Family oversight and the quality of nursing home care for residents with advanced dementia.

Abstract:

BACKGROUND:The quality of nursing home (NH) care for residents with advanced dementia has been described as suboptimal. One relatively understudied factor in the provision of NH care is the role of private oversight and monitoring by family members and friends. OBJECTIVE:To examine the association between private oversight and the quality of end-of-life care for NH residents with advanced dementia. RESEARCH DESIGN:This study employed longitudinal data on 323 NH residents with advanced dementia living in 22 Boston area facilities. Using bivariate and multivariate methods, we analyzed the association between visit time by the resident's health care proxy (HCP) and measures of quality of end-of-life care. RESULTS:The relationship between visit time and quality was nonlinear. Residents who were visited 1 to 7 h/wk had less pain, fewer pressure ulcers, less dyspnea, and fewer hospital transfers compared with residents who had no visits or who were visited >7 h/wk. After adjusting for covariates, residents who were visited >7 h/wk had more pressure ulcers, more pain, greater dyspnea, fewer do-not-hospitalize orders, and lower HCP satisfaction with care compared with residents who were visited 1 to 7 h/wk. CONCLUSIONS:Several measures of quality of NH care for end-stage dementia exhibit a nonlinear relationship with the degree of HCP oversight, such that no visiting or very high levels of visiting are associated with worse quality. Future research will need to address whether families with greater oversight tend to make decisions that promote worse quality of care, or whether worse quality of care promotes greater family oversight.

journal_name

Med Care

journal_title

Medical care

authors

Grabowski DC,Mitchell SL

doi

10.1097/MLR.0b013e318195fce7

subject

Has Abstract

pub_date

2009-05-01 00:00:00

pages

568-74

issue

5

eissn

0025-7079

issn

1537-1948

journal_volume

47

pub_type

杂志文章
  • Influence of knowledge and attitudes on the quality of physicians' transfusion practice.

    abstract::Studies evaluating relationships between physician background characteristics (e.g. years of practice and medical training) and quality of care have found few consistent associations. Site of practice variables have been better predictors of quality than have characteristics of individual physicians. This study explor...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199310000-00002

    authors: Salem-Schatz SR,Avorn J,Soumerai SB

    更新日期:1993-10-01 00:00:00

  • Use of Medicare Claims Data for the Identification of Myocardial Infarction: The Reasons for Geographic And Racial Differences in Stroke Study.

    abstract:OBJECTIVES:Assess the validity of Medicare claims for identifying myocardial infarction (MI). METHODS:We used data from 9951 Medicare beneficiaries 65 years and above in the Reasons for Geographic And Racial Differences in Stroke study. Between 2003 and 2012, 669 participants had an MI identified and adjudicated throu...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001004

    authors: Colantonio LD,Levitan EB,Yun H,Kilgore ML,Rhodes JD,Howard G,Safford MM,Muntner P

    更新日期:2018-12-01 00:00:00

  • When courts review medical appropriateness.

    abstract:OBJECTIVES:The authors examined how the courts have responded to public and private insurers' use of medical appropriateness criteria to establish coverage and payment policies. METHODS:A structured review of all federal and state court health insurance cases decided between 1960 and June 1994 that involved a dispute ...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/00005650-199808000-00016

    authors: Anderson G,Hall MA,Smith TR

    更新日期:1998-08-01 00:00:00

  • Comparability of patient-reported health status: multicountry analysis of EQ-5D responses in patients with type 2 diabetes.

    abstract:BACKGROUND:Valid and comparable measures of health outcomes are needed for clinical trials, studies on quality of healthcare, and population health monitoring. OBJECTIVE:To examine comparability of patient-reported health status across populations. RESEARCH DESIGN:Logistic regression analysis of health status across ...

    journal_title:Medical care

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/MLR.0b013e3182239489

    authors: Salomon JA,Patel A,Neal B,Glasziou P,Grobbee DE,Chalmers J,Clarke PM

    更新日期:2011-10-01 00:00:00

  • Reducing bias in the assessment of treatment effectiveness: androgen deprivation therapy for prostate cancer.

    abstract:BACKGROUND:Indication bias is the major challenge in assessing treatment effectiveness in observational studies. We explored the potential advantages of using an instrumental variable approach in the context of primary androgen deprivation therapy (ADT) for prostate cancer. METHODS:We identified 31,930 men in the link...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e318245a086

    authors: Kuo YF,Montie JE,Shahinian VB

    更新日期:2012-05-01 00:00:00

  • Prevalence and predictors of unmet need for supportive services among HIV-infected persons: impact of case management.

