Methodologic issues in conducting research on hospitalized older people

J Am Geriatr Soc. 2001 Feb;49(2):172-8. doi: 10.1046/j.1532-5415.2001.49039.x.

Abstract

Objective: To describe challenges in conducting research with hospitalized geriatric patients.

Design: Quasi-experimental longitudinal study with inperson interviews at baseline and discharge and a three-month postdischarge telephone interview. Study protocol required baseline interviews within 48 hours of admission for patients or 72 hours for proxies.

Setting: 813-bed urban teaching hospital.

Participants: 240 patients, mean age 83.8 years, at moderate to high risk for functional decline during hospitalization, admitted from the emergency room to a general medical unit.

Measurements: Delays starting or interruptions continuing interviews; patient and environmental conditions potentially affecting data quality; and information on proxy use.

Results: Timely access to patients or proxies was a major difficulty, resulting in the screening of only 53.1% of 867 potentially eligible patients. Multiple patient contacts and visits were required to complete interviews. Only 61.3% of baseline and 28.1% of follow-up interviews were completed on the initial day of contact. Despite having on-site interviewers 7 days a week, 29% of discharge interviews were conducted by telephone. Interviews were >90% complete in 487 of 503 of encounters (97%). Baseline delays and interruptions were usually due to the presence of medical staff, off-unit tests, patient illness, nurse unavailability for interview, and need for a proxy. Most in-hospital interviews were conducted with others present. Proxies were required for approximately one-third of patients at all three interviews.

Conclusion: Conducting clinical research with older adults in the current inpatient setting, where patients are more severely ill yet have shorter lengths of stay now than in the past, proves a challenging yet achievable goal. Effective procedures for negotiating the acute care environment are critical to successful studies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute Disease
  • Aged*
  • Aged, 80 and over
  • Attitude to Health
  • Data Collection / methods
  • Evaluation Studies as Topic
  • Geriatrics / standards
  • Guidelines as Topic
  • Health Services Research / methods*
  • Hospitalization*
  • Humans
  • Inpatients*
  • Interviews as Topic / methods
  • Length of Stay
  • Longitudinal Studies
  • New York City
  • Outcome Assessment, Health Care / organization & administration*
  • Patient Selection
  • Quality of Health Care
  • Research Design / standards*
  • Severity of Illness Index
  • Surveys and Questionnaires