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Aim: That geriatric evaluation and management (GEM) is associated with better quality of care for elderly patients has been reported by previous studies, but evidence supporting that GEM can reduce the burden of morbidity (BOM) was lacking. The aim of this study was to evaluate the benefits of outpatient GEM on reducing BOM and medical utilization in Taiwan. Methods: Data of this retrospective case-control study were obtained from the 2004-2006 Taiwan National Health Insurance Research Database (NHIRD). Patients who attended the outpatient GEM program for over 6 months in a tertiary medical center in 2005 were enrolled as the case group, and a 1:5 age and gender-matched control group was formed by randomly-selected patients from the same medical center for comparisons. BOM was obtained by applying the Adjusted Clinical Group (ACG) program, and medical utilization variables were totalled for each patient from the NHIRD. Patients were further reassigned to two morbidity categories, the low (resource utilization bands ≤ 3) and high (resource utilization bands > 3) morbidity category, according to their degree of morbidity before statistical analyses. Results: Data of 4254 elderly patients (709 cases, 3545 controls) were included in the study. BOM and medical utilization were increased in both groups in both morbidity categories during the study period. However, the growth of BOM, total medical expenditure, number of emergency department visit, and days and expenditure of hospitalization were significantly reduced in the case than the control group in the low morbidity category, not the high morbidity category. Conclusion: Outpatient GEM could effectively reduce growth of BOM and medical utilization for relatively healthy elderly patients in Taiwan where elderly patients haverelatively free access to general and specialty care. The results of this study implied the potential benefits of systematically implementing GEM in primary health-care settings to improve the quality of care and slow down the growth of BOM for elderly patients. Geriatr Gerontol Int 2012; ••: ••-••. [ABSTRACT FROM AUTHOR]

Thirty-one cases of severe acute respiratory syndrome (SARS) occurred after exposure in the emergency room at the National Taiwan University Hospital. The index patient was linked to an outbreak at a nearby municipal hospital. Three clusters were identified over a 3-week period. The first cluster (5 patients) and the second cluster (14 patients) occurred among patients, family members, and nursing aids. The third cluster (12 patients) occurred exclusively among healthcare workers. Six healthcare workers had close contact with SARS patients. Six others, with different working patterns, indicated that they did not have contact with a SARS patient. Environmental surveys found 9 of 119 samples of inanimate objects to be positive for SARS coronavirus RNA. These observations indicate that although transmission by direct contact with known SARS patients was responsible for most cases, environmental contamination with the SARS coronavirus may have lead to infection among healthcare workers without documented contact with known hospitalized SARS patients. [ABSTRACT FROM AUTHOR]