National Healthcare Quality and Disparities Report
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Topics
- Access to Care (5)
- Adverse Drug Events (ADE) (5)
- Adverse Events (8)
- Antibiotics (4)
- Antimicrobial Stewardship (4)
- Back Health and Pain (2)
- Behavioral Health (7)
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- Comparative Effectiveness (3)
- COVID-19 (4)
- Dementia (11)
- Dental and Oral Health (2)
- Depression (5)
- Diabetes (1)
- Diagnostic Safety and Quality (4)
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- Digestive Disease and Health (3)
- Disparities (7)
- Education: Patient and Caregiver (1)
- (-) Elderly (116)
- Electronic Health Records (EHRs) (5)
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- Injuries and Wounds (8)
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- Medication: Safety (5)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Mortality (9)
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- Nursing (1)
- Nursing Homes (33)
- Opioids (2)
- Outcomes (10)
- Pain (3)
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- Research Methodologies (4)
- Respiratory Conditions (2)
- Risk (12)
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- Screening (5)
- Sex Factors (1)
- Shared Decision Making (6)
- Sleep Problems (1)
- Social Determinants of Health (3)
- Stroke (1)
- Surgery (6)
- Teams (1)
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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 116 Research Studies DisplayedQian JZ, McAdams-DeMarco M, Ng DK
Arteriovenous fistula placement, maturation, and patency loss in older patients initiating hemodialysis.
The current clinical guidelines for vascular access do not have specific recommendations for older hemodialysis patients. This retrospective cohort study aimed to determine the association of age with arteriovenous fistula (AVF) placement, maturation, and primary and secondary patency loss among older hemodialysis recipients. The authors conclude that the likelihood of AVF maturation is an important consideration for vascular access planning.
AHRQ-funded; HS022931.
Citation: Qian JZ, McAdams-DeMarco M, Ng DK .
Arteriovenous fistula placement, maturation, and patency loss in older patients initiating hemodialysis.
Am J Kidney Dis 2020 Oct;76(4):480-89.e1. doi: 10.1053/j.ajkd.2020.02.449..
Keywords: Elderly, Dialysis, Kidney Disease and Health, Surgery
Roberts ET, Mehrotra A
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
In this study, the investigators examined disparities in digital access (ie, access at home to technology that enables video telemedicine visits) among Medicare beneficiaries by socioeconomic and demographic characteristics. The investigators concluded that the proportion of beneficiaries who lacked digital access was higher among those with low socioeconomic status, those 85 years or older, and in communities of color.
AHRQ-funded; HS026727.
Citation: Roberts ET, Mehrotra A .
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
JAMA Intern Med 2020 Oct;180(10):1386-89. doi: 10.1001/jamainternmed.2020.2666..
Keywords: Elderly, Medicare, Telehealth, Health Information Technology (HIT), Disparities, Access to Care, Social Determinants of Health, Low-Income, Racial and Ethnic Minorities
Zullo AR, Riester MR, Erqou S
Comparative effectiveness of angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors in older nursing home residents after myocardial infarction: a retrospective cohort study.
Evidence regarding differences in outcomes between angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) among older nursing home (NH) residents after acute myocardial infarction (AMI) is limited. The purpose of this study was to estimate the post-AMI effects of ARBs versus ACEIs on mortality, rehospitalization, and functional decline outcomes in this important population.
AHRQ-funded; HS022998.
Citation: Zullo AR, Riester MR, Erqou S .
Comparative effectiveness of angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors in older nursing home residents after myocardial infarction: a retrospective cohort study.
Drugs Aging 2020 Oct;37(10):755-66. doi: 10.1007/s40266-020-00791-w..
Keywords: Elderly, Nursing Homes, Heart Disease and Health, Medication, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
Wu SS, Bellantoni m, Weiner JP
Geriatric syndrome risk factors among hospitalized postacute Medicare patients.
