Abstract:
OBJECTIVES:To identify the impact of the regulations implemented in Maryland in 2001, related to nursing home attending physicians and medical directors, and nursing home quality assurance requirements, on Maryland nursing homes, administrators, and physicians. DESIGN:Two surveys were mailed to all nursing home administrators in Maryland, one for their completion and one to give to their medical directors to complete. These surveys were to be returned by mail to the authors. SETTING:All nursing homes in all jurisdictions in Maryland. PARTICIPANTS:Two-fifths of administrators and medical directors in Maryland nursing homes completed and returned the survey. MEASUREMENTS:Results were tabulated for each question of each survey, and were calculated as percentages of the total responses. Additionally, individual comments were reviewed. RESULTS:A relatively large sample of administrators and medical directors in Maryland responded. Most respondents were positive or at least neutral about the impact of these regulations on them and their organizations. Many administrators agreed that there had been improvements in medical director participation and performance. There were significant advances in medical director compensation. There were relatively few negative comments about the impact. CONCLUSION:Requirements for physician and medical director accountability appear to have had a positive impact on medical director performance and relationships with nursing home administrators. Additional study is warranted to measure the impact of that performance on patient care outcomes and facility performance.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Boyce BF,Bob H,Levenson SAdoi
10.1097/01.JAM.0000066022.74526.CFkeywords:
subject
Has Abstractpub_date
2003-05-01 00:00:00pages
157-63issue
3eissn
1525-8610issn
1538-9375pii
S1525-8610(04)70326-6journal_volume
4pub_type
杂志文章abstract:OBJECTIVES:To develop a prognostic model to predict the probability of a short-term fall (within the next 7 to 30 days) in older adults with dementia. DESIGN:Prospective observational study. SETTING AND PARTICIPANTS:Fifty-one individuals with dementia at high risk of falls from a specialized dementia inpatient unit. ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.07.030
更新日期:2020-09-05 00:00:00
abstract:OBJECTIVES:To test whether coordination of discharge from hospital reduces hospitalizations in patients with chronic obstructive pulmonary disease (COPD). DESIGN:Randomized controlled clinical trial. SETTING:Specialized pulmonary hospital. PARTICIPANTS:Patients hospitalized for an acute exacerbation of COPD. INTERV...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jamda.2013.03.003
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVES:This study examined the association between intensive rehabilitation for subacute stroke patients and medical costs and readmission ratio during the year after discharge. DESIGN:This was a natural experiment study. SETTING AND PARTICIPANTS:We identified individuals with a diagnosis of cerebrovascular disor...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.12.015
更新日期:2021-01-18 00:00:00
abstract:OBJECTIVES:This study investigates the transitions of community-dwelling patients with a proximal femoral fracture towards recovery of independence using multistate modeling. The prognostic value of factors affecting the short-term rate of recovery of independence in activities of daily living was assessed for the resi...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.08.006
更新日期:2020-09-19 00:00:00
abstract::Falls are a major cause of injury and disability in older people, leading to serious health and social consequences including fractures, poor quality of life, loss of independence, and institutionalization. To design and provide adequate prevention measures, accurate understanding and identification of person's indivi...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2017.08.001
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVES:Prevention and public reporting of falls have suffered due to inadequate attention given to the association of falls and cognitive impairment (CI) among nursing home (NH) residents. This study examines the relationship between CI, residence on dementia special care units (SCUs) and other resident characteris...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2012.07.018
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVES:To examine the bidirectional temporal relationship between depressive symptoms and cognition in relation to risk, reaction, and prodrome. DESIGN:Cross-lag analysis of longitudinal data collected online at baseline and 12-month follow-up. SETTING AND PARTICIPANTS:A United Kingdom population cohort of 11,855...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.01.106
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:The purpose of this descriptive, retrospective analysis was to develop a demographic and clinical profile of nursing home residents with a diagnosis of Huntington's disease (HD). METHODS:Queries were made of a large data repository of linked and de-identified Minimum Data Set version 3.0 and prescription cl...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.01.010
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVES:Coronavirus disease 2019 (COVID-19) has caused many nursing homes to prohibit resident visits to prevent viral spread. Although visiting restrictions are instituted to prolong the life of nursing home residents, they may detrimentally affect their quality of life. The aim of this study was to capture perspec...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.09.031
更新日期:2020-12-01 00:00:00
abstract::Currently, the Agency for Healthcare Research and Quality (AHRQ) Common Format for nursing homes (NHs) accommodates voluntary reporting for 4 adverse events: falls with injury, pressure ulcers, medication errors, and infections. In 2015, AHRQ funded a technical brief to describe the state of the science related to saf...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2016.03.005
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:The rate of suicide is highest among the oldest old and is associated with chronic medical illness and functional impairment. These risk factors are prevalent among nursing home (NH) residents, yet little has been published on suicide in this population. METHODS:We performed a population-based, retrospective...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVES:To investigate the effects of light therapy on cognition, depression, sleep, and circadian rhythms in a general, nonselected population of seniors living in a long term care facility. DESIGN:A double-blind, placebo-controlled trial. SETTING:The experiment took place at a long term care facility in Pennsylv...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jamda.2011.05.006
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVES:Safe and easily implemented treatment regimens are needed for the management of patients with type 2 diabetes mellitus (T2DM) in long-term care (LTC) and skilled nursing facilities. DESIGN:This 6-month open-label randomized controlled trial compared the efficacy and safety of a DPP4 inhibitor (linagliptin) ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jamda.2017.11.002
