Program for Geriatric Assessments, Care Beneficial Among Older Veterans

Comprehensive geriatric assessments and care to high risk, community-dwelling older adults as well as high rates of satisfaction from patients, caregivers, and providers were a result of the Veterans Affairs Geriatric Resources for Assessment and Care of Elders (VA-GRACE).

Researchers published their findings in Journal of the American Geriatrics Society.

Patients admitted to the Richard L. Roudebush VA hospital between 2010 and 2019 who received VA-GRACE services post-discharge, as well as usual care controls potentially eligible for VA-GRACE but did not receive services, were included in the retrospective cohort study.

Home-based comprehensive, multidisciplinary geriatrics assessment, and ongoing care were provided by the VA-GRACE program.

Patients from VA-GRACE included in the study (n = 683) were older than controls (n = 4313) (mean age 78.3 ± 8.2 standard deviation v. 72.2 ± 6.9 years; P < .001) and had greater comorbidity (median Charlson Comorbidity Index 3 vs. 0; P < .001).

Higher 90-day readmissions (adjusted odds ratio [aOR] 1.55 [95%CI 1.01-2.38]) and higher 1-year readmissions (aOR 1.74 [95%CI 1.22-2.48]) were experienced by VA-GRACE patients.

When compared to controls, VA-GRACE patients had lower 90-day mortality, (aOR 0.31 [95%CI 0.11-0.92]), but no statistically significant difference in 1-year mortality (aOR 0.88 [95%CI 0.55-1.41]). 

“Patients and caregivers reported that VA-GRACE home visits reduced travel burden and the program linked Veterans and caregivers to needed resources,” wrote study authors.

According to primary care providers, the VA-GRACE team improved medication management for their patients, helped to reduce their workload, and provided a view into patients’ daily living situation.

“Widespread deployment of programs like VA-GRACE will be required to support Veterans aging in place,” concluded researchers.

Reference:
Schubert CC, Perkins AJ, Myers LJ, et al. Effectiveness of the VA-Geriatric Resources for Assessment and Care of Elders (VA-GRACE) program: an observational cohort study. J Am Geriatr Soc. Published online August 29, 2022. doi:10.1111/jgs.18013