The purpose of this study was to assess the association of geriatric syndrome risk factors with postacute utilization among hospitalized Medicare patients (both Medicare Advantage [MA] and fee-for-service [FFS] cohorts) and to examine patterns of postacute care for MA and FFS cohorts with high geriatric syndrome risk. The investigators found that geriatric syndrome risk factors not only play a role in postacute care and inpatient utilization in MA and FFS cohorts but also explain different utilizations between MA and FFS cohorts.
AHRQ-funded; HS000029.
Citation: Wu SS, Bellantoni m, Weiner JP .
Geriatric syndrome risk factors among hospitalized postacute Medicare patients.
Am J Manag Care 2020 Oct;26(10):e319-e26. doi: 10.37765/ajmc.2020.88505..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Medicare, Risk, Healthcare Utilization, Hospitalization
Schiltz NK, Dolansky MA, Warner DF
Impact of instrumental activities of daily living limitations on hospital readmission: an observational study using machine learning.
Data from the population-based Health and Retirement Study linked to Medicare claims data was used to study the importance of limitations in instrumental activities of daily living (IADL) on hospital readmission rates. Hospitalization data was collected for adults age 65 and older (n = 20,007) from 6617 unique subjects. The overall 30-day readmission rate calculated was 16.4%. ADL limitations were associated with 1.17 times higher risk of readmission even after adjusting for other covariates.
AHRQ-funded; HS023113.
Citation: Schiltz NK, Dolansky MA, Warner DF .
Impact of instrumental activities of daily living limitations on hospital readmission: an observational study using machine learning.
Data from the population-based Health and Retirement Study linked to Medicare claims data was used to study the importance of limitations in instrumental activities of daily living (IADL) on hospital readmission rates. Hospitalization data was collected for adults age 65 and older (n = 20,007) from 6617 unique subjects. The overall 30-day readmission rate calculated was 16.4%. ADL limitations were associated with 1.17 times higher risk of readmission even after adjusting for other covariates..
Keywords: Elderly, Hospital Readmissions
Dos Santos Marques IC, Theiss LM, Baker SJ
Low health literacy exists in the inflammatory bowel disease (IBD) population and is disproportionately prevalent in older African Americans.
This study assessed the prevalence of low health literacy rates among adult patients with inflammatory bowel disease (IBD) in a diverse population and identified risk factors for low health literacy. IBD patients at a single institution from November 2017 to May 2018 were assessed for health literacy using the Newest Vital Sign (NWS). Secondary outcomes were length-of-stay (LOS) and 30-day readmissions after surgery. There were 175 patients surveyed who were 59% female, 23% African Americans, 91% with Crohn’s disease, and mean age was 46. Overall the low health literacy rate was 24%, with African Americans having a higher prevalence (47.5%) versus 17.0% for white IBD patients. Low health literacy was associated with older age and African American race. There were no significant differences between LOS and readmissions rates by health literacy levels.
AHRQ-funded; HS023009.
Citation: Dos Santos Marques IC, Theiss LM, Baker SJ .
Low health literacy exists in the inflammatory bowel disease (IBD) population and is disproportionately prevalent in older African Americans.
Crohns Colitis 360 2020 Oct;2(4). doi: 10.1093/crocol/otaa076..
Keywords: Elderly, Health Literacy, Digestive Disease and Health, Racial and Ethnic Minorities, Chronic Conditions
Zhou J, Calip GS, Rowan S
Potentially inappropriate medication combination with opioids among older dental patients: a retrospective review of insurance claims data.
Opioid prescribing by dentists for older patients receiving medications with potential contraindications and the subsequent impact on acute care outcomes is not well described. The objective of this paper was to evaluate the use of potentially inappropriate medication combinations (PIMCs) involving opioids prescribed by dentists according to the Beers Criteria and risks of 30-day emergency department (ED) visits and all-cause hospitalization among commercially insured dental patients ages 65 years and older.
