MEASURING OUTCOMES IN CARE OF THE ELDERLY

This observational study was designed to assess whether routine measur ement of outcomes using standard instruments is possible as part of cl inical routine in care of the elderly, and to establish if such instru ments are responsive to clinical change. Indices of functional status, cognitive function and subjective health status were collected routin ely on admission and discharge in 540 inpatients and 340 patients atte nding a day hospital. Data collection became integrated into clinical routine. Response rates were generally good and yielded acceptably com plete data. For inpatients, outcome was reflected by measurement of su rvival, physical function (Barthel index) and social status, each of t hese indicators showing significant change between admission and disch arge. For day hospital patients, neither these, nor the Nottingham ADL scale, nor a health status indicator proved sufficiently responsive t o clinical change to merit recommendation as outcome indicators for ro utine use in older patients. In ambulatory care in older patients, suc h as those attending a day hospital, new approaches are needed to meas ure clinical outcomes.