National Healthcare Quality and Disparities Report
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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
26 to 50 of 57 Research Studies DisplayedDaiello LA, Gardner R, Epstein-Lubow G
Association of dementia with early rehospitalization among Medicare beneficiaries.
This study examined the question of whether dementia was associated with a greater likelihood of Medicare patients being readmitted to the hospital within 30 days. Using a group of 25,839 hospitalizations, including 3,908 admissions of Me.icare beneficiaries with dementia, it found that those with a dementia diagnosis were more likely (17.8 percent vs. 14.5 percent) to be readmitted within 30 days.
AHRQ-funded; HS017735.
Citation: Daiello LA, Gardner R, Epstein-Lubow G .
Association of dementia with early rehospitalization among Medicare beneficiaries.
Arch Gerontol Geriatr. 2014 Jul-Aug;59(1):162-8. doi: 10.1016/j.archger.2014.02.010..
Keywords: Medicare, Elderly, Dementia, Hospital Readmissions
Chrischilles EA, Hourcade JP, Doucette W
Personal health records: a randomized trial of effects on elder medication safety.
The purpose of this study was to compare patient-reported medication self-management behaviors and safety indicators among older adult participants invited to use an electronic personal health record (PHR). Among the 16.1 percent of participants who used the PHR frequently, there were significantly more changes in medication use, improved medication reconciliation behaviors, and more recognition of side effects.
AHRQ-funded; HS017034
Citation: Chrischilles EA, Hourcade JP, Doucette W .
Personal health records: a randomized trial of effects on elder medication safety.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):679-86. doi: 10.1136/amiajnl-2013-002284..
Keywords: Elderly, Medication, Medication: Safety, Health Information Technology (HIT), Patient Safety, Patient Self-Management
Daniels AH, Daiello LA, Lareau CR
Preoperative cognitive impairment and psychological distress in hospitalized elderly hip fracture patients.
The authors conducted a study to evaluate the prevalence of cognitive impairment (CI) compared with normal cognition (NC) in elderly hip fracture patients 65 years and older. Results showed many patients had unrecognized CI before surgery and had significantly more pain and fear than the NC group.
AHRQ-funded; HS017735
Citation: Daniels AH, Daiello LA, Lareau CR .
Preoperative cognitive impairment and psychological distress in hospitalized elderly hip fracture patients.
Ame J Orthop. 2014 Jul; 43(7):E146-52..
Keywords: Elderly, Injuries and Wounds, Neurological Disorders, Surgery
Tong L, Ahn C, Symanski E
Effects of newly developed chemotherapy regimens, comorbidities, chemotherapy-related toxicities on the changing patterns of the leading causes of death in elderly patients with colorectal cancer.
This study examined the effects of newly developed chemotherapy regimens, comorbidities, and chemotherapy-related toxicities on the changing patterns of the leading causes of death in elderly patients with colorectal cancer (CRC). It found that the risks of CRC-specific death decreased with diagnostic time periods only in chemotherapy recipients.
AHRQ-funded; HS018956
Citation: Tong L, Ahn C, Symanski E .
Effects of newly developed chemotherapy regimens, comorbidities, chemotherapy-related toxicities on the changing patterns of the leading causes of death in elderly patients with colorectal cancer.
Ann Oncol. 2014 Jun;25(6):1234-42. doi: 10.1093/annonc/mdu131..
Keywords: Elderly, Mortality, Treatments, Medicare
Wang CY, Graham JE, Karmarkar AM
FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture.
A major goal of this study was to identify which discharge functional independence measure (FIM)--total, motor, or cognition--best discriminates community versus institutional discharges. It found that the FIM motor scale yields the best overall discrimination of patients discharged to the community versus those discharged to an institution after inpatient rehabilitation for hip fracture.
AHRQ-funded; HS022134.
Citation: Wang CY, Graham JE, Karmarkar AM .
FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture.
PM & R 2014 Jun; 6(6):493-7. doi: 10.1016/j.pmrj.2013.12.008..
Keywords: Hospital Discharge, Injuries and Wounds, Elderly
Aparasu RR, Chatterjee S, Chen H
Risk of hospitalization and use of first- versus second-generation antipsychotics among nursing home residents.
