National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (4)
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- (-) Elderly (129)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 129 Research Studies DisplayedShah MN, Wasserman EB, Gillespie SM
High-intensity telemedicine decreases emergency department use for ambulatory care sensitive conditions by older adult senior living community residents.
The aim of this study was to assess the effect of a high-intensity telemedicine program for senior living community (SLC) residents on the rate of Emergency department (ED) visits for ambulatory care sensitive conditions (ACSCs). It found that providing acute illness care by high-intensity telemedicine to older adults residing in SLCs significantly decreases the rate of ED use for ACSCs over 1 year.
AHRQ-funded; HS018047.
Citation: Shah MN, Wasserman EB, Gillespie SM .
High-intensity telemedicine decreases emergency department use for ambulatory care sensitive conditions by older adult senior living community residents.
J Am Med Dir Assoc 2015 Dec;16(12):1077-81. doi: 10.1016/j.jamda.2015.07.009..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Emergency Department, Healthcare Utilization, Long-Term Care
Lairson DR, Parikh RC, Cormier JN
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
The researchers assessed the cost-effectiveness of chemotherapy regimens by age and disease stage under "real-world" conditions for patients with breast cancer. They found that anthracycline-based chemotherapy was found cost-effective for elderly patients with early stage (stage I, II, IIIa) breast cancer considering the US threshold of $100,000 per QALY.
AHRQ-funded; HS018956.
Citation: Lairson DR, Parikh RC, Cormier JN .
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
Value Health 2015 Dec;18(8):1070-8. doi: 10.1016/j.jval.2015.08.008..
Keywords: Cancer: Breast Cancer, Treatments, Healthcare Costs, Elderly, Social Determinants of Health
Johnson SL, Palta M, Bartels CM
Examining systemic steroid use in older inflammatory bowel disease patients using hurdle models: a cohort study.
In order to evaluate the relationship between patient characteristics and the frequency and duration of incident steroid use, the researchers applied a 2-part hurdle model to Medicare data. Their study identified differences in predictors of frequency and duration of medication use and suggests the utility of two-part models to examine drug utilization patterns.
AHRQ-funded; HS022786.
Citation: Johnson SL, Palta M, Bartels CM .
Examining systemic steroid use in older inflammatory bowel disease patients using hurdle models: a cohort study.
BMC Pharmacol Toxicol 2015 Dec 8;16:34. doi: 10.1186/s40360-015-0034-9..
Keywords: Elderly, Medicare, Medication
Nadpara P, Madhavan SS, Tworek C
Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: a population-based study.
This study evaluated the variations in guideline-concordant timely lung cancer care and prognosis among elderly in the US. It found that the time to diagnosis and treatment varied significantly among the elderly. However, 77.5 percent received guideline-concordant timely lung cancer care. The likelihood of receiving timely care significantly decreased with early stage diagnosis, increasing age, non-white race, higher comorbidity score, and lower income.
AHRQ-funded; HS018622.
Citation: Nadpara P, Madhavan SS, Tworek C .
Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: a population-based study.
Cancer Epidemiol 2015 Dec;39(6):1136-44. doi: 10.1016/j.canep.2015.06.005.
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Keywords: Cancer: Lung Cancer, Elderly, Guidelines, Disparities, Diagnostic Safety and Quality
Bali V, Chatterjee S, Carnahan RM
Risk of dementia among elderly nursing home patients using paroxetine and other selective serotonin reuptake inhibitors.
This study evaluated the comparative risk of dementia associated with use of paroxetine and other selective serotonin reuptake inhibitors (SSRIs) among elderly nursing home patients. It found that compared with use of other SSRIs, use of paroxetine was not associated with higher risk of dementia among elderly nursing home patients with depression.
AHRQ-funded; HS021264.
Citation: Bali V, Chatterjee S, Carnahan RM .
Risk of dementia among elderly nursing home patients using paroxetine and other selective serotonin reuptake inhibitors.
Psychiatr Serv 2015 Dec;66(12):1333-40. doi: 10.1176/appi.ps.201500011.
