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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 11 of 11 Research Studies Displayed
Sun EC, Rishel CA, Jena AB
Association between changes in postoperative opioid utilization and long-term health care spending among surgical patients with chronic opioid utilization.
There is growing interest in identifying and developing interventions aimed at reducing the risk of increased, long-term opioid use among surgical patients. While understanding how these interventions impact health care spending has important policy implications and may facilitate the widespread adoption of these interventions, the extent to which they may impact health care spending among surgical patients who utilize opioids chronically is unknown. This study examined the association between changes in postoperative opioid utilization and long-term health care spending among surgical patients with chronic opioid utilization.
Citation: Sun EC, Rishel CA, Jena AB . Association between changes in postoperative opioid utilization and long-term health care spending among surgical patients with chronic opioid utilization. Anesth Analg 2022 Mar;134(3):515-23. doi: 10.1213/ane.0000000000005865..
Keywords: Opioids, Medication, Healthcare Costs, Long-Term Care, Substance Abuse
Zimmerman S, Carder P, Schwartz L
The imperative to reimagine assisted living.
Assisted living (AL) has existed in the United States for decades, evolving in response to older adults' need for supportive care and distaste for nursing homes and older models of congregate care. AL is state-regulated, provides at least 2 meals a day, around-the-clock supervision, and help with personal care, but is not licensed as a nursing home. This article presents the background regarding those tensions, as well as potential solutions that have been borne out, paving the path to a better future of assisted living.
Citation: Zimmerman S, Carder P, Schwartz L . The imperative to reimagine assisted living. J Am Med Dir Assoc 2022 Feb;23(2):225-34. doi: 10.1016/j.jamda.2021.12.004..
Keywords: Elderly, Long-Term Care, Healthcare Delivery, Workforce, Quality of Care, Quality of Life, Healthcare Costs
Nelson RE, Lautenbach E, Chang N
Attributable cost of healthcare-associated methicillin-resistant Staphylococcus aureus infection in a long-term care center.
The purpose of this study was to estimate the attributable cost of methicillin-resistant Staphylococcus aureus (MRSA) healthcare-associated infections in long-term care centers (LTCCs) within the Department of Veterans Affairs. Findings showed a significant increase in the odds of being transferred to an acute care facility and in acute care costs. These findings of high cost and increased risk of transfer from LTCC to acute care are important because they highlight the substantial clinical and economic impact of MRSA infections in this population.
Citation: Nelson RE, Lautenbach E, Chang N . Attributable cost of healthcare-associated methicillin-resistant Staphylococcus aureus infection in a long-term care center. Clin Infect Dis 2021 Jan 29;72(Suppl 1):S27-s33. doi: 10.1093/cid/ciaa1582..
Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Infectious Diseases, Healthcare Costs, Long-Term Care
Werner RM, Konetzka RT, Qi M
The impact of Medicare copayments for skilled nursing facilities on length of stay, outcomes, and costs.
The objective of this study was to investigate the impact of Medicare's skilled nursing facility (SNF) copayment policy, with a large increase in the daily copayment rate on the 20th day of a benefit period, on length of stay, patient outcomes, and costs. The investigators concluded that Medicare's SNF copayment policy was associated with shorter lengths of stay and worse patient outcomes, suggesting the copayment policy had unintended and negative effects on patient outcomes.
Citation: Werner RM, Konetzka RT, Qi M . The impact of Medicare copayments for skilled nursing facilities on length of stay, outcomes, and costs. Health Serv Res 2019 Dec;54(6):1184-92. doi: 10.1111/1475-6773.13227..
Keywords: Medicare, Nursing Homes, Payment, Long-Term Care, Healthcare Costs, Elderly, Hospitalization, Hospital Discharge
Makam AN, Nguyen OK, Kirby B
Effect of site-neutral payment policy on long-term acute care hospital use.
The purpose of this study was to assess the projected effect of the Centers for Medicare and Medicaid Services new site-neutral payment policy, which aims to decrease unnecessary long-term acute care hospital (LTACH) admissions by reducing reimbursements for less-ill individuals by 2020. The investigators concluded that the site-neutral payment policy may limit LTACH access in existing LTAC-scarce markets, with potential adverse implications for recovery of hospitalized older adults.
Citation: Makam AN, Nguyen OK, Kirby B . Effect of site-neutral payment policy on long-term acute care hospital use. J Am Geriatr Soc 2018 Nov;66(11):2104-11. doi: 10.1111/jgs.15539..
