Observational studyInquiry : a journal of medical care organization, provision and financing
Assessing Equitable Adherence to the Age-Friendly Health System's 4Ms Framework in an Academic Inpatient Setting.
Observational study in Inquiry : a journal of medical care organization, provision and financing. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Impact of ACE Units and Geriatrics Consults on Adherence to the 4Ms and Patient Outcomes.Journal of the American Geriatrics Society · 2026Article
- From 4Ms to 5 domains: ensuring new CMS Age-Friendly hospital measure improves care for older adults.Health affairs scholar · 2025Article
- Outcomes Evidence Must Keep Up with the Implementation of the 4Ms Framework to Ensure Age-Friendly Health System Transformation.Inquiry : a journal of medical care organization, provision and financingArticle
- Age Friendly Health Systems: Pivoting from Breadth to Depth.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
While thousands of health systems have begun to implement the Age-Friendly Health System's 4Ms Framework to improve care for older patients, an important phase of work is achieving consistent adherence to 4Ms care processes. Identifying mechanisms that may lead to higher versus lower adherence serves to guide efforts to achieve consistent, equitable adherence. Drawing from prior literature, we identified three mechanisms that may influence 4Ms adherence. We then conducted a 3-year retrospective, observational study of inpatient encounters (n = 28 833) at UCSF Health System with patients aged 65+. We used least squares regression models to assess associations between hospital encounter-level measures of 4Ms adherence and proxy measures of patient and encounter characteristics for each hypothesized mechanism along with control variables. Encounter-level adherence to the 4Ms was 65.5% (SD = 14.3%). We found support for all three mechanisms. Negative implicit biases were associated with lower adherence for patients who were obese [0.79 percentage points (PP) lower;
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