Geriatric assessment in the inpatient sector : 20 years quality assurance of the Geriatrics in Bavaria Database.

BACKGROUND: Geriatric assessment is an integral part of geriatrics and leads to various improvements in the treatment of geriatric patients. MATERIAL AND METHODS: Analysis of assessment data and patient characteristics in a large inpatient geriatric patient population. Evaluation of data from the Geriatrics in Bavaria Database (GiB-DAT) over 20 years as well as a cross-sectional study from 2020. Presentation of data for patients in inpatient acute geriatrics as well as continuing geriatric rehabilitation. RESULTS: The number of patient records and participating hospitals has steadily increased for both inpatient care types to 821,913 (status 31 March 2021). The Barthel index and other assessment results show differentiated values between acute geriatrics and continuing geriatric rehabilitation. CONCLUSION: The results demonstrate the differences in patient outcomes between the two types of care as well as changes in the setting over time. The constancy of the applied assessment instruments contributes to the comparability of the different hospitals; however, it is necessary to introduce new and alternative assessment instruments and to further develop inpatient geriatrics.

[Effectiveness of geriatric rehabilitation in the oldest old: evaluation of South German observational data]. / Wirksamkeit geriatrischer Rehabilitation bei Hochbetagten : Eine Auswertung süddeutscher Versorgungsdaten.

BACKGROUND: Geriatric rehabilitation might be the only way for the very old to maintain their participation in social life, since in many cases self care, everyday skills and basic activities of daily living can only be recovered by an integrative treatment approach using a multiprofessional team setting. At the same time limited financial resources in health care have to be considered to make appropriate allocation decisions in geriatric rehabilitation. PURPOSE: The goal of this work was to determine whether chronological age is a limiting factor for functional outcome in geriatric rehabilitation. MATERIALS AND METHODS: Data from the state of Baden-Württemberg (KODAS data set) from the years 2005-2011 for nonagenarians and data for centenarians from the Geriatrics in Bavaria database (GiB-DAT) project from the years 2003-2011 were compared to the data of the younger seniors undergoing geriatric rehabilitation. For the KODAS data collection, 31 geriatric rehabilitation clinics in Baden-Württemberg were involved. The GiB-DAT project included 59 geriatric rehabilitation clinics in Bavaria. Both databases compare the results of the geriatric assessment at the beginning and at the end of geriatric rehabilitation. RESULTS: The analyzed data are presented with regard to the functional outcome in the very elderly and are discussed with respect to policy implications.

[Implementation and results of a geriatric medication database]. / Aufbau und Ergebnisse einer geriatrischen Medikamentendatenbank.

BACKGROUND: The aim of this project was to obtain information about drug therapy in geriatric units. PATIENTS AND METHODS: Members of the geriatrics in Bavaria database (GiB-DAT) collected data on discharge medication and transferred them to the database. A total of 88,840 data sets of geriatric rehabilitation clinics and acute geriatric units were evaluated according to the anatomical therapeutic chemical (ATC) system. RESULTS: Patients (mean age: 81.1 years, female 67.7%) had an average of 10.4 diagnoses and took 8.0 drugs at discharge. A peak number of prescribed drugs was reached at the age of 60-70 years with a decrease in the following decades of life. Female patients received more drugs, significantly those in the decades from 71 to 80 and 81 to 90 years old. The bulk of the drugs were from the ATC groups "Cardiovascular system" (89.9%), "Nervous system" (82.3%) and "Alimentary tract and metabolism" (78%).

[Geriatrics in Bavaria-Database (GiB-DAT): Conception, structure and results of implementation (part I)]. / Geriatrie in Bayern-Datenbank (GiB-DAT): Konzept, Struktur und Ergebnisse der Implementation (Teil I).

In the year 2000, a database was implemented in Bavaria, covering the majority of geriatric clinics. Benchmarking statistics are generated in quarterly periods and scientifically analyzed. Actually, 41 of the 57 geriatric clinics in Bavaria participate in the project 'Geriatrics in Bavaria-Database' (GiB-DAT). For geriatric rehabilitation, the coverage is 82.4%. In addition, all 7 geriatric day clinics participate; thus, a total of 24,000 cases are documented each year. Therefore, GiB-DAT is the largest database for geriatric rehabilitation in Germany and Europe. To make documentation more effective and easy, new software (GERIDOCTM) has been generated which is integrated in the process of daily treatment. GiB-DAT offers good data quality, especially concerning completeness of items. This manuscript describes conception and construction of GiB-DAT and identifies differences compared to the Geriatric Minimum-Dataset (GEMIDAS), a nationwide geriatric database in Germany.

[Geriatrics in Bavaria-Database (GiB-DAT): Basic data analysis of geriatric rehabilitation in Bavaria and analysis of inter-clinic variability (part II)]. / Geriatrie in Bayern-Datenbank (GiB-DAT): Patientenstrukturen und Ergebnisse der geriatrischen Rehabilitation. Eine erste statistische Analyse von Benchmarking-Parametern (Teil II).

OBJECTIVE: Presentation and comparison of basic data from geriatric rehabilitation in Bavaria with analysis of statistical influences on characteristic values like length of stay and Barthel Index. Are differences between participating clinics due to patient characteristics? SETTING: There were a total of 21 656 data records of the Geriatrics in Bavaria- Database (GiB-DAT) collected by 35 clinics within 1 year. RESULTS (PERCENTAGE OR MEAN): 70.6% female patients, age 80.0 years, 95.9% enrollment from acute care hospitals, length of stay in previous hospitals 24.3 days, length of stay in geriatric rehabilitation 24.6 days. DIAGNOSIS: 41.7% orthopedics, 24.9% neurological, 33.4% others. Barthel Index on admission 44.1 points, on discharge 65.8 points (difference 21.8 points). We found a large variance of all items between participating clinics. Variance for Barthel Index and length of stay is partly cleared up by regression analysis (multinomial logistic) and is mostly due to patient characteristics. CONCLUSIONS: Basic data of Bavarian geriatric rehabilitation clinics is matching with nationwide reference statistics. Differences exist for the lower rate of stroke and direct enrollment of outpatients. A simple ranking of outcome parameters (e. g. Barthel Index) does not make sense due to multiple influencing factors.