Keywords: Policy, Hospitalization, Payment, Long-Term Care, Healthcare Costs, Medicare, Elderly, Hospitals
Jutkowitz E, Kuntz KM, Dowd B
Effects of cognition, function, and behavioral and psychological symptoms on out-of-pocket medical and nursing home expenditures and time spent caregiving for persons with dementia.
This study used cross-sectional data (Aging, Demographics, and Memory Study) to estimate probabilities of experiencing outcomes by clinical features. It found that no clinical feature predicted the probability of having out-of-pocket medical expenditures. For those with medical expenditures, higher cognition and poorer function were associated with more spending.
Citation: Jutkowitz E, Kuntz KM, Dowd B . Effects of cognition, function, and behavioral and psychological symptoms on out-of-pocket medical and nursing home expenditures and time spent caregiving for persons with dementia. Alzheimers Dement 2017 Jul;13(7):801-09. doi: 10.1016/j.jalz.2016.12.011.
Keywords: Caregiving, Dementia, Elderly, Healthcare Costs, Long-Term Care, Neurological Disorders, Nursing Homes
Murray MT, Heitkempber E, Jackson O
Direct costs of acute respiratory infections in a pediatric long-term care facility.
Acute respiratory tract infections (ARI) are a major burden in pediatric long-term care. The researchers analyzed the financial impact of ARI in 2012-2013. Costs associated with ARI during the respiratory viral season were ten times greater than during the non-respiratory viral season, $31,224 and $3,242 per 1000 patient-days, respectively.
Citation: Murray MT, Heitkempber E, Jackson O . Direct costs of acute respiratory infections in a pediatric long-term care facility. Influenza Other Respir Viruses 2016 Jan;10(1):34-6. doi: 10.1111/irv.12350.
Keywords: Children/Adolescents, Respiratory Conditions, Long-Term Care, Healthcare Costs, Children/Adolescents
McGarry BE, Temkin-Greener H, Chapman BP
The impact of consumer numeracy on the purchase of long-term care insurance.
The researchers sought to determine the effect of consumers' numeric abilities on the likelihood of owning private long-term care insurance (LTCI). Using the 2010 wave of the Health and Retirement Study, they found that each additional correct answer on a numeracy scale was associated with a 13% increase in the likelihood of holding LTCI. They recommended that policy efforts aimed at increasing consumer decision support or restructuring the marketplace for long-term care insurance may be needed to increase older adults' ability to prepare for future long-term care expenses.
Citation: McGarry BE, Temkin-Greener H, Chapman BP . The impact of consumer numeracy on the purchase of long-term care insurance. Health Serv Res 2016 Aug;51(4):1612-31. doi: 10.1111/1475-6773.12439.
Keywords: Education: Patient and Caregiver, Healthcare Costs, Health Insurance, Long-Term Care
Rahman M, Keohane L, Trivedi AN
High-cost patients had substantial rates of leaving Medicare Advantage and joining traditional Medicare.
The investigators examined the rates at which participants who used three high-cost services switched between Medicare Advantage and traditional Medicare. They found that the switching rate from 2010 to 2011 away from Medicare Advantage and to traditional Medicare exceeded the switching rate in the opposite direction for participants who used long-term nursing home care, short-term nursing home care, and home health care. These results were magnified among people who were enrolled in both Medicare and Medicaid.
Citation: Rahman M, Keohane L, Trivedi AN . High-cost patients had substantial rates of leaving Medicare Advantage and joining traditional Medicare. Health Aff 2015 Oct;34(10):1675-81. doi: 10.1377/hlthaff.2015.0272.
Keywords: Healthcare Costs, Home Healthcare, Long-Term Care, Medicare, Nursing Homes
Huckfeldt PJ, Sood NB, Romley JA
Medicare payment reform and provider entry and exit in the post-acute care market.
The researchers examined the impact of Medicare payment reform on the entry and exit of post-acute providers (home health agencies and skilled nursing facilities). They found that payment reforms reducing average and marginal payments reduced entries and increased exits from the market, with entries more likely to be affected.
Citation: Huckfeldt PJ, Sood NB, Romley JA . Medicare payment reform and provider entry and exit in the post-acute care market. Health Serv Res. 2013 Oct;48(5):1557-80. doi: 10.1111/1475-6773.12059..
Keywords: Medicare, Critical Care, Healthcare Costs, Home Healthcare, Long-Term Care
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.
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