An overview of hospital-based models of care

The science of geriatric health care has evolved tremendously during the last 30 years including the development of several geriatric models of care across all healthcare settings. This chapter provides an overview of the various geriatric hospital models of care, including their objectives, unique strategies, and outcomes, including costs. Each geriatric care model may differ in its approach to prevent complications and address hospital factors that can contribute to complications, yet all embrace a common set of general objectives that refl ect the care domains of CGA: physical health, functional status, psychological health, and socioenvironmental parameters. These include patient-family-centric care, evidencebased geriatric screening, prevention and treatment, function-focused care, and discharge planning (or transitional care). Institutional approaches utilized by geriatric models of care address workforce issues as well as how the evidence-based geriatric care processes are embedded within the organizational structure of the hospital or health system. Specifi c models of care described include the consultative service or mobile ACE unit, NICHE, and HELP as well as evolving specialty models of care.