This study examined the risk of all-cause hospitalization among dual-eligible elderly nursing home residents who were using antipsychotic medications and found that, on average, there was a 58 percent increase in hospitalization risk after 20 days of using a first-generation drug.
AHRQ-funded; HS016920
Citation: Aparasu RR, Chatterjee S, Chen H .
Risk of hospitalization and use of first- versus second-generation antipsychotics among nursing home residents.
Psychiatr Serv. 2014 Jun;65(6):781-8. doi: 10.1176/appi.ps.201300093..
Keywords: Long-Term Care, Medication, Hospitalization, Elderly, Risk
Jarvik JG, Comstock BA, Heagerty PJ
Back pain in seniors: the Back pain Outcomes using Longitudinal Data (BOLD) cohort baseline data.
Back pain, function, and health-related quality of life varied by demographic and geographic factors among seniors, based on data in the Back pain Outcomes using Longitudinal Data (BOLD) Registry. Lower education, female sex, black race, and older age were linked to worse disability.
AHRQ-funded; HS019222
Citation: Jarvik JG, Comstock BA, Heagerty PJ .
Back pain in seniors: the Back pain Outcomes using Longitudinal Data (BOLD) cohort baseline data.
BMC Musculoskelet Disord. 2014 Apr 23;15:134. doi: 10.1186/1471-2474-15-134..
Keywords: Back Health and Pain, Elderly, Outcomes, Registries
Jang Y, Chiriboga DA, Molinari V
Telecounseling for the linguistically isolated: a pilot study with older Korean immigrants.
This study explored the feasibility and preliminary efficacy of a telecounseling program in the client’s native language. Participants who were native Korean language speakers living in Florida showed generally high levels of acceptance and adherence to the telecounseling program. The high retention of the participants may be due to multiple factors including brevity of the program and convenience of the location.
AHRQ-funded; HS020636
Citation: Jang Y, Chiriboga DA, Molinari V .
Telecounseling for the linguistically isolated: a pilot study with older Korean immigrants.
Gerontologist 2014 Apr;54(2):290-6. doi: 10.1093/geront/gns196..
Keywords: Depression, Elderly, Health Information Technology (HIT), Behavioral Health, Racial and Ethnic Minorities, Telehealth
Chrischilles E, Schneider K, Wilwert J
Beyond comorbidity: expanding the definition and measurement of complexity among older adults using administrative claims data.
Studies of patients with multiple chronic conditions using claims data are often missing important determinants of treatments and outcomes, such as function status and disease severity. In this study, the investigators sought to identify and evaluate a class of function-related indicators (FRIs) from administrative claims data. The investigators concluded that claims data studies that include indicators of potentially diminished patient functional status better capture heterogeneity of patients with multiple chronic conditions.
AHRQ-funded; HS019440.
Citation: Chrischilles E, Schneider K, Wilwert J .
Beyond comorbidity: expanding the definition and measurement of complexity among older adults using administrative claims data.
Med Care 2014 Mar;52(Suppl 3):S75-S84. doi: 10.1097/mlr.0000000000000026..
Keywords: Elderly, Chronic Conditions, Medicare
Albrecht JS, Gruber-Baldini AL, Hirshon JM
Depressive symptoms and hospital readmission in older adults.
The purpose of this study was to quantify the risk of 30-day unplanned hospital readmission in adults aged 65 and older with depressive symptoms. The investigators concluded that, although not associated with hospital readmission, depressive symptoms were associated with other poor outcomes and may be underdiagnosed in hospitalized older adults. They asserted that hospitals interested in reducing readmission should focus on older adults with more comorbid illness and recent hospitalizations.
AHRQ-funded; HS021068.
Citation: Albrecht JS, Gruber-Baldini AL, Hirshon JM .
Depressive symptoms and hospital readmission in older adults.
J Am Geriatr Soc 2014 Mar;62(3):495-9. doi: 10.1111/jgs.12686..
