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First author Taiwo A Kuye MD Co


Authors -author James F Hanley III MDTitle You get what you pay for the failure to document Functional Status in Hospitalized Elderly PatientsIntroductionFunctional status and cognitive function are t

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Document on Subject : "First author Taiwo A Kuye MD Co"— Transcript:

1 Authors: First author: Taiwo A. Kuye, M
Authors: First author: Taiwo A. Kuye, MD; Co - author: James F. Hanley III, MD. Title: You get what you pay for: the failure to document Functional Status in Hospitalized Elderly Patients. Introduction: Functional status and cognitive function are two important predictors of health care outcome in hospitalized elderly patients. Centers for Medicare & Medicaid Services (CMS) pays for the care of most elderly patients and it requires the documentation of specific items for optimal reimbursement. Some it ems, such as functional status, have good prognostic values but are not required; while others such as family history and review of systems often have little effect in the care or the prognosis in acutely hospitalized elderly patients. In light of this f inancial incentive, we hypothesized that there would be little documentation of functional status, compared to review of system (ROS) and family history (FH). Methods Single center retrospective chart review of one hundred (100) elderly patients,� age 65 years old who were hospitalized at a community hospital over one year. Patients 65 years old, with advanced dementia or intubated were excluded. Items reviewed include Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADLs) , cognitive status, ROS and FH. Results Demographically, there were nearly an equal number of male and female patients. Majority of the reviewed charts ha d no documentation of ADLs and IADLs, 18% and 2% respectively, mobility was 37%, cognitive function - 2% and confusion Assessment was documented in 1%; whereas, ROS and FH were consistently documented in 100% and 78% of the charts, respectively. Conclusion We found excellent compliance and documentation with items required by CMS, but poor documentati on of items that may have greater prognostic value in geriatric patients. If we are to provide meaningful care to the elderly patient, it is crucial that we focus on, and properly document, the elements of the H&P with good prognostic values while elimina ting those with little to no prognostic value.