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Acute Care for Elders

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Geriatrics Models of Care

Abstract

The Acute Care for Elders (ACE) model of care was developed to address hospitalization-associated disability (HAD) in older adults. HAD occurs in one-third of hospitalized older adults and carries significant risks for persistent disability, nursing home placement and death. Initial studies demonstrated that the ACE intervention reduces HAD and improves physical function without increasing costs, compared to patients receiving usual care. Later studies documented that the ACE model of care has other important benefits including improved processes of care; fewer complications common to older adults such as delirium; improved patient, family, provider, and nurse satisfaction with care; reduced length of stay and 30-day readmissions; and lower per capita cost of care. Thus, the ACE model of care achieves the triple aim of simultaneously improving the health of the population, enhancing the experience and outcomes of the patient, and reducing per capita cost of care for the benefit of communities. Future steps for the ACE model include outcomes research evaluating the impact of ACE on additional geriatric syndromes such as polypharmacy as well as patient status in the weeks to months following a hospitalization. Opportunities also exist to disseminate the ACE model of care to hospitalized elders admitted to non-ACE units. Health care reform provides new incentives for hospitals to embrace ACE as a means of achieving new quality and patient experience goals.

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Author information

Authors and Affiliations

  1. Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, 1720 2nd Ave South, CH-19, Room 201, Birmingham, AL, 35294-2041, USA

    Kellie L. Flood M.D. & Katrina Booth M.D.

  2. Division of Hospital Medicine and Geriatrics, San Francisco General Hospital, University of California, San Francisco, CA, USA

    Edgar Pierluissi M.D.

  3. Aurora Sinai Medical Center and University of Wisconsin School of Medicine & Public Health, Milwaukee, WI, USA

    Ellen S. Danto-Nocton M.D.

  4. Louis Stokes VA Medical Center and Adult Medical Surgical Nursing Department, University Hospitals of Cleveland, Cleveland, OH, USA

    Denise M. Kresevic Ph.D., R.N.

  5. Glennan Center for Geriatrics and Gerontology, Norfolk, VA, USA

    Robert M. Palmer M.D., M.P.H.

  6. Eastern Virginia Medical School, Norfolk, VA, USA

    Robert M. Palmer M.D., M.P.H.

Authors
  1. Kellie L. Flood M.D.
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  2. Katrina Booth M.D.
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  3. Edgar Pierluissi M.D.
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  4. Ellen S. Danto-Nocton M.D.
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  5. Denise M. Kresevic Ph.D., R.N.
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  6. Robert M. Palmer M.D., M.P.H.
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Corresponding author

Correspondence to Kellie L. Flood M.D. .

Editor information

Editors and Affiliations

  1. Senior Services – Aurora Health Care, University of Wisconsin School of Medicine & Public Health, Milwaukee, Wisconsin, USA

    Michael L. Malone

  2. Hunter-Bellevue School of Nursing, Hunter College of the City University of New York, New York, New York, USA

    Elizabeth A. Capezuti

  3. Eastern Virginia Medical School, Norfolk, Virginia, USA

    Robert M. Palmer

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Flood, K.L., Booth, K., Pierluissi, E., Danto-Nocton, E.S., Kresevic, D.M., Palmer, R.M. (2015). Acute Care for Elders. In: Malone, M., Capezuti, E., Palmer, R. (eds) Geriatrics Models of Care. Springer, Cham. https://doi.org/10.1007/978-3-319-16068-9_1

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  • DOI: https://doi.org/10.1007/978-3-319-16068-9_1

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-16067-2

  • Online ISBN: 978-3-319-16068-9

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