National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
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- Elderly (6)
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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 8 of 8 Research Studies DisplayedZullo AR, Hersey M, Lee Y
Outcomes of "diabetes-friendly" vs "diabetes-unfriendly" beta-blockers in older nursing home residents with diabetes after acute myocardial infarction.
This study analyzed outcomes of using beta-blockers that are considered “diabetes-friendly” vs “diabetes-unfriendly” in older nursing home residents with diabetes after acute myocardial infarction (AMI). Primary outcomes included hospitalizations for hypoglycemia and hyperglycemia in the 90 days after AMI and secondary outcomes functional decline, death, all-cause re-hospitalization and fracture hospitalization. Out of 2855 nursing home residents with type-2 diabetes (T2D), 29% were prescribed a diabetes-friendly beta-blocker vs. 24% without. T2D medicine showed a reduction in hospitalization for hyperglycemia but was unassociated with hypoglycemia. For secondary outcomes T2D-friendly beta-blocks were associated with a greater rate of re-hospitalization but not death, functional decline, or fracture.
AHRQ-funded; HS022998.
Citation: Zullo AR, Hersey M, Lee Y .
Outcomes of "diabetes-friendly" vs "diabetes-unfriendly" beta-blockers in older nursing home residents with diabetes after acute myocardial infarction.
Diabetes Obes Metab 2018 Dec;20(12):2724-32. doi: 10.1111/dom.13451..
Keywords: Cardiovascular Conditions, Diabetes, Elderly, Heart Disease and Health, Hospitalization, Medication, Nursing Homes, Outcomes, Patient-Centered Outcomes Research
Murray KS, Prunty M, Henderson A
Functional status in patients requiring nursing home stay after radical cystectomy.
The objective of this study was to evaluate the ability to perform activities of daily living (ADLs) in patients who required nursing home (NH) care after radical cystectomy (RC), as this surgery can impair patients' ability to perform ADLs in the post-operative period. The investigators found that ADLs, as measured by the Minimum Data Set (MDS)-ADL Long Form score, worsen after RC. They suggest this should be an important part of the risks and benefits conversation with patients, their families, and caregivers.
AHRQ-funded; HS022140.
Citation: Murray KS, Prunty M, Henderson A .
Functional status in patients requiring nursing home stay after radical cystectomy.
Urology 2018 Nov;121:39-43. doi: 10.1016/j.urology.2018.07.030..
Keywords: Cancer, Nursing Homes, Outcomes, Patient-Centered Outcomes Research
Li S, Middleton A, Ottenbacher KJ
Trajectories over the first year of long-term care nursing home residence.
This retrospective cohort study examined changes in situation for Medicare fee-for-service beneficiaries newly admitted to long-term nursing homes from July 2012 to December 2013 for the first year after admission. Data was used from the Minimum Data Set and Medicare Provider and Analysis Reviews claims data. Median length of stay in long-term care was 127 days, and for any institution 158 days. At 12 months post admission, 35% had died, 36.9% remained in long-term care, 23.4% were in the community, and 4.7% were in acute care hospitals or other institutions.
AHRQ-funded; HS022134.
Citation: Li S, Middleton A, Ottenbacher KJ .
Trajectories over the first year of long-term care nursing home residence.
J Am Med Dir Assoc 2018 Apr;19(4):333-41. doi: 10.1016/j.jamda.2017.09.021.
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Keywords: Long-Term Care, Nursing Homes, Elderly, Medicare, Patient-Centered Outcomes Research, Outcomes
Zullo AR, Zhang T, Beudoin FL
Pain treatments after hip fracture among older nursing home residents.
In this retrospective cohort study the investigators examined the association between use of opioids versus other analgesics with death and functioning after hip fracture in older nursing home (NH) residents. The investigators concluded that a rigorous study addressing the limitations of their study is critical to validate their preliminary findings and provide evidence about the effect of using opioid versus nonopioid analgesics to optimize acute pain in NH residents with a hip fracture.
AHRQ-funded; HS022998.
Citation: Zullo AR, Zhang T, Beudoin FL .
Pain treatments after hip fracture among older nursing home residents.