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Keywords: Adverse Drug Events (ADE), Dementia, Elderly, Nursing Homes, Medication
Batsis JA, Mackenzie TA, Lopez-Jimenez F
Sarcopenia, sarcopenic obesity, and functional impairments in older adults: National Health and Nutrition Examination Surveys 1999-2004.
The researchers tested the hypothesis that the prevalence of sarcopenia and sarcopenic obesity would be similar based on the different NIH criteria, increase with age, and be associated with risk of impairment limitations. They concluded that the prevalence of sarcopenia and sarcopenic obesity varies greatly, and a uniform definition is needed to identify and characterize these high-risk populations.
AHRQ-funded; HS021695.
Citation: Batsis JA, Mackenzie TA, Lopez-Jimenez F .
Sarcopenia, sarcopenic obesity, and functional impairments in older adults: National Health and Nutrition Examination Surveys 1999-2004.
Nutr Res 2015 Dec;35(12):1031-9. doi: 10.1016/j.nutres.2015.09.003.
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Keywords: Elderly, Obesity, Chronic Conditions, Health Status
Yun H, Xie F, Delzell E
The comparative effectiveness of biologics among older adults and disabled rheumatoid arthritis patients in the Medicare population.
Older and disabled rheumatoid arthritis (RA) patients are often not present in large numbers in clinical trials or registries. Using a novel, claims-based clinical effectiveness algorithm with the potential to compare the effectiveness of different biologics among this population using large administrative databases, researchers found that abatacept, adalimumab and etanercept are more effective than infliximab among RA patients initiating biologics.
AHRQ-funded; HS021694; HS023009; HS018517.
Citation: Yun H, Xie F, Delzell E .
The comparative effectiveness of biologics among older adults and disabled rheumatoid arthritis patients in the Medicare population.
Br J Clin Pharmacol 2015 Dec;80(6):1447-57. doi: 10.1111/bcp.12709.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Elderly, Arthritis, Medicare
Sanghavi P, Jena Newhouse, JP
Outcomes of basic versus advanced life support for out-of-hospital medical emergencies.
The researchers compared outcomes after advanced life support (ALS) and basic life support (BLS) in out-of-hospital medical emergencies. They found that advanced life support is associated with substantially higher mortality for several acute medical emergencies than BLS.
AHRQ-funded; HS022798.
Citation: Sanghavi P, Jena Newhouse, JP .
Outcomes of basic versus advanced life support for out-of-hospital medical emergencies.
Ann Intern Med 2015 Nov 3;163(9):681-90. doi: 10.7326/m15-0557..
Keywords: Elderly, Medicare, Emergency Medical Services (EMS), Outcomes
Sutkowi-Hemstreet A, Vu M, Harris R
Adult patients' perspectives on the benefits and harms of overused screening tests: a qualitative study.
This study determined how patients think about the harms and benefits of overused screening tests and how they consider these and other factors when making decisions. It found that many patients could not name a harm of screening. When they did name harms, patients often focused on only the harms of the screening test itself and rarely mentioned harms further along the screening cascade.
AHRQ-funded; HS021133.
Citation: Sutkowi-Hemstreet A, Vu M, Harris R .
Adult patients' perspectives on the benefits and harms of overused screening tests: a qualitative study.
J Gen Intern Med 2015 Nov;30(11):1618-26. doi: 10.1007/s11606-015-3283-9.
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Keywords: Prevention, Screening, Patient Experience, Elderly, Education: Patient and Caregiver
Pezzin LE, Pollak RA, Schone BS
AHRQ Author: Schone BS
Bargaining power, parental caregiving, and intergenerational coresidence.
The researchers examined the effect of changes in parent–child coresidence on caregiving decisions of non-resident siblings over a 5-year period while controlling for characteristics of the elderly parent and adult children in the family network. They found that find that children whose parent and sibling begin coresiding during the study period are less likely to provide care and provide fewer hours of care than children whose parents never coresided with a child.
AHRQ-authored.
Citation: Pezzin LE, Pollak RA, Schone BS .
Bargaining power, parental caregiving, and intergenerational coresidence.
J Gerontol B Psychol Sci Soc Sci 2015 Nov;70(6):969-80. doi: 10.1093/geronb/gbu079..