    abstract:BACKGROUND:Previous research has indicated that the needs of persons infected with human immunodeficiency virus (HIV) for supportive services often go unmet. Although case management has been advocated as a method of decreasing unmet needs for supportive services, its effectiveness is poorly understood. OBJECTIVES:To ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-200001000-00007

    authors: Katz MH,Cunningham WE,Mor V,Andersen RM,Kellogg T,Zierler S,Crystal SC,Stein MD,Cylar K,Bozzette SA,Shapiro MF

    更新日期:2000-01-01 00:00:00

  • Pain and the use of outpatient services among persons with HIV: results from a nationally representative survey.

    abstract:BACKGROUND:The negative impact of pain on health-related quality of life has been documented for persons with human immunodeficiency virus (HIV). Furthermore, pain could be an important factor in seeking medical care. However, the relationship between pain and health service utilization is poorly understood. OBJECTIVE...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000108744.45327.d4

    authors: Dobalian A,Tsao JC,Duncan RP

    更新日期:2004-02-01 00:00:00

  • Identification of hospital-acquired catheter-associated urinary tract infections from Medicare claims: sensitivity and positive predictive value.

    abstract:BACKGROUND AND OBJECTIVE:Hospital-acquired catheter-associated urinary tract infection (CAUTI) is one of the first 6 conditions Medicare is targeting to reduce payment associated with hospital-acquired conditions under Congressional mandate. This study was to determine the positive predictive value (PPV) and sensitivit...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e31818af83d

    authors: Zhan C,Elixhauser A,Richards CL Jr,Wang Y,Baine WB,Pineau M,Verzier N,Kliman R,Hunt D

    更新日期:2009-03-01 00:00:00

  • Physical and role functioning among persons with HIV: results from a nationally representative survey.

    abstract:BACKGROUND:Functional limitations of persons living with HIV affect their care needs and ability to perform social roles such as employment. Earlier estimates are outdated, and nationally representative estimates of prevalence and distribution of these limitations have not previously been available. OBJECTIVES:The obj...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-200012000-00008

    authors: Crystal S,Fleishman JA,Hays RD,Shapiro MF,Bozzette SA

    更新日期:2000-12-01 00:00:00

  • Defining Multiple Chronic Conditions for Quality Measurement.

    abstract:BACKGROUND/OBJECTIVE:Patients with multiple chronic conditions (MCCs) are a critical but undefined group for quality measurement. We present a generally applicable systematic approach to defining an MCC cohort of Medicare fee-for-service beneficiaries that we developed for a national quality measure, risk-standardized ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000853

    authors: Drye EE,Altaf FK,Lipska KJ,Spatz ES,Montague JA,Bao H,Parzynski CS,Ross JS,Bernheim SM,Krumholz HM,Lin Z

    更新日期:2018-02-01 00:00:00

  • Disparities in Potentially Preventable Hospitalizations Between American Indian and Alaska Native and Non-Hispanic White Medicare Enrollees.

    abstract:OBJECTIVE:A number of health care initiatives seek to improve health outcomes by increasing access to outpatient services while reducing preventable acute events. We evaluated disparities between American Indian and Alaska Native (AI/AN) and non-Hispanic white (white) Medicare enrollees in access to outpatient preventi...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000698

    authors: O'Connell J,Rockell J,Ouellet JC,LeBeau M

    更新日期:2017-06-01 00:00:00

  • Costs of Nonfatal Traumatic Brain Injury in the United States, 2016.

    abstract:BACKGROUND:Traumatic brain injury (TBI) is a serious public health problem in the United States. Each year, TBIs substantially contribute to health care costs, which vary by severity. This is important to consider given the variability in recovery time by severity. RESEARCH DESIGN:This study quantifies the annual incr...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001511

    authors: Miller GF,DePadilla L,Xu L

    更新日期:2021-01-28 00:00:00

  • An epidemiologic approach to drug prescribing quality assessment: a study in primary care practice in France.

