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Research on Social Work Practice
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Long-Term Effects of Outpatient Geriatric Evaluation and Management on Health Care Utilization, Cost, and Survival

Joseph B. Engelhardt

Veteran's Administration Medical Center

Ronald W. Toseland

Institute of Gerontology

Jian Gao

Veteran's Administration Medical Center

Steven Banks

National Institutes of Health

Purpose: The long-term effectiveness and efficiency of an outpatient geriatric evaluation and management (GEM) program was compared to usual primary care (UPC). Design and Method: A randomized controlled group design was used. Health care utilization, cost of care, and survival were assessed during a 48-month period among a sample of 160 male veterans age 55 and over who were above-average users of outpatient services. Results: The results indicate that GEM patients incurred significantly lower overall health care costs than UPC patients by 24 months and that cost savings plateaued during the 24- to 48-month period. Cost savings were due primarily to fewer hospital days of care. No significant differences were found in survival. Implications: Results of this follow-up study suggest that outpatient GEMoffers a specialized health delivery option for frail older persons that may reduce costs over the long term without having a negative impact on survival rates.

Key Words: assessment • health economics • health care utilization

Research on Social Work Practice, Vol. 16, No. 1, 20-27 (2006)
DOI: 10.1177/1049731505276047
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