In the present study we assessed the rate of implementation of recommendations given following geriatric assessment for home-ridden patients; a retrospective review of medical records to evaluate the implementation of geriatric recommendations given to patients in the Home Geriatric Service (HGS) between 2015 and 2016. The patients were categorized into two groups: the HGS-clinic (HGS-C) group, in which the primary care physician was responsible for implementation of the recommendations, and the HGS-home care (HGS-H) group, in which the responsibility for implementation of the recommendations was on the geriatrician. The results were compared with the implementation of recommendations in other ambulatory models for mobile patients—Clinic-Based Geriatric Assessment Services (CBGAS). The study included 865 patients. The highest rate of implementation was in the HGS-H group (85.7%), compared with 66.6% in the HGS-C group and 52.7% in the CBGAS group (p < 0.0001). In the logistic regression model for prediction of patients with implementation rates above 75%, the only variable that entered the prediction model was affiliation with the HGS-H group (odds ratio [OR] = 4.8, 95% confidence interval [CI] 2.3–9.6, p < 0.0001) or the HGS-C group (OR = 1.7, 95% CI 1.0–2.9, p = 0.046). The implementation rate for geriatric recommendations is higher for home-ridden patients compared with mobile patients, with the maximum recommendation rate in the subgroup, where geriatricians implemented the recommendations themselves. These findings raise the possibility that the most successful model, in terms of the implementation of recommendations, is the model in which implementation is carried out by the same staff that conducted the assessment.

中文翻译：

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医生对老年病学建议的实施：移动和居家患者老年病学评估模型的比较。

在本研究中，我们评估了对居家患者进行老年评估后给出的建议的执行率；对医疗记录进行回顾性审查，以评估 2015 年至 2016 年间家庭老年服务 (HGS) 中为患者提供的老年医学建议的实施情况。 患者分为两组：HGS 诊所 (HGS-C) 组，其中初级保健医生负责实施这些建议，而 HGS-家庭护理 (HGS-H) 小组则负责实施这些建议的责任在老年科医生身上。将结果与其他移动患者门诊模型中的建议实施情况进行了比较——基于临床的老年评估服务 (CBGAS)。该研究包括 865 名患者。p  < 0.0001)。在用于预测实施率高于 75% 的患者的逻辑回归模型中，进入预测模型的唯一变量是与 HGS-H 组的从属关系（优势比 [OR] = 4.8，95% 置信区间 [CI] 2.3– 9.6，p  < 0.0001）或 HGS-C 组（OR = 1.7，95% CI 1.0–2.9，p = 0.046）。与流动患者相比，居家患者的老年医学建议的实施率更高，在亚组中的建议率最高，在该亚组中，老年科医生自己实施了建议。这些发现提出了这样一种可能性，即在建议的实施方面，最成功的模式是由进行评估的同一工作人员实施的模式。