{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T09:21:01Z","timestamp":1787822461387,"version":"build-2784847793"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000909","name":"John A. Hartford Foundation","doi-asserted-by":"publisher","award":["2020\u20100056"],"award-info":[{"award-number":["2020\u20100056"]}],"id":[{"id":"10.13039\/100000909","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K01AG073533"],"award-info":[{"award-number":["K01AG073533"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Age\u2010Friendly 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational study of 28,833 hospital encounters for patients aged \u2265\u200965 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\u2010day readmissions. Multivariable regression was completed to assess the relationship between 4Ms adherence and health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Inpatient Geriatrics models improve adherence to Age\u2010Friendly care practices, but their effects on outcomes are mixed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70666","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T08:52:00Z","timestamp":1787820720000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of\n                    <scp>ACE<\/scp>\n                    Units and Geriatrics Consults on Adherence to the\n                    <scp>4Ms<\/scp>\n                    and Patient Outcomes"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8609-6338","authenticated-orcid":false,"given":"Sandra","family":"Zeng","sequence":"first","affiliation":[{"name":"John A. Burns School of Medicine  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0262-6491","authenticated-orcid":false,"given":"Julia","family":"Adler\u2010Milstein","sequence":"additional","affiliation":[{"name":"Division of Clinical Informatics and Digital Transformation University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Thombley","sequence":"additional","affiliation":[{"name":"Division of Clinical Informatics and Digital Transformation University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7761-7039","authenticated-orcid":false,"given":"James D.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melody","family":"Luo","sequence":"additional","affiliation":[{"name":"Division of Geriatrics University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. John","family":"Boscardin","sequence":"additional","affiliation":[{"name":"Division of Geriatrics University of California  San Francisco California USA"},{"name":"Department of Epidemiology and Biostatistics University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9678-8522","authenticated-orcid":false,"given":"Sarah","family":"Ngo","sequence":"additional","affiliation":[{"name":"Division of Geriatrics University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Rogers","sequence":"additional","affiliation":[{"name":"Division of Geriatrics University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjq.2024.02.003"},{"key":"e_1_2_12_3_1","unstructured":"\u201cAge\u2010Friendly Health Systems Recognized Health Care Sites \u201dInstitute for Healthcare Improvement (2025) https:\/\/www.ihi.org\/age\u2010friendly\u2010health\u2010systems\u2010recognized\u2010health\u2010care\u2010sites."},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199505183322006"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/geriatrics3030059"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.2000.tb03866.x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2012.0142"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.outlook.2015.11.014"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2017.10.011"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17788"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.1990.tb01368.x"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199505183322007"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010110\u20101\u201079"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.1987.tb06350.x"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afl102"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.2011.03488.x"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/00469580251334511"},{"key":"e_1_2_12_18_1","unstructured":"\u201cAssessing Equitable Adherence to the Age\u2010Friendly Health System's 4Ms Framework in an Academic Inpatient Setting \u2013 PubMed \u201d(2025) https:\/\/pubmed\u2010ncbi\u2010nlm\u2010nih\u2010gov.eres.library.manoa.hawaii.edu\/39314001\/."},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18722"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.7819"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70666","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.70666","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70666","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T08:52:01Z","timestamp":1787820721000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.70666"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":19,"alternative-id":["10.1111\/jgs.70666"],"URL":"https:\/\/doi.org\/10.1111\/jgs.70666","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]},"assertion":[{"value":"2025-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jgs.70666"}}