Evidence map›Paper›PMID 42657482›Full record

ArticleJournal of the American Geriatrics Society2026

Impact of ACE Units and Geriatrics Consults on Adherence to the 4Ms and Patient Outcomes.

Sandra Zeng, Julia Adler-Milstein, Robert Thombley, James D Harrison, Melody Luo, W John Boscardin, Sarah Ngo, Stephanie Rogers

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In one paragraph

Article in Journal of the American Geriatrics Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sandra ZengJohn A. Burns School of Medicine, Honolulu, Hawaii, USA.ORCID https://orcid.org/0000-0001-8609-6338
Julia Adler-MilsteinDivision of Clinical Informatics and Digital Transformation, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-0262-6491
Robert ThombleyDivision of Clinical Informatics and Digital Transformation, University of California, San Francisco, California, USA.
James D HarrisonDivision of Hospital Medicine, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-7761-7039
Melody LuoDivision of Geriatrics, University of California, San Francisco, California, USA.
W John BoscardinDivision of Geriatrics, University of California, San Francisco, California, USA.
Sarah NgoDivision of Geriatrics, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0001-9678-8522
Stephanie RogersDivision of Geriatrics, University of California, San Francisco, California, USA.

Funding

Placing patient preferences at the center of care plans for older adults transitioning from the hospital to a skilled nursing facilityK01AG073533 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HARRISON, JAMES DAVID · 2021 to 2025
$660k
2024 4Ms Spread Collaborative CohortInstitute for Healthcare Improvement as an Age-Friendly Health SystemJohn A. Hartford Foundation 2020-0056Medical Student Training in Aging ResearchNIA NIH HHS K01 AG073533NIA NIH HHS K01AG073533
6 · The paper itself

Abstract

backgroundThe Age-Friendly Health Systems (AFHS) movement, guided by the 4Ms framework has been widely adopted to improve care for older adults. While specialized inpatient models such as Acute Care for Elders (ACE) units and Geriatrics Consults aim to improve outcomes, gaps remain in understanding how these models align with 4Ms adherence and their relationship to patient outcomes.

methodsWe conducted a retrospective observational study of 28,833 hospital encounters for patients aged ≥ 65 at an academic health system. Encounters were categorized into four groups: Usual Care, Geriatrics Consult, ACE Unit, and ACE Unit and Consult. Adherence to each M and a composite 4Ms score was derived from 16 process measures. Outcomes included falls, length of stay, discharge to a facility, and 30-day readmissions. Multivariable regression was completed to assess the relationship between 4Ms adherence and health outcomes.

resultsPatients receiving any Geriatrics clinical model had higher overall 4Ms adherence than usual care. High 4Ms adherence was associated with lower readmissions in the Consult Only group but higher readmissions in the ACE + Consult group. Facility discharge rates increased with high adherence in Consult and ACE + Consult groups. No group differences were observed in falls. ACE Unit patients with high adherence showed shorter lengths of stay, whereas Consult groups had longer stays.

conclusionInpatient Geriatrics models improve adherence to Age-Friendly care practices, but their effects on outcomes are mixed.

Indexed as

4MsACE unitsage‐friendly health systemsinpatient geriatrics consults

Identifiers

PMID42657482
PMCPMC13587902

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.