Keywords: Depression, Elderly, Emergency Department, Hospital Readmissions, Risk
Boyd CM, Wolff JL, Giovannetti E
Healthcare task difficulty among older adults with multimorbidity.
The purpose of this study was to describe and validate a measure of healthcare task difficulty (HCTD) in a sample of older adults with multimorbidity. The investigators assessed predictive ability, cross-sectional associations of HCTD and number of chronic diseases, and conditions that add to health status complexity (falls, visual, and hearing impairment). They suggest that their study establishes the construct validity of the HCTD scale.
AHRQ-funded; HS014580; HS017650.
Citation: Boyd CM, Wolff JL, Giovannetti E .
Healthcare task difficulty among older adults with multimorbidity.
Med Care 2014 Mar;52 Suppl 3:S118-25. doi: 10.1097/MLR.0b013e3182a977da..
Keywords: Chronic Conditions, Elderly
Konetzka RT, Brauner DJ, Shega J
The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.
The purpose of this paper was to assess whether reductions in physical restraint use associated with quality reporting may have had the unintended consequence of increasing antipsychotic use in nursing home (NH) residents with severe cognitive impairment. Physical restraint use declined significantly from 1999 to 2008 in NH residents with severe cognitive impairment. Correspondingly, antipsychotic use in the same residents increased more in NHs that were subject to public reporting. This analysis suggests that public reporting of physical restraint use had the unintended consequence of increasing use of antipsychotics in NH residents with severe cognitive impairment.
AHRQ-funded; HS018718.
Citation: Konetzka RT, Brauner DJ, Shega J .
The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.
J Am Geriatr Soc 2014 Mar;62(3):454-61. doi: 10.1111/jgs.12711.
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Keywords: Dementia, Elderly, Medication, Nursing Homes, Public Reporting
Thomas KS
The relationship between Older Americans Act in-home services and low-care residents in nursing homes.
This study examining the relationship between the proportion of older adults in a State who receive in-home services funded by the Older Americans Act and the proportion of residents in nursing homes finds that for every additional 1 percent of the 65+ population that receives personal care services, there is a 0.8% decrease in the proportion of low-care residents in nursing homes.
AHRQ-funded; HS00011
Citation: Thomas KS .
The relationship between Older Americans Act in-home services and low-care residents in nursing homes.
J Aging Health. 2014 Mar;26(2):250-60. doi: 10.1177/0898264313513611..
Keywords: Elderly, Long-Term Care, Home Healthcare, Nursing Homes, Healthcare Delivery
Ottenbacher KJ, Karmarkar A, Graham JE
Thirty-day hospital readmission following discharge from postacute rehabilitation in fee-for-service Medicare patients.
This study sought to determine 30-day readmission rates and factors related to readmission for patients receiving postacute inpatient rehabilitation. It found that among postacute rehabilitation facilities providing services to Medicare fee-for-service beneficiaries, 30-day readmission rates ranged from 5.8 percent to 18.8 percent for selected impairment groups.
AHRQ-funded; HS022134.
Citation: Ottenbacher KJ, Karmarkar A, Graham JE .
Thirty-day hospital readmission following discharge from postacute rehabilitation in fee-for-service Medicare patients.
JAMA 2014 Feb 12;311(6):604-14. doi: 10.1001/jama.2014.8..
Keywords: Hospital Readmissions, Medicare, Rehabilitation, Elderly, Quality Indicators (QIs)
Stone EE, Skubic M, Back J
Automated health alerts from Kinect-based in-home gait measurements.
This paper details initial investigation of a method for automatically generating alerts to clinicians in response to changes in in-home gait parameters. The three case studies discussed illustrate the potential of automated alerts based on in-home gait data for notifying caregivers of changes in an individual's gait that may be indicative of changes in health status.
AHRQ-funded; HS018477.
Citation: Stone EE, Skubic M, Back J .
Automated health alerts from Kinect-based in-home gait measurements.
Conf Proc IEEE Eng Med Biol Soc 2014;2014:2961-4. doi: 10.1109/embc.2014.6944244..