J Am Med Dir Assoc 2018 Feb;19(2):174-76. doi: 10.1016/j.jamda.2017.11.008..
Keywords: Opioids, Pain, Nursing Homes, Long-Term Care, Elderly, Medication, Injuries and Wounds, Patient-Centered Outcomes Research, Healthcare Utilization
Marra MV, Simmons SF, Shotwell MS
Elevated serum osmolality and total water deficit indicate impaired hydration status in residents of long-term care facilities regardless of low or high body mass index.
The researchers assessed hydration status and the adequacy of total water intake, and further determined relationships between hydration status, total water intake, and body mass index (BMI) in long-term care residents. They found that dehydration and inadequate total water intake is prevalent in long-term care residents across all BMI categories. They recommended that the type of liquid beverages, type of ONS, and type of between-meal snacks are factors that could be targeted for nutrition interventions designed to prevent or reverse dehydration.
AHRQ-funded; HS018580.
Citation: Marra MV, Simmons SF, Shotwell MS .
Elevated serum osmolality and total water deficit indicate impaired hydration status in residents of long-term care facilities regardless of low or high body mass index.
J Acad Nutr Diet 2016 May;116(5):828-36.e2. doi: 10.1016/j.jand.2015.12.011.
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Keywords: Elderly, Long-Term Care, Nursing Homes, Patient-Centered Outcomes Research
Lepore M, Leland NE
Nursing homes that increased the proportion of Medicare days saw gains in quality outcomes for long-stay residents.
The authors examined nationwide facility-level nursing home data for the period 2007-2010. They found that increasing the proportion of Medicare-covered patient days in a nursing home was significantly associated with improvements in the quality of daily pain, pressure ulcers, and performing activities of daily living.
AHRQ-funded; HS022907.
Citation: Lepore M, Leland NE .
Nursing homes that increased the proportion of Medicare days saw gains in quality outcomes for long-stay residents.
Health Aff 2015 Dec;34(12):2121-8. doi: 10.1377/hlthaff.2015.0303.
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Keywords: Long-Term Care, Medicare, Nursing Homes, Patient-Centered Outcomes Research, Quality Improvement
Beffa LR, Petroski GF, Kruse RL
Functional status of nursing home residents before and after abdominal aortic aneurysm repair.
The authors evaluated the effects of elective open AAA repair (OAR) and endovascular AAA repair (EVAR) and evaluated comorbidities for their impact on functional trajectories after discharge. They found that procedure type was not significantly related to postoperative function or to the subsequent rate of improvement. OAR and EVAR were associated with similar initial declines and comparable postoperative trajectories, suggesting that less invasive EVAR was not associated with improved functional preservation compared with OAR. Longer stays were associated with poorer functional trajectories.
AHRQ-funded; HS022140.
Citation: Beffa LR, Petroski GF, Kruse RL .
Functional status of nursing home residents before and after abdominal aortic aneurysm repair.
J Vasc Nurs 2015 Sep;33(3):106-11. doi: 10.1016/j.jvn.2015.02.003.
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Keywords: Adverse Events, Elderly, Nursing Homes, Patient-Centered Outcomes Research, Surgery
Grebla RC, Keohane L, Lee Y
Waiving the three-day rule: admissions and length-of-stay at hospitals and skilled nursing facilities did not increase.
The authors compared hospital and postacute skilled nursing facility utilization among Medicare Advantage enrollees in matched plans that did or did not eliminate that requirement in 2006-10. Among hospitalized enrollees with a skilled nursing facility admission, the mean hospital length-of-stay declined for those no longer subject to the qualifying stay but increased among those still subject to it. The elimination of the three-day-stay requirement was not associated with more hospital or skilled nursing facility admissions or with longer lengths-of-stay in a skilled nursing facility.
AHRQ-funded; HS000011.
Citation: Grebla RC, Keohane L, Lee Y .
Waiving the three-day rule: admissions and length-of-stay at hospitals and skilled nursing facilities did not increase.
Health Aff 2015 Aug;34(8):1324-30. doi: 10.1377/hlthaff.2015.0054.
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Keywords: Elderly, Hospitalization, Long-Term Care, Nursing Homes, Patient-Centered Outcomes Research