AHRQ-funded; HS025177.
Citation: Zhou J, Calip GS, Rowan S .
Potentially inappropriate medication combination with opioids among older dental patients: a retrospective review of insurance claims data.
Pharmacotherapy 2020 Oct;40(10):992-1001. doi: 10.1002/phar.2452..
Keywords: Elderly, Opioids, Dental and Oral Health, Medication: Safety, Medication, Practice Patterns
Khera R, Kondamudi N, Zhong L
Temporal trends in heart failure incidence among Medicare
This retrospective, national cohort study looked at temporal trends in heart failure (HF) incidence among Medicare beneficiaries from 2011 to 2016. There had been a decline in claims during that time period. Five percent of all fee-for-service Medicare beneficiaries with no prior HF diagnosis were followed up from 2011-2016. Annual trends were examined in HF incidence among groups with and without primary HF risk factors (hypertension, diabetes, and obesity) and predisposing cardiovascular conditions (acute myocardial infarction (MI) and atrial fibrillation (AF). Of the approximately 1.8 million Medicare beneficiaries at risk for HF, 249,832 had a new diagnosis of HF. The prevalence of all 5 risk factors had increased during the 5-year study period. There was a relative decline in HF incidence among beneficiaries with primary HF risk factors, but incidence increased among individuals with acute MI and AF.
AHRQ-funded; HS022418.
Citation: Khera R, Kondamudi N, Zhong L .
Temporal trends in heart failure incidence among Medicare
JAMA Netw Open 2020 Oct;3(10):e2022190. doi: 10.1001/jamanetworkopen.2020.22190.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Medicare, Risk, Elderly, Mortality
Dresden SM, Lo AX, Lindquist LA
The impact of Geriatric Emergency Department Innovations (GEDI) on health services use, health related quality of life, and costs: protocol for a randomized controlled trial.
The objective of this randomized controlled trial is to evaluate the efficacy of the Geriatric Emergency Department Innovations (GEDI) program, an ED nurse-led geriatric assessment and care coordination program, in decreasing unnecessary health services use and improving Health-Related Quality-of-Life (HRQoL) for older adults in the ED. Community-dwelling older adults aged 65 and older who are vulnerable or frail according to the Clinical Frailty Scale during an ED visit will be randomized to either GEDI or to usual ED care. The primary outcome is hospitalization or death within 30 days of the ED visit. Secondary outcomes include health service use outcomes, healthcare costs, and HRQoL outcomes.
AHRQ-funded; HS026489.
Citation: Dresden SM, Lo AX, Lindquist LA .
The impact of Geriatric Emergency Department Innovations (GEDI) on health services use, health related quality of life, and costs: protocol for a randomized controlled trial.
Contemp Clin Trials 2020 Oct;97:106125. doi: 10.1016/j.cct.2020.106125..
Keywords: Elderly, Emergency Department, Quality of Life, Hospitalization, Hospital Discharge
White EM, Kosar CM, Feifer RA
Variation in SARS-CoV-2 prevalence in U.S. skilled nursing facilities.
The objective of this study was to identify county and facility factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks in skilled nursing facilities (SNFs). The investigators concluded that larger SNFs and SNFs in areas of high SARS-CoV-2 prevalence were at high risk for outbreaks and must have access to universal testing to detect cases, implement mitigation strategies, and prevent further potentially avoidable cases and related complications.
AHRQ-funded; HS000011.
Citation: White EM, Kosar CM, Feifer RA .
Variation in SARS-CoV-2 prevalence in U.S. skilled nursing facilities.
J Am Geriatr Soc 2020 Oct;68(10):2167-73. doi: 10.1111/jgs.16752..
Keywords: COVID-19, Elderly, Nursing Homes, Long-Term Care, Public Health, Infectious Diseases
Ramly E, Tong M, Bondar S
Workflow barriers and strategies to reduce antibiotic overuse in nursing homes.