Keywords: Patient Safety, Health Information Technology (HIT), Elderly, Falls
Haas MC, Bodner EV, Brown CJ
Calorie restriction in overweight seniors: response of older adults to a dieting study: the CROSSROADS randomized controlled clinical trial.
The researchers conducted a study designed to evaluate whether the benefits of intentional weight loss exceed the potential risks in a group of community-dwelling obese older adults. The development and implementation of the CROSSROADS protocol, including a description of the methodology, as well as unique data management features of the trial results, are presented in this article.
AHRQ-funded; HS013852.
Citation: Haas MC, Bodner EV, Brown CJ .
Calorie restriction in overweight seniors: response of older adults to a dieting study: the CROSSROADS randomized controlled clinical trial.
J Nutr Gerontol Geriatr 2014;33(4):376-400. doi: 10.1080/21551197.2014.965993..
Keywords: Elderly, Nutrition, Obesity
Spector WD
AHRQ Author: Spector WD
Response to letter to the editor regarding the paper "potentially avoidable hospitalization for elderly long-stay residents in nursing homes".
The author argues against the strategy than is implied by Dr. Powers’ letter to the editor. Rather than adding one aspect of care organization at a time to administrative data, he states that we should identify a small set of easily collected measures that generally modify the effects of care organization innovations. With these in place, we can then add measures like consistent assignment to better understand how it improves clinical outcomes.
AHRQ-authored
Citation: Spector WD .
Response to letter to the editor regarding the paper "potentially avoidable hospitalization for elderly long-stay residents in nursing homes".
Med Care 2014 Jan;52(1):93-4. doi: 10.1097/mlr.0000000000000072..
Keywords: Hospitalization, Elderly, Outcomes, Long-Term Care, Nursing Homes
Sorkin DH, Ngo-Metzger Q
AHRQ Author: Ngo-Metzger Q
The unique health status and health care experiences of older Asian Americans: research findings and treatment recommendations.
Asian Americans over 65 years of age are among the fastest growing minority groups in the United States. Although the health status of Asian Americans when considered as a group is remarkably good, certain Asian American groups suffer high rates of illness and disability from specific health causes. This article discusses the unique health status and health care experiences of older Asian Americans and includes research findings and treatment recommendations.
AHRQ-authored.
Citation: Sorkin DH, Ngo-Metzger Q .
The unique health status and health care experiences of older Asian Americans: research findings and treatment recommendations.
Clin Gerontol 2014 2014/11/06;37(1):18-32. doi: 10.1080/07317115.2013.847513..
Keywords: Elderly, Patient Experience, Racial and Ethnic Minorities
Taha J, Czaja SJ, Sharit J
Factors affecting usage of a personal health record (PHR) to manage health.
This study evaluated the ability of middle-aged and older adults to use a simulated electronic personal health record (PHR) to perform 15 common health management tasks including medication management, interpretation of lab results, and health maintenance activities. Participants in both age groups experienced significant difficulties in using the PHR, with older adults with lower numeracy and technology experience having greater problems.
AHRQ-funded; HS018239
Citation: Taha J, Czaja SJ, Sharit J .
Factors affecting usage of a personal health record (PHR) to manage health.
Psychol Aging. 2013 Dec;28(4):1124-39. doi: 10.1037/a0033911..
Keywords: Electronic Health Records (EHRs), Elderly, Health Information Technology (HIT), Patient Self-Management
Mennemeyer ST, Owsley C, McGwin Jr G
Reducing older driver motor vehicle collisions via earlier cataract surgery.
The researchers used a Monte Carlo simulation model to examine a hypothetical situation where rules in place in the U.S. for authorizing payment for cataract surgery were relaxed in favor of allowing surgery earlier for less bothersome complaints of visual difficulties in doing daily activities. They found that motor vehicle collisions, fatalities, and total societal costs can all be reduced by earlier cataract surgery.
AHRQ-funded; HS017962
Citation: Mennemeyer ST, Owsley C, McGwin Jr G .
Reducing older driver motor vehicle collisions via earlier cataract surgery.
Accid Anal Prev. 2013 Dec;61:203-11. doi: 10.1016/j.aap.2013.01.002..
