). |
| Interventions |
‐ Multidisciplinary ACE unit. Specially designed environment, patient centred care, nursing care plans for prevention of functional decline, rehabilitation, patient discharge to home and review of medical care to prevent iatrogenic illness. Daily team rounds.
Exercise: 3 times per day walk or stand. Daily ambulation to activity room for exercises and meals. Encouraged by staff. Patient or caregivers taught exercises. |
| Outcomes |
‐ Function (ADL and IADL), mobility, mortality, discharge destination, hospital costs and LOS, satisfaction and use of at‐risk medications.
‐ Time of outcome measure assessment: hospital discharge and 1, 3, 6 and 12 months after discharge. |
| Notes |
‐ Language: English
‐ PEDro score: 7
‐ Additional information from authors: no
‐ Author conclusions: "ACE in a community hospital improved the process of care and patient and provider satisfaction without increasing hospital length of stay or costs." |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment? |
Low risk |
A ‐ Adequate |