Antibiotic overuse is a significant problem in nursing homes (NHs). Strategies to improve antibiotic prescribing practices in NHs are a critical need. In this study, the investigators analyzed antibiotic prescribing workflows to identify strategies for improving antibiotic prescribing in NHs. They found that such strategies included structured information tools, nurse and prescriber education, and organizational improvement.
AHRQ-funded; HS022465.
Citation: Ramly E, Tong M, Bondar S .
Workflow barriers and strategies to reduce antibiotic overuse in nursing homes.
J Am Geriatr Soc 2020 Oct;68(10):2222-31. doi: 10.1111/jgs.16632..
Keywords: Workflow, Antibiotics, Medication, Nursing Homes, Long-Term Care, Elderly, Antimicrobial Stewardship, Practice Patterns
Burns Z, Khasnabish S, Hurley AC
Classification of injurious fall severity in hospitalized adults.
The purpose of this project was to refine the National Database of Nursing Quality Indicators Major injury classification to derive a valid and reliable categorization of the types and severities of Major inpatient fall-related injuries. Three subcategories were created: A - injuries that caused temporary functional impairment, major facial injury without internal injury, or disruption of a surgical wound; B - injuries that caused long-term functional impairment or had the potential risk of increased mortality; and C - injuries that had a well-established risk of mortality. These subcategories enhanced the National Database of Nursing Quality Indicators categorization. Using this project’s administration manual, trained personnel can classify injurious fall severity with excellent reliability.
AHRQ-funded; HS025128.
Citation: Burns Z, Khasnabish S, Hurley AC .
Classification of injurious fall severity in hospitalized adults.
J Gerontol A Biol Sci Med Sci 2020 Sep 25;75(10):e138-e44. doi: 10.1093/gerona/glaa004..
Keywords: Elderly, Falls, Injuries and Wounds, Nursing, Quality Measures, Quality Indicators (QIs), Quality of Care, Inpatient Care
Shah S, Gilson AM, Jacobson N
Understanding the factors influencing older adults' decision-making about their use of over-the-counter medications-a scenario-based approach.
The potential risks of over-the-counter (OTC) medications are often aggravated in vulnerable populations, such as older adults. The elevated patterns of older-adult OTC medication use do not necessarily translate into a greater understanding of these medications or their safety implications. The objective of this study was to assess how older adults' knowledge, beliefs, and attitudes informed their decision-making regarding OTC use.
AHRQ-funded; HS024490.
Citation: Shah S, Gilson AM, Jacobson N .
Understanding the factors influencing older adults' decision-making about their use of over-the-counter medications-a scenario-based approach.
Pharmacy 2020 Sep 18;8(3). doi: 10.3390/pharmacy8030175..
Keywords: Elderly, Shared Decision Making, Medication, Medication: Safety, Patient Safety, Health Literacy
Nayfe R, Chansard M, Hynan LS
Comparison of patient-reported outcomes measurement information system and legacy instruments in multiple domains among older veterans with chronic back pain.
This study evaluated construct (convergent and discriminant) validity and time to complete NIH's Patient Reported Outcomes Measurement Information System (PROMIS) as compared to legacy instruments. Results showed that, given time efficiency of using PROMIS, along with strong construct validity, PROMIS instruments are a practical choice for measuring multidimensional patient-reported outcomes in older Veterans with chronic low back pain for both research and clinical purposes.
AHRQ-funded; HS022418.
Citation: Nayfe R, Chansard M, Hynan LS .
Comparison of patient-reported outcomes measurement information system and legacy instruments in multiple domains among older veterans with chronic back pain.
BMC Musculoskelet Disord 2020 Sep 8;21(1):598. doi: 10.1186/s12891-020-03587-6..
Keywords: Elderly, Back Health and Pain, Pain, Chronic Conditions, Patient-Centered Outcomes Research, Research Methodologies
Li J, Qi M, Werner RM
Assessment of receipt of the first home health care visit after hospital discharge among older adults.