Keywords: Elderly, Eye Disease and Health, Healthcare Costs
Waters TM, Chandler AM, Mion LC
Use of International Classification of Diseases, Ninth Revision, Clinical Modification, codes to identify inpatient fall-related injuries.
The researchers compared falls and fall-related injuries that a fall evaluator or hospital incident report identified with injuries identified according to discharge ICD-9-CM codes for the same set of inpatient episodes of care. They found that the CMS-targeted ICD-9-CM codes used to identify fall-related injuries in claims data do not always detect the most-serious falls.
AHRQ-funded; HS020627.
Citation: Waters TM, Chandler AM, Mion LC .
Use of International Classification of Diseases, Ninth Revision, Clinical Modification, codes to identify inpatient fall-related injuries.
J Am Geriatr Soc 2013 Dec;61(12):2186-91. doi: 10.1111/jgs.12539..
Keywords: Falls, Elderly, Patient Safety, Inpatient Care, Adverse Events
Shah MN, Gillespie SM, Wood N
High-intensity telemedicine-enhanced acute care for older adults: an innovative healthcare delivery model.
This article describes an innovative healthcare model that uses high-intensity telemedicine services to provide rapid acute care for older adults without requiring them to leave their senior living community (SLC) residences. The project demonstrated that high-intensity telemedicine services for acute illnesses are feasible and acceptable and can provide definitive care without requiring ED or urgent care use.
AHRQ-funded; HS018047.
Citation: Shah MN, Gillespie SM, Wood N .
High-intensity telemedicine-enhanced acute care for older adults: an innovative healthcare delivery model.
J Am Geriatr Soc 2013 Nov;61(11):2000-7. doi: 10.1111/jgs.12523..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Long-Term Care
Zeidan AM, Gore SD, McNally DL
AHRQ Author: Davidoff AJ
Lenalidomide performance in the real world: patterns of use and effectiveness in a Medicare population with myelodysplastic syndromes.
The authors examined the use of lenalidomide in the Medicare population. They found that reductions in transfusion rates were overall consistent with data from clinical trials, and response rates were higher when ≥ 3 lenalidomide cycles were received.
AHRQ-authored.
Citation: Zeidan AM, Gore SD, McNally DL .
Lenalidomide performance in the real world: patterns of use and effectiveness in a Medicare population with myelodysplastic syndromes.
Cancer 2013 Nov 1;119(21):3870-8. doi: 10.1002/cncr.28298.
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Keywords: Comparative Effectiveness, Elderly, Medicare, Medication
Moga DC, Carnahan RM, Lund BC
Risks and benefits of bladder antimuscarinics among elderly residents of Veterans Affairs Community Living Centers.
This study evaluated the risks and benefits of drugs to reduce urinary incontinence that were used by elderly VA nursing home residents. It found that the use of these drugs, known as bladder antimuscarinics, resulted in improved continence rates and better social engagement but also led to a higher risk of fractures in new users.
AHRQ-funded; HS016094
Citation: Moga DC, Carnahan RM, Lund BC .
Risks and benefits of bladder antimuscarinics among elderly residents of Veterans Affairs Community Living Centers.
J Am Med Dir Assoc. 2013 Oct;14(10):749-60. doi: 10.1016/j.jamda.2013.03.008..
Keywords: Elderly, Medication, Medication: Safety, Nursing Homes, Long-Term Care, Injuries and Wounds, Patient Safety
Sheppard KD, Brown CJ, Hearld KR
Symptom burden predicts nursing home admissions among older adults.
Using a sample of community-dwelling Medicare beneficiaries in Alabama who were contacted by telephone every 6 months during an eight and a half-year study, researchers found that symptom burden is an independent risk factor for NH admission. The study suggests that symptom assessment and management may reduce NH utilization.
AHRQ-funded; HS013852
Citation: Sheppard KD, Brown CJ, Hearld KR .
Symptom burden predicts nursing home admissions among older adults.
J Pain Symptom Manage. 2013 Oct;46(4):591-7. doi: 10.1016/j.jpainsymman.2012.10...
Keywords: Medicare, Long-Term Care, Elderly, Nursing Homes, Healthcare Costs