Comparing Geriatrics-Focused Primary Care to Traditional Care in the VA Health Care System

A cohort study published in JAMA Open Network comparing geriatrics-focused primary care with traditional care for older veterans in the Department of Veterans Affairs (VA) health care system found no difference in home time but significant improvements in falls, incontinence, and functional assessments.

Participants in this cohort study included patient dyads from VA medical centers with geriatrics-focused primary care clinics. Patients aged 65 or older who had transferred to geriatrics-focused primary care within the past year were enrolled, along with their traditional primary care controls. Data collection for patient outcomes was completed in June 2021, with analysis taking place from June 2023 to January 2024. The exposure period required at least 2 visits to geriatrics-focused primary care, which offers comprehensive care for older veterans with complex needs through interprofessional teams.

Home time within 18 months was the primary outcome measured. Secondary outcomes included completion of advance directives, assessments (falls, incontinence, and function), and medication quality. Patients were surveyed using various measures to assess their care experiences over the 18-month period. A total of 568 patients, mostly male, were enrolled in the study, with baseline variables being comparable between the geriatrics-focused primary care and traditional primary care groups. 

While geriatrics-focused primary care was not associated with increased home time, it was linked to higher odds of assessments for falls, incontinence, and function at 18 months. However, there was no association between geriatrics-focused primary care and advance directive completion, medication quality, or self-reported health and well-being.

“In this cohort study, geriatrics-focused primary care did not increase time at home or other measures of self-reported health and well-being or integration of care within the first 18 months after care transition. However, increases in some process measures important for quality of care were observed, suggesting that further studies are needed to evaluate outcomes over a longer time frame,” researchers said. 

Reference
Hastings SN, Van Houtven CH, Stanwyck CL, et al. Geriatrics-focused vs traditional primary care in the veterans affairs health care system. JAMA Netw Open. 2025;8(1):e2454865. doi:10.1001/jamanetworkopen.2024.54865