    abstract:OBJECTIVE:To assess drug prescribing by primary care physicians in France for various types of conditions, and to identify patterns and risk factors for poor prescribing quality. METHODS:The orders (n = 23,080) written for patients with five target diseases (acute nasopharyngitis, acute tonsillitis, essential hyperten...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199912000-00012

    authors: Coste J,Venot A

    更新日期:1999-12-01 00:00:00

  • Differential item functioning (DIF) and the Mini-Mental State Examination (MMSE). Overview, sample, and issues of translation.

    abstract:BACKGROUND:Various forms of differential item functioning (DIF) in the Mini-Mental State Examination (MMSE) have been identified. Items have been found to perform differently for individuals of different educational levels, racial/ethnic groups, and/or of groups whose first language is not English. The articles in this...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.mlr.0000245181.96133.db

    authors: Ramirez M,Teresi JA,Holmes D,Gurland B,Lantigua R

    更新日期:2006-11-01 00:00:00

  • Identification of differential item functioning using item response theory and the likelihood-based model comparison approach. Application to the Mini-Mental State Examination.

    abstract:BACKGROUND:An important part of examining the adequacy of measures for use in ethnically diverse populations is the evaluation of differential item functioning (DIF) among subpopulations such as those administered the measure in different languages. A number of methods exist for this purpose. OBJECTIVE:The objective o...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.mlr.0000245251.83359.8c

    authors: Orlando Edelen MO,Thissen D,Teresi JA,Kleinman M,Ocepek-Welikson K

    更新日期:2006-11-01 00:00:00

  • Nonresponse bias in a survey of patient perceptions of hospital care.

    abstract:BACKGROUND:Incomplete participation is of particular concern for surveys of patient perceptions of care because patients who have negative opinions may be least likely to participate. OBJECTIVE:We sought to examine indirect evidence of nonresponse bias. DESIGN:We re-analyzed data from a cross-sectional patient survey...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000156856.36901.40

    authors: Perneger TV,Chamot E,Bovier PA

    更新日期:2005-04-01 00:00:00

  • Family structure and children's use of ambulatory physician services.

    abstract::The purpose of this article is to examine children's use of ambulatory physician services in relation to three dimensions of family life: maternal employment, single-parent versus two-parent households, and the presence of a nuclear or extended family. Data from the National Medical Care Expenditure Survey show that m...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198504000-00007

    authors: Cafferata GL,Kasper JD

    更新日期:1985-04-01 00:00:00

  • The future of kidney transplantation. The effect of improvements in survival rate on the shortage of donated kidneys.

    abstract::New drugs and other medical advances in organ transplantation are expected to increase the rate of retention of transplanted kidneys, or grafts, and therefore also raise patient survival rates. In particular, the immunosuppressive drug cyclosporine has been found to reduce the likelihood of rejection of a transplanted...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:

    authors: Ruth RJ,Wyszewianski L,Campbell DA

    更新日期:1987-03-01 00:00:00

  • Physician and practice characteristics associated with the early utilization of new prescription drugs.

    abstract:BACKGROUND:Prescription of new drugs contributes to substantial increases in annual drug expenditures. A small proportion of physicians appear to be early users of new prescription drugs and little is known about their characteristics. OBJECTIVE:To estimate the initial utilization rate of new prescription drugs among ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-200308000-00004

    authors: Tamblyn R,McLeod P,Hanley JA,Girard N,Hurley J

    更新日期:2003-08-01 00:00:00

  • Attitudes toward self-care: a consumer study.

    abstract::Although self-care is emerging as a growing movement wherein lay persons are assuming more responsibility for prvention, detection and treatment of health problems, we have almost no basic descriptive studies of attitudes toward self-care of professionals and consumers. The present study explored the reliability and v...

    journal_title:Medical care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00005650-198008000-00009

    authors: Green KE,Moore SH

    更新日期:1980-08-01 00:00:00

  • Missing links in the human services nonsystem.

    abstract::Four separate human services programs and their West Philadelphia service consumers were studied by the 1971 Health Network Project: a hospital receiving ward, a community mental health satellite center, a public assistance district office, and a public child welfare agency. The basic hypotheses were that 1) the four ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-197507000-00007

    authors: Leopold EA,Schein L

    更新日期:1975-07-01 00:00:00

  • A prospective evaluation of the effect of managed care on medical care utilization among severely disabled independently living adults.

    abstract::We conducted an 18-month longitudinal evaluation of a model-managed medical care program for severely disabled, independently living adults. Regression analyses using an additive model (no interaction effects) suggest that persons in the study group did not have statistically significantly different utilization experi...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198711000-00004

    authors: Meyers AR,Cupples A,Lederman RI,Branch LG,Feltin M,Master RJ,Nicastro D,Glover M,Kress D