Investigators examined how often patients referred to home health care at hospital discharge receive it and whether there is evidence of disparities. Their study used Medicare data regarding the postacute home health care setting; participants were Medicare fee-for-service and Medicare Advantage beneficiaries discharged from the hospital with a referral to home health care. They found that only 54% of patients discharged received home health care services within 14 days of discharge. Of the remaining 46% discharged, 37.7% never received any home health care, while 8.3% were institutionalized or died within 14 days without a preceding home health care visit. Patients who were Black or Hispanic received home health at lower rates than did patients who were White. They concluded that disparities in the use of home health care remain an issue in the US.
AHRQ-funded; HS024266; HS026836.
Citation: Li J, Qi M, Werner RM .
Assessment of receipt of the first home health care visit after hospital discharge among older adults.
JAMA Netw Open 2020 Sep;3(9):e2015470. doi: 10.1001/jamanetworkopen.2020.15470..
Keywords: Elderly, Hospital Discharge, Home Healthcare, Disparities, Access to Care, Racial and Ethnic Minorities
Li Y, Temkin-Greener H, Shan G
COVID-19 infections and deaths among Connecticut nursing home residents: facility correlates.
This study looked at the relationship between higher registered nurse (RN) staffing, quality ratings, the concentration of Medicaid residents or racial/ethnic minorities; and the number of COVID-19 confirmed cases and deaths at nursing homes. All Connecticut nursing homes (n = 215) were included in the study. As of April 16, 2020, the average number of confirmed cases was 8 per nursing home (zero in 107 facilities) and the number of confirmed deaths was 1.7 per nursing (zero in 131 facilities). In nursing homes with at least one death, every 20-minute increase in RN staffing significantly predicted 26% fewer COVID-19 deaths and was associated with 22% fewer confirmed cases. Facilities with a high concentration of Medicaid residents or racial/ethnic minority residents had 16% and 15% more confirmed cases.
AHRQ-funded; HS024923; HS026893.
Citation: Li Y, Temkin-Greener H, Shan G .
COVID-19 infections and deaths among Connecticut nursing home residents: facility correlates.
J Am Geriatr Soc 2020 Sep;68(9):1899-906. doi: 10.1111/jgs.16689..
Keywords: Elderly, COVID-19, Nursing Homes, Long-Term Care, Mortality, Racial and Ethnic Minorities
Johnson J, Rodriguez MA, Al Snih S
Life-space mobility in the elderly: current perspectives.
The authors conducted a narrative review: a) to provide a summary of the articles that have assessed validation of the University of Alabama at Birmingham Life-Space Assessment instrument, the most widely used instrument to assess life-space mobility (LSM) in older adults; and b) to provide a summary of the research articles that have examined LSM as independent or outcome variable. They found that the identified studies showed that LSM instruments can accurately predict morbidity, mortality, and healthcare use.
AHRQ-funded; HS026122.
Citation: Johnson J, Rodriguez MA, Al Snih S .
Life-space mobility in the elderly: current perspectives.
Clin Interv Aging 2020;15:1665-74. doi: 10.2147/cia.S196944..
Keywords: Elderly, Health Status
Wretman CJ, Zimmerman S, Ward K
Measuring self-efficacy and attitudes for providing mouth care in nursing homes.
Mouth care is increasingly recognized as an important component of care in nursing homes (NHs) yet is known to be deficient. To promote quality improvement and inform research efforts, it is necessary to have valid measures of staff self-efficacy and attitudes to provide mouth care. The purpose of this study was to measure self-efficacy and attitudes for providing mouth care in nursing homes.
AHRQ-funded; HS022298.
Citation: Wretman CJ, Zimmerman S, Ward K .
Measuring self-efficacy and attitudes for providing mouth care in nursing homes.