更新日期:2018-05-01 00:00:00
abstract::More than 6 million adults in the United States are homebound or semi-homebound and would benefit from home-based medical care (HBMC). There is currently no nationally recognized quality of care framework for home-based medical care. We sought to capture diverse stakeholder perspectives on the essential aspects of qua...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.05.020
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:The primary objective of this study was to identify proton pump inhibitor (PPI) prescribing patterns in a population of older adults admitted to 22 Midwestern skilled long term care facilities (LTCF) with medical coverage provided by the US Medicare Part A program. The relationship between PPI prescribing pa...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2013.01.021
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVES:Older age is associated with higher risk of death during acute exacerbations of chronic obstructive pulmonary disease (AE-COPD). Older patients hospitalized for AE-COPD often require post-acute care after acute phase. The aim of this study was to evaluate components of a comprehensive geriatric assessment an...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.01.125
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:The Beers (2012) criteria and the screening tool of older persons' potentially inappropriate prescriptions (STOPP) criteria are often used to identify potentially inappropriate medication (PIM) use in elderly patients. The aim of this study is to determine the prevalence of PIM use in nursing home residents ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.08.008
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:The Geriatric Level of Dysfunction Scale (GLDS) was developed to assess the intensity, frequency, and duration of 19 behavioral disturbance categories that can potentially interfere with long-term care. DESIGN:Secondary analysis of data collected from residents in long-term care facilities. PARTICIPANTS:Par...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2005.04.006
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Anemia and frailty are both common in older people and are associated with adverse health outcomes. There have been some cross-sectional studies of anemia and frailty but no longitudinal studies. The objectives of this study were to examine cross-sectional and longitudinal associations between anemia and fra...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.02.014
更新日期:2015-07-01 00:00:00
abstract::The role of nutrition in modulating Alzheimer disease (AD) remains uncertain. Persons ingesting a Mediterranean-type diet appear to be less likely to develop AD. Epidemiologically, food combinations rich in antioxidant vitamins reduced the risk of AD. Combination formulas (eg, Souvenaid) appear to have small effects o...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2013.01.014
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVES:The purpose of the study was to develop and validate a simple caregiver-rated questionnaire to screen for chronic obstructive pulmonary disease (COPD) in nursing home residents. DESIGN:Part 1: Identification of screening parameters by the Delphi process using geriatric and pulmonary experts. Part 2: Retrosp...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2010.11.007
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:For persons with dementia, the appropriate duration of cholinesterase inhibitor (ChEI) use remains unclear. We examined patterns of ChEI use during nursing home (NH) transition and the factors associated with discontinuation following admission. DESIGN:Population-based retrospective cohort study using linke...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.07.020
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVES:Telomere length is associated with aging-related pathologies. Although the association between telomere length and frailty has been studied previously, only a few studies assessing longitudinal changes in telomere length and frailty exist. DESIGN:Longitudinal cohort study. SETTING AND PARTICIPANTS:A subpop...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.05.011
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:In nursing home settings, providers often think that most percutaneous endoscopic gastrostomy (PEG) tubes are placed in older people, some perhaps inappropriately. We sought to describe the relationships between patient age and the indications for, the decision making behind, and the outcomes of gastrostomy ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2005.05.010
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVES:Nursing facilities have lagged behind in the adoption of interoperable health information technology (ie technologies that allow the sharing and use of electronic patient information between different information systems). The objective of this study was to estimate the nationwide prevalence of electronic he...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.11.002
更新日期:2019-08-01 00:00:00
abstract::Community care provision for older Australians is growing in places and options, based on older people's preference to stay in their own homes, coupled with its cost efficiency compared to long-term residential care. Australia's aging population, cultural diversity, and dispersed population in rural and remote areas p...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2007.11.010
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVES:Structured programs for routine pain assessment and treatment are necessary to optimize care for residents of long-term care facilities (LTCFs). A pilot study was designed to develop, implement, and evaluate a system for pain assessment and monitoring in a LTCF. Additional goals were to determine whether a v...
journal_title:Journal of the American Medical Directors Association
pub_type: 临床试验,杂志文章
doi:10.1016/j.jamda.2004.12.024
更新日期:2005-03-01 00:00:00
abstract::Up to 80% of nursing home residents are affected by pain. Pain assessment aims to determine pain intensity, quality, and course of pain to underpin diagnostic decision making. In the nursing home population, pain assessment is frequently compromised by cognitive impairment. Characteristics of the nursing home setting,...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.08.002
更新日期:2020-02-01 00:00:00
abstract::The prevalence of malnutrition ranges up to 50% among patients in hospitals worldwide, and disease-related malnutrition is all too common in long-term and other health care settings as well. Regrettably, the numbers have not improved over the past decade. The consequences of malnutrition are serious, including increas...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.05.011
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:To identify nursing home standards related to items brought in from the community for residents through a nationwide survey of directors of nursing. Specifically we examined the policies with regard to food, cigarettes, alcoholic beverages, and over-the-counter medications. METHODS:A national survey was dist...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2009.03.003
更新日期:2009-07-01 00:00:00