Comprehensive geriatric care in hospitals
Authors: Deschodt Mieke , Claes Veerle , Van Grootven Bastiaan , Milisen Koen , Boland Benoit , Flamaing Johan , Denis Alain , Daue François , Mergaert Lut , Devos Carl , Mistiaen Patriek , Van Den Heede Koen 
Published: January 2025

SCIENTIFIC REPORT .8 1 -- INTRODUCTION 8 -- 1.1 AN AGEING (HOSPITAL) POPULATION .8 -- 1.1.1 General demographic trend 8 -- 1.1.2 Ageing hospital population .9 -- 1.2 THE GERIATRIC CARE CONCEPT 9 -- 1.2.1 Definition geriatric patients .9 -- 1.2.2 Comprehensive geriatric care 10 -- 1.2.3 Geriatric care models .10 -- 1.3 RESEARCH QUESTIONS AND STUDY APPROACH 11 -- 2 FACTUAL DESCRIPTION OF THE ORGANISATION OF HOSPITAL CARE FOR GERIATRIC PATIENTS.13 -- 2.1 INTRODUCTION .13 -- 2.2 ACUTE GERIATRIC UNITS.14 -- 2.2.1 Aim and scope of acute geriatric units.14 -- 2.2.2 Organisational characteristics of acute geriatric units.14 -- 2.2.3 Volume of G-beds in Belgium 15 -- 2.2.4 Payment system 17 -- 2.3 GERIATRIC AMBULATORY CONSULTATION.20 -- 2.4 GERIATRIC DAY HOSPITALS 20 -- 2.5 GERIATRIC CONSULTATION TEAMS.21 -- 2.5.1 Inpatient geriatric consultation. .21 -- 2.5.2 External geriatric liaison 27 -- 2.6 GERIATRICIANS AND NURSES 27 -- 3 SWOT-ANALYSIS OF BELGIAN INPATIENT GERIATRIC CONSULTATION TEAMS..29 -- -- 3.1 METHODOLOGY 29 -- 3.1.1 Step 1: Preparation .29 -- 3.1.2 Step 2: Case analysis of experiences 30 -- 3.1.3 Step 3: First wave of focus groups.30 -- 3.1.4 Step 4: Second wave of focus groups.31 -- 3.1.5 Reflections on the approach 31 -- 3.2 SWOT: ANALYSIS OF RESULTS .31 -- 3.2.1 Strengths.33 -- 3.2.2 Weaknesses 35 -- 3.2.3 Opportunities.38 -- 3.2.4 Threats.39 -- 3.3 LEVERAGES AND BARRIERS FOR AN EFFECTIVE FUNCTIONING OF IGCT 40 -- 3.3.1 Leverages 40 -- 3.3.2 Barriers.41 -- 3.4 SUGGESTIONS FOR IMPROVING THE EFFECTIVENESS OF IGCT .42 -- 3.4.1 What can be done by policy-makers? 42 -- 3.4.2 What can hospitals do? .43 -- 3.4.3 Suggestions for IGC teams themselves 44 -- 4 INTERNATIONAL CONTEXT OF INPATIENT GERIATRIC CONSULTATION TEAMS .45 -- 4.1 INTRODUCTION .45 -- 4.2 METHODOLOGY 45 -- 4.2.1 Scoping review.45 -- 4.2.2 International survey .48 -- 4.2.3 Semi-structured interviews with caregivers and researchers in the USA 50 -- 4.3 RESULTS 50 -- 4.3.1 Database and hand search .51 -- 4.3.2 Grey literature search .69 -- 4.3.3 International survey .77 -- 4.3.4 Semi-structured interviews with caregivers and researchers in the USA 89 -- 5 QUALITY CRITERIA FOR THE EVALUATION OF INPATIENT GERIATRIC CONSULTATION TEAMS.94 -- 5.1 INTRODUCTION .94 -- 5.2 METHODOLOGY 94 -- 5.2.1 Scoping review.94 -- 5.3 RESULTS 97 -- 5.3.1 Identification and selection of relevant papers.97 -- 5.3.2 Study characteristics.97 -- 5.3.3 Selection of quality indicators 103 -- 5.3.4 Belgian initiatives 104 -- 6 DISCUSSION 107 -- 6.1 ACUTE GERIATRIC NURSING UNITS FAIL TO ACCOMMODATE THE INCREASING PREVALENCE OF FRAIL OLDER PERSONS 107 -- 6.2 THE IGCT CARE MODEL: HIGH FACE VALIDITY BUT ABSENCE OF EVIDENCE ON ITS EFFECTIVENESS 108 -- 6.3 HETEROGENEITY IN THE WAY IGCT TEAMS ARE IMPLEMENTED IN BELGIAN HOSPITALS 108 -- 6.4 INTERNATIONAL CONTEXT OF IGCT 109 -- 6.5 IS THE QUALITY OF THE CARE OF IGCTS SYSTEMATICALLY EVALUATED? 112 -- 6.6 ALTERNATIVE CARE MODELS EMERGE .113 -- 6.7 METHODOLOGICAL CONSIDERATIONS 114 -- REFERENCES 116