J Am Med Dir Assoc 2020 Sep;21(9):1316-21. doi: 10.1016/j.jamda.2020.02.007..
Keywords: Elderly, Nursing Homes, Long-Term Care, Dental and Oral Health
Modi PK, Moloci N, Herrel LA
Medicare accountable care organizations reduce spending on surgery.
This study examined the impact that Medicare accountable care organization (ACO) alignment has on spending for inpatient and outpatient surgical care. Researchers identified adults 65 years of age and older enrolled in fee-for-service Medicare from among a 20% random sample of beneficiaries and distinguished between those aligned and unaligned with a Medicare ACO, then measured payments for surgical services made on the enrollees’ behalf. Findings showed that ACO alignment was associated with savings on surgical care. These savings resulted from increased outpatient surgery and reduced use of inpatient surgery as well as reduced spending per inpatient surgical episode. Greater focus on surgical care to improve the ability of ACOs to control healthcare spending was recommended.
AHRQ-funded; HS024728; HS024525; HS026908.
Citation: Modi PK, Moloci N, Herrel LA .
Medicare accountable care organizations reduce spending on surgery.
Am J Accountable Care 2020 Sep;8(3):12-19..
Keywords: Medicare, Surgery, Healthcare Costs, Health Insurance, Elderly
Germack HD, Bizhanova Z, Roberts ET
Substantial hospital level variation in all-cause readmission rates among Medicare beneficiaries with serious mental illness.
This study’s purpose was to examine the variation across hospitals in readmissions for patients with serious mental illness (SMI) and differences in the characteristics of hospitals with the highest and lowest readmission rates. A cross-sectional analysis was conducted of pooled inpatient claims from 2013-2016. The 5% sample of fee-for-service Medicare beneficiaries included patients with SMI. The authors identified 2066 hospitals with at least 30 index admissions for Medicare beneficiaries with SMI. Factors most strongly associated with increased risk of readmission included substance use disorder and end stage renal disease. Hospital readmission rates ranged from 7.05% to 15.24%. Hospitals with the lowest adjusted readmission rates were more likely to be teaching hospitals and located in the South or Midwest.
AHRQ-funded; HS026727.
Citation: Germack HD, Bizhanova Z, Roberts ET .
Substantial hospital level variation in all-cause readmission rates among Medicare beneficiaries with serious mental illness.
Healthc 2020 Sep;8(3):100453. doi: 10.1016/j.hjdsi.2020.100453..
Keywords: Elderly, Behavioral Health, Hospital Readmissions, Medicare, Hospitals, Hospitalization
Earl TR, Katapodis ND, Schneiderman SR
Using deprescribing practices and the screening tool of older persons' potentially inappropriate prescriptions criteria to reduce harm and preventable adverse drug events in older adults.
This paper is a systematic review of the literature published between 2008 to 2018 that studies the effect of interventions to reduce preventable adverse drug effects (ADEs) for adults who are prescribed multiple medications. Two safety practices were examined: 1) deprescribing interventions to reduce polypharmacy; and 2) use of the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) to reduce potentially inappropriate medications (PIMS). A total of 26 studies and 1 systematic review were included (14 for deprescribing and 12 for STOPP). Deprescribing interventions included decision support tools, educational interventions, and medication reviews. The STOPP tool most reported changes in PIMS, as well as some economic outcomes. Both methods were found to be effective.
AHRQ-funded; HHSP233201500013I.
Citation: Earl TR, Katapodis ND, Schneiderman SR .
Using deprescribing practices and the screening tool of older persons' potentially inappropriate prescriptions criteria to reduce harm and preventable adverse drug events in older adults.
J Patient Saf 2020 Sep;16(3S Suppl 1):S23-s35. doi: 10.1097/pts.0000000000000747..
Keywords: Elderly, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Screening, Prevention
Bolstad CJ, Moak R, Brown CJ
Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults.
