How Geriatric Neurology Patients' Preference Varies from Their Chief Compliant─ A Look into What Matters Section of Age-friendly Health System
Golnoush Akhlaghipour1, Jessica Zwerling1, Sara Shapouran1
1the Saul R Korey Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine
Objective:

To assess the primary concerns of geriatric inpatients, using the "What Matters Most" question from the Age-Friendly Health System (AFHS) framework, to guide more effective care, particularly in neurology, where individuals may have complex hospitalisation courses.

Background:

The AFHS, developed by the Institute for Healthcare Improvement (IHI), emphasises four essential elements (4 M's): What Matters, Medication, Mentation, and Mobility. This project, promoted by Montefiore Age Friendly Governance Committee, focuses on "What Matters" component, which prioritises aligning care with specific preferences of older adults.

Design/Methods:

A total of 58 patients aged 65 and older (22 males, 36 females), who were admitted at Montefiore Medical Center Neurology Department, from 6/15/2024 till 9/15/2024, were surveyed as part of this study. Patients who were unable to respond due to cognitive impairment or other conditions have been excluded. The patients were asked, "What matters most to you?”. Responses were categorised into six predefined categories:health recovery, shorter hospitalisation, hospital care, pain management, physical therapy/rehabilitation (PT/Rehab), social and family interaction, and safety. The percentage of patients identifying each category as their first or second priority was calculated. 

Results:

Among male patients(n=22), shorter hospital stay and PT/Rehab were equally important with 36% of men identifying each as a primary concern. In contrast, among female patients(n=36), shorter hospitalisation was consistently the top priority (41%), followed by health recovery(27%) and PT/rehab(11%). Across both groups, pain management and safety were mentioned by less than 10%. 

Conclusions:
Our study measures the importance of considering priorities of elderly patients when hospitalised, indicating a strong preference for shorter hospital stays and timely transition to rehabilitation or home, reflecting broader goals of the AFHS. Further exploration can be done on tailored needs, and considering strategic adjustment to shift non-urgent diagnostics and rehabilitation services to outpatient care, if aligns with overall care, which may improve outcome and optimise healthcare resources. 
10.1212/WNL.0000000000212074
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