Keywords: Caregiving, Elderly
Simmons SF, Keeler E, An R
Cost-effectiveness of nutrition intervention in long-term care.
The researchers sought to determine the cost-effectiveness of two nutrition interventions on food, beverage, and supplement intake and body weight. They found that oral liquid nutrition supplements and snack offers were efficacious in promoting caloric intake when coupled with assistance to promote consumption and a variety of options, but neither intervention resulted in significant weight gain.
AHRQ-funded; HS018580.
Citation: Simmons SF, Keeler E, An R .
Cost-effectiveness of nutrition intervention in long-term care.
J Am Geriatr Soc 2015 Nov;63(11):2308-16. doi: 10.1111/jgs.13709..
Keywords: Elderly, Long-Term Care, Nursing Homes, Nutrition, Comparative Effectiveness
Pfoh E, Mojtabai R, Bailey J
Impact of Medicare annual wellness visits on uptake of depression screening.
This study assessed whether patients with an initial annual wellness visit (AWV) were more likely to be screened for depression than those with a primary care visit. Fifteen percent of patients with non-AWVs and 10 percent of patients with AWVs received depression screening. After accounting for clustering, there was no statistically significant difference in depression screening by visit type.
AHRQ-funded; HS000029.
Citation: Pfoh E, Mojtabai R, Bailey J .
Impact of Medicare annual wellness visits on uptake of depression screening.
Psychiatr Serv 2015 Nov;66(11):1207-12. doi: 10.1176/appi.ps.201400524.
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Keywords: Depression, Screening, Medicare, Elderly, Primary Care
Kenzik KM, Morey MC, Cohen HJ
Symptoms, weight loss, and physical function in a lifestyle intervention study of older cancer survivors.
This study examined how overweight long-term survivors’ symptom severity associated with comorbidity prior to a diet and exercise intervention was associated with post-intervention function. It found that symptom severity of older, overweight cancer survivors negatively affects physical function. However, greater weight loss and more physical activity were associated with higher functioning scores, regardless of symptom severity.
AHRQ-funded; HS013852.
Citation: Kenzik KM, Morey MC, Cohen HJ .
Symptoms, weight loss, and physical function in a lifestyle intervention study of older cancer survivors.
J Geriatr Oncol 2015 Nov;6(6):424-32. doi: 10.1016/j.jgo.2015.08.004..
Keywords: Cancer, Elderly, Obesity, Nutrition
Ndumele CD, Sommers BD, Trivedi AN
The ACA's 65th birthday challenge: moving from Medicaid to Medicare.
Following the Affordable Care Act’s coverage expansion, many newly-insured older enrollees will lose Medicaid coverage on their 65th birthday and transition from Medicaid to Medicare as their primary insurer. This article discusses the transition in primary health insurance coverage that includes changes to benefits, patient cost-sharing, and provider reimbursement, which could have profound consequences on the use of health services and associated health outcomes for low-income seniors.
AHRQ-funded; HS021291.
Citation: Ndumele CD, Sommers BD, Trivedi AN .
The ACA's 65th birthday challenge: moving from Medicaid to Medicare.
J Gen Intern Med 2015 Nov;30(11):1704-6. doi: 10.1007/s11606-015-3328-0..
Keywords: Health Insurance, Medicare, Elderly, Low-Income
Singh S, Lin YL, Nattinger AB
Variation in readmission rates by emergency departments and emergency department providers caring for patients after discharge.
This study of Texas acute-care hospitals and ED facilities has found that the risk of readmission varies by ED provider caring for patients after discharge. A large part of this variation is explained by the ED facility in which the ED providers practice. Thus, ED provider practices patterns and ED facility systems of care may be a target for interventions to reduce readmissions.
AHRQ-funded; HS022134.
Citation: Singh S, Lin YL, Nattinger AB .
Variation in readmission rates by emergency departments and emergency department providers caring for patients after discharge.
J Hosp Med 2015 Nov;10(11):705-10. doi: 10.1002/jhm.2407.
