In a commentary in last October's edition of JAMA, Walter Ettinger, MD, of the division of geriatric medicine at the University of Massachusetts Medical School agreed that new onset hospitalization-associated disability is a serious problem.
But he also noted that the phenomenon "is virtually ignored by healthcare professionals and policy makers."
"One reason for this lack of awareness is that health-related quality of life and sustainability of independence are not measured as outcomes of Care. The Centers for Medicare & Medicaid Services publishes hospital quality measures on its Hospital Compare Web site, but neither the current nor proposed hospital quality metrics measure health-related quality of life."
In their paper JAMA last year, the San Francisco physicians examined several ACE units around the country and concluded that ACE units can reduce hospital length of stay and the resulting cost savings may be greater than the added costs of the unit." They also can improve patient and provider satisfaction.
They advocate a re-engineering of hospital care "that focuses on function, including assessment on admission, and throughout the hospital stay, promoting physical activity, avoiding hospital processes and complications that impair functional recovery" are among strategies that "may reduce the incidence of hospitalization-associated disability."