GOT Care! 2.0: A Secondary Analysis of an Interprofessional Geriatric Care Model

TL;DR

GOT Care! 2.0 is an improved geriatric care model that reduces emergency department use and healthcare costs for older adults through interprofessional education and home-based care.

Contribution

The study presents a secondary analysis of a geriatric care model, revealing cost reductions and risk factors for healthcare utilization.

Findings

Direct medical costs were significantly reduced in the post-program period compared to the pre-program period.

Multiple factors influencing medical expenditures at 6 and 12 months were identified.

An in-home interprofessional geriatric service pilot was launched based on the findings.

Abstract

Geriatric Outreach and Training with Care (GOT Care!) was created as a model for interprofessional geriatric education and practice. An interprofessional team of geriatric expert clinical faculty guided students from seven health professions in learning about and caring for chronically ill homebound older adults experiencing high emergency department (ED) use. The GOT Care! project was evaluated using the IHI Quadruple AIM framework and positive outcomes supported development of this model within a health system, however, gaps and need for further inquiry were also identified. GOT Care! 2.0, a secondary analysis of GOT Care! program data, was conducted with the aim of better understanding medical expenditures, healthcare utilization risk factors, and the observed reduction in ED visits for GOT Care! participants. Electronic health records, billing records and medical expenditures were extracted and analyzed for a 6 month pre- and post-program period. Direct costs were reduced significantly in the post-period (mean=$1,264.85) compared to the pre-period (mean=$4,457.44) (p < 0.001) and at 12 months (p < 0.001). Multiple factors associated with the likelihood of increased or decreased medical expenditures at 6 and 12 months were identified. With the support of the findings of the secondary analysis, an in-home interprofessional geriatric service pilot was launched. This pilot was based on the GOT Care! model and integrates the IHI Age-Friendly health system criteria focused on improving the IHI Quadruple AIM for a health system’s vulnerable older adult population.