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Keywords: Emergency Department, Elderly, Hospital Discharge, Hospital Readmissions, Medicare
Huang ES, Davis AM
Glycemic control in older adults with diabetes mellitus.
These comprehensive guidelines emphasize an individualized approach to diabetes care goals and treatment among adults. The glycemic control recommendations suggest a general goal for glycated hemoglobin (HbA1c) in older adults of 7.5 percent to 8.0 percent (level IA evidence). A target HbA1c level between 7.0 percent and 7.5 percent may be appropriate if it can be safely achieved in healthy older adults.
AHRQ-funded; HS018542.
Citation: Huang ES, Davis AM .
Glycemic control in older adults with diabetes mellitus.
JAMA 2015 Oct 13;314(14):1509-10. doi: 10.1001/jama.2015.8345..
Keywords: Diabetes, Guidelines, Patient-Centered Outcomes Research, Elderly, Quality Improvement
Peterson LR, Wright MO, Beaumont JL
Nonimpact of decolonization as an adjunctive measure to contact precautions for the control of methicillin-resistant Staphylococcus aureus transmission in acute care.
This was an observational study comparing methicillin-resistant Staphylococcus aureus (MRSA) transmission with no decolonization of medical patients to required decolonization of all MRSA carriers during two consecutive periods: baseline with no decolonization of medical patients and universal MRSA carrier decolonization. The study concluded that decolonization of MRSA patients does not add benefit when contact precautions are used for patients colonized with MRSA in acute (hospital) care.
AHRQ-funded; HS019968.
Citation: Peterson LR, Wright MO, Beaumont JL .
Nonimpact of decolonization as an adjunctive measure to contact precautions for the control of methicillin-resistant Staphylococcus aureus transmission in acute care.
Antimicrob Agents Chemother 2015 Oct 12;60(1):99-104. doi: 10.1128/aac.02046-15.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Critical Care, Antimicrobial Stewardship, Elderly, Patient Safety
Singh JA, Ramachandran R
Age-related differences in the use of total shoulder arthroplasty over time: use and outcomes.
The authors assessed the age-related differences in the use of total shoulder arthroplasty (TSA) and outcomes, and associated time-trends using the United States Nationwide Inpatient Sample (NIS) between 1998 and 2010. They noted a time-related increase in the use of TSA and increasing age-related differences in outcomes indicating a changing epidemiology of the use of TSA and concluded that age-related differences in outcomes suggest that attention should focus on groups with the worst outcomes.
AHRQ-funded; HS021110.
Citation: Singh JA, Ramachandran R .
Age-related differences in the use of total shoulder arthroplasty over time: use and outcomes.
Bone Joint J 2015 Oct;97-b(10):1385-9. doi: 10.1302/0301-620x.97b10.35696.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Orthopedics, Surgery
Kuo YF, Goodwin JS, Chen NW
Diabetes mellitus care provided by nurse practitioners vs primary care physicians.
The study objective was to compare processes and cost of care of older adults with diabetes mellitus cared for by nurse practitioners (NPs) with processes and cost of those cared for by primary care physicians (PCPs). It concluded that nurse practitioners were similar to PCPs or slightly lower in their rates of diabetes mellitus guideline–concordant care.
AHRQ-funded; HS020642; HS022134.
Citation: Kuo YF, Goodwin JS, Chen NW .
Diabetes mellitus care provided by nurse practitioners vs primary care physicians.
J Am Geriatr Soc 2015 Oct;63(10):1980-8. doi: 10.1111/jgs.13662..
Keywords: Chronic Conditions, Diabetes, Elderly, Primary Care, Practice Patterns
Ning J, Peng S, Ueno N
Has racial difference in cause-specific death improved in older patients with late-stage breast cancer?
The researchers evaluated factors associated with overall, breast cancer-specific and other-cause mortalities using contemporary population data. They concluded that breast cancer-specific mortality among older women modestly improved from 2002 to 2009 across all races, but not other-cause mortality. Racial disparity in mortality persisted, but did not widen in this period.
AHRQ-funded; HS002026.
Citation: Ning J, Peng S, Ueno N .
Has racial difference in cause-specific death improved in older patients with late-stage breast cancer?