    更新日期:1987-11-01 00:00:00

  • Nonresponse bias: does it affect measurement of clinician behavior?

    abstract:BACKGROUND:Previous studies of nonresponders have not assessed the effects of nonresponse on the accuracy of clinician behavior measurements. Knowledge of these effects is critical to both research and quality improvement. OBJECTIVE:To evaluate the hypothesis that nonresponders to a survey would not adversely affect t...

    journal_title:Medical care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00005650-200204000-00010

    authors: Solberg LI,Beth Plane M,Brown RL,Underbakke G,McBride PE

    更新日期:2002-04-01 00:00:00

  • Health perceptions of primary care patients and the influence on health care utilization.

    abstract::This prospective study was conducted to determine the influence of primary care patients' health perceptions on their utilization of health care services. Patients' health perceptions were measured using the RAND Corporation's General Health Perceptions Questionnaire. Physicians provided scores of how they thought the...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198903001-00009

    authors: Connelly JE,Philbrick JT,Smith GR Jr,Kaiser DL,Wymer A

    更新日期:1989-03-01 00:00:00

  • Labor unions in medicine: the intersection of patient advocacy and self-advocacy.

    abstract:BACKGROUND:Labor unions have been a weak force in the medical marketplace. OBJECTIVES:To briefly review the history of physicians' and nurses' labor unions, explore the ethics of unions in medicine, and offer a solution that simultaneously serves patients and professionals. RESEARCH DESIGN:A selective review of the l...

    journal_title:Medical care

    pub_type: 评论,杂志文章

    doi:10.1097/MLR.0000000000000123

    authors: Manthous CA

    更新日期:2014-05-01 00:00:00

  • Designing and implementing research on a statewide quality improvement initiative: the DIAMOND study and initiative.

    abstract:OBJECTIVE:To demonstrate a rigorous methodology that optimally balanced internal validity with generalizability to evaluate a statewide collaborative that implemented an evidence-based, collaborative care model for depression management in primary care. STUDY DESIGN AND SETTING:Several operational features of the DIAM...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e318249d8a4

    authors: Crain AL,Solberg LI,Unützer J,Ohnsorg KA,Maciosek MV,Whitebird RR,Beck A,Molitor BA

    更新日期:2013-09-01 00:00:00

  • The Effects of the Transition From Medicaid to Medicare on Health Care Use for Adults With Mental Illness.

    abstract:BACKGROUND:The transition from Medicaid-only to dual Medicare/Medicaid coverage has the potential to reduce financial barriers to health care for patients with serious mental illness through increased coverage or expanded access to clinicians as their reimbursement increases. AIMS:To estimate the effect of dual covera...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000572

    authors: Burns ME,Huskamp HA,Smith JC,Madden JM,Soumerai SB

    更新日期:2016-09-01 00:00:00

  • Hospital restructuring and the epidemiology of hospital utilization: recent experience in Ontario.

    abstract:OBJECTIVES:The author highlights changes in hospital utilization that have occurred in association with restructuring of Ontario hospitals. The basic features of the epidemiology of hospital utilization described link the analysis of the organizational and structural components of hospitals with a more comprehensive ev...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199710001-00012

    authors: Anderson GM

    更新日期:1997-10-01 00:00:00

  • Patterns and predictors of treatment delay for mental disorders in a nationally representative, active Canadian military sample.

    abstract:BACKGROUND:Although mental disorders constitute a significant public health problem in military populations, little is known about whether military members seek mental health treatment in a timely manner. OBJECTIVE:The objective of this study was to examine delays in making the initial treatment contact for various me...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e3181bd4bf9

    authors: Fikretoglu D,Liu A,Pedlar D,Brunet A

    更新日期:2010-01-01 00:00:00

  • A prospective study of 2,000 patients attending a chiropractic college teaching clinic.

    abstract::A prospective study was undertaken to characterize 2,000 patients attending a chiropractic teaching clinic and the effectiveness of the care they received. Fifty-two percent of the patients were between 21 and 34 years old; 41% categorized their occupation as professional and 14% as skilled blue collar; 79% presented ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198706000-00006

    authors: Nyiendo J,Haldeman S

    更新日期:1987-06-01 00:00:00