This study tested how neighborhood disadvantage (ND) relates to depressive symptomology and diagnosis to assess for neighborhood disparities in mental health care cross-sectionally. Using data from the University of Alabama at Birmingham Study of Aging, the investigators found living in the high and mid-ND tertiles to be associated with depressive symptomology, yet ND had no significant relation to depression diagnosis. They concluded that older adults living in high and mid-disadvantaged neighborhoods may be more likely to experience depressive symptomology but not receive a diagnosis, indicating a possible disparity in mental health care.
AHRQ-funded; HS013852.
Citation: Bolstad CJ, Moak R, Brown CJ .
Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults.
Int J Environ Res Public Health 2020 Aug 8;17(16). doi: 10.3390/ijerph17165745..
Keywords: Elderly, Depression, Behavioral Health, Diagnostic Safety and Quality, Disparities, Social Determinants of Health
Hoffman GJ, Tinetti ME, Ha J
Prehospital and posthospital fall injuries in older US adults.
Investigators estimated the risk of older adult fall injury within and across discrete periods during a 12-month care episode anchored by an acute hospitalization using national data from 2006 to 2014. Participants in this cohort study included Medicare fee-for-service beneficiaries aged 65 and older from the Health and Retirement Study. The investigators found that an episode-based assessment of fall injury illustrated substantial variability in period-specific risks over an extended period including an anchor hospitalization. Risk transitions between periods included sizable increases just before hospitalization that do not fully subside after hospital discharge. Financial incentives to coordinate hospital and posthospital care for patients at risk for fall injury are needed.
AHRQ-funded; HS025838.
Citation: Hoffman GJ, Tinetti ME, Ha J .
Prehospital and posthospital fall injuries in older US adults.
JAMA Netw Open 2020 Aug 3;3(8):e2013243. doi: 10.1001/jamanetworkopen.2020.13243..
Keywords: Elderly, Falls, Injuries and Wounds, Risk, Hospitalization, Medicare
Wu S, Mulcahy J, Kasper JD
Comparing survey-based frailty assessment to Medicare claims in predicting health outcomes and utilization in Medicare beneficiaries.
The purpose of this study was to assess two models for the prediction of health utilization and functions using standardized in-person assessments of frailty and administrative claims-based geriatric risk measures among Medicare fee-for-service beneficiaries aged 65 years and above. Outcomes of hospitalizations, death, and functional help were investigated for participants in the 2011 National Health and Aging Trends Study.
AHRQ-funded; HS000029.
Citation: Wu S, Mulcahy J, Kasper JD .
Comparing survey-based frailty assessment to Medicare claims in predicting health outcomes and utilization in Medicare beneficiaries.
J Aging Health 2020 Aug-Sep;32(7-8):764-77. doi: 10.1177/0898264319851995..
Keywords: Elderly, Medicare, Healthcare Utilization, Risk
Abrahamson K, Hass Z, Arling G
Shall I stay or shall I go? The choice to remain in the nursing home among residents with high potential for discharge.
This study examines why private-pay nursing home (NH) residents who expressed a desire for discharge and had relatively low-care needs chose to remain in the NH. The Minnesota Return to Community Initiative (RTCI) is a program that assists those residents to return to the community. Those who remained were more likely to beolder, more cognitively impaired, unmarried, had behavior problems, or diagnosed with dementia. At a 90-day assessment, residents who remained in the facility had a small decline in cognitive status, their continence improved, and they become more independent in activities of daily living (ADLs). Seventy-four percent of those remaining reported a perception of health barriers to discharge.
AHRQ-funded; HS020224.
Citation: Abrahamson K, Hass Z, Arling G .
Shall I stay or shall I go? The choice to remain in the nursing home among residents with high potential for discharge.
J Appl Gerontol 2020 Aug;39(8):863-70. doi: 10.1177/0733464818807818..
Keywords: Elderly, Nursing Homes, Long-Term Care, Transitions of Care, Shared Decision Making