Ann Oncol 2015 Oct;26(10):2161-8. doi: 10.1093/annonc/mdv330.
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Keywords: Cancer, Cancer: Breast Cancer, Elderly, Mortality, Racial and Ethnic Minorities
Doll JA, Hellkamp A, Ho PM
Participation in cardiac rehabilitation programs among older patients after acute myocardial infarction.
This study identified opportunities to improve the use of cardiac rehabilitation by older adults. It concluded that quality improvement efforts should focus not only on increasing referral rates but also on addressing barriers to attending rehabilitation sessions, such as travel distance, copayments, and lack of coordination between inpatient and outpatient clinicians.
AHRQ-funded; HS021092.
Citation: Doll JA, Hellkamp A, Ho PM .
Participation in cardiac rehabilitation programs among older patients after acute myocardial infarction.
JAMA Intern Med 2015 Oct;175(10):1700-2. doi: 10.1001/jamainternmed.2015.3819..
Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions
Cantor SB, Deshmukh AA, Krahn MD
Use of forecasted assessment of quality of life to validate time-trade-off utilities and a prostate cancer screening decision-analytic model.
The researchers sought to determine whether the forecasted assessment of how someone would feel in a future health state can be predictive of utilities (e.g. as elicited by the time-trade-off method) and also predictive of optimal decisions as determined by a decision-analytic model. They concluded that anticipated difficulty adjusting to adverse health effects were highly related to preferences and could be used as a proxy measure of utility.
AHRQ-funded; HS08992.
Citation: Cantor SB, Deshmukh AA, Krahn MD .
Use of forecasted assessment of quality of life to validate time-trade-off utilities and a prostate cancer screening decision-analytic model.
Health Expect 2015 Oct;18(5):1610-20. doi: 10.1111/hex.12150.
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Keywords: Shared Decision Making, Cancer: Prostate Cancer, Elderly, Quality of Life, Screening
Culley CM, Perera S, Marcum ZA
Using a clinical surveillance system to detect drug-associated hypoglycemia in nursing home residents.
The authors determined whether a clinical surveillance system could be used to detect drug-associated hypoglycemia events and determine their incidence in nursing home (NH) residents. Their evaluation found a high incidence of drug-associated hypoglycemia in a general NH population.
AHRQ-funded; HS018721.
Citation: Culley CM, Perera S, Marcum ZA .
Using a clinical surveillance system to detect drug-associated hypoglycemia in nursing home residents.
J Am Geriatr Soc 2015 Oct;63(10):2125-9. doi: 10.1111/jgs.13648.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication: Safety, Medication, Nursing Homes
Gozalo P, Leland NE, Christian TJ
Volume matters: returning home after hip fracture.
This study examined the effect of the relationship between volume (number of hip fracture admissions during the 12 months before participant’s fracture) and other facility characteristics on outcomes. It concluded that in community-dwelling persons with their first hip fracture, successful return to the community varies substantially, according to skilled nursing facility provider volume and staffing characteristics.
AHRQ-funded; HS000011.
Citation: Gozalo P, Leland NE, Christian TJ .
Volume matters: returning home after hip fracture.
J Am Geriatr Soc 2015 Oct;63(10):2043-51. doi: 10.1111/jgs.13677..
Keywords: Injuries and Wounds, Elderly, Outcomes, Hospital Discharge
Valley TS, Sjoding MW, Ryan AM
Association of intensive care unit admission with mortality among older patients with pneumonia.
The purpose of this study was to estimate the relationship between ICU admission and outcomes for elderly patients with pneumonia. It concluded that among Medicare beneficiaries hospitalized with pneumonia, ICU admission of patients for whom the decision appeared to be discretionary was associated with improved survival and no significant difference in costs.
AHRQ-funded; HS020672.
Citation: Valley TS, Sjoding MW, Ryan AM .
Association of intensive care unit admission with mortality among older patients with pneumonia.
JAMA 2015 Sep 22-29;314(12):1272-9. doi: 10.1001/jama.2015.11068..
Keywords: Patient Safety, Intensive Care Unit (ICU), Elderly, Mortality, Hospitalization