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 disorder (ICD-10: I60-I69 cerebrovascular disease) in an insurance claims database in Japan from January 2005 to December 2017. From the database, 980 patients who were admitted to a convalescent rehabilitation unit with stroke were identified. After excluding 575 patients, 405 were eligible for the study. METHODS:In Japan, from April 2011, a new policy was established that allows special costs to be added as rehabilitation time increases. This policy provides an additional medical fee for inpatients in a convalescent rehabilitation unit who receive more than 120 minutes of rehabilitation therapy. We defined high-intensity rehabilitation as transfer from hospitalization to a convalescent rehabilitation unit after April 2011. Outcomes were total direct medical costs and readmission ratio during the year after discharge from the convalescent rehabilitation unit. RESULTS:Daily rehabilitation time, total rehabilitation time, and total medical costs of the high-intensity rehabilitation group were significantly higher than those of the low-intensity rehabilitation group (P < .001, P < .001, P = .011, respectively). However, there was no significant difference in the medical costs during the year after discharge (P = .653) or in the readmission ratio (hazard ratio: 1.09, 95% confidence interval: 0.55-2.18, P = .804). CONCLUSIONS AND IMPLICATIONS:Intensive rehabilitation did not reduce medical costs or the readmission ratio during the first year after discharge. Future studies should consider the necessary rehabilitation intensity given the severity of the patient's condition, using large sample sizes.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Nagayama H,Tomori K,Ikeda K,Yamauchi Kdoi
10.1016/j.jamda.2020.12.015subject
Has Abstractpub_date
2021-01-18 00:00:00eissn
1525-8610issn
1538-9375pii
S1525-8610(20)31063-Xpub_type
杂志文章abstract:OBJECTIVE:Motoric cognitive risk syndrome (MCR) is a predementia stage associated with increased risk for falls. There are conflicting results regarding its association with recurrent falls and no information about its association with postfall fractures. The aim of the study was to examine the association of MCR and i...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.04.021
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To report on the process and effect of a quality improvement project on end-of-life (EOL) care in a state veterans' home. DESIGN:The design uses survey data from representatives of the deceased, continuous quality improvement (QI) techniques, and interdisciplinary team activities. Representatives of the dece...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2005.12.020
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:To identify the differences of incidence of disability between frail older persons with and without slow walking speed. DESIGN:Prospective cohort study. SETTING:Japanese community. PARTICIPANTS:A total of l4,081 older adults aged ≥65 years living in the community, participated in a baseline assessment and ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.03.019
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Although traditional Chinese medicine (TCM) is known as an integrative part of China's health care system, little is known on the prevalence and determinants of using TCM among the middle-aged and older Chinese population, especially among those with chronic conditions. METHODS:The nationwide survey data of...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.07.011
更新日期:2015-11-01 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:OBJECTIVES:Distressing behavioral symptoms often associated with dementia are not uncommon in the long term care setting. Culture change with its "person-centered approach to care" provides a potential nonpharmacological intervention to reduce these symptoms. The purpose of this study was to examine the relationship be...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2012.02.006
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To determine if participation in a 12-month longitudinal long-term care (LTC) rotation resulted in improved knowledge and attitudes about geriatrics. DESIGN:Longitudinal study with paired measurements. SETTING:A community LTC facility and a university-affiliated, community-based internal medicine residency ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2006.05.009
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:Good scientific evidence indicates that calcium and vitamin D supplementation decrease the incidence of osteoporosis-related fractures among institutionalized elderly. OBJECTIVE:The objective was to study the frequency of prescribing calcium and vitamin D supplements in elderly institutionalized individuals...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1097/01.JAM.0000110649.22467.B4
更新日期:2004-03-01 00:00:00
abstract:PURPOSE:The purpose of this study was to explore approaches used by administrators to respond to grief and bereavement among staff after the death of a resident. METHODS:Continuing care retirement community (CCRC) facilities (n = 10) were randomly selected from a larger study of 31 facilities. Open-ended interviews we...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.06.013
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:Our study examined the proportion of skilled nursing facility (SNF) post-acute care residents who did not receive timely primary care provider (PCP) services following discharge, factors associated with lack of timely PCP services, and factors associated with perfect 30-day home time among those who did not ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.09.016
更新日期:2020-10-26 00:00:00
abstract:OBJECTIVE:To describe the prevalence of periodic eye examinations by eye professionals and to examine nursing facility resident characteristics associated with lack of periodic screening. DESIGN:Retrospective chart review. SETTING:Two Midwestern nursing facilities. PARTICIPANTS:Between 1995 and 1997, 134 subjects ag...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVES:To establish the reliability and validity of a measure to assess pain in individuals with advanced dementia. DESIGN:Sixty-five residents of long-term care facilities were assessed using a new rating tool, the Pain Assessment for the Dementing Elderly (PADE), in two separate studies: (1) Residents were asses...
journal_title:Journal of the American Medical Directors Association
pub_type: 临床试验,杂志文章
doi:10.1097/01.JAM.0000043419.51772.A3
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To investigate whether polypharmacy is associated with a higher incidence of frailty in a large cohort of North Americans during 8 years of follow-up. DESIGN:Longitudinal study, follow-up of 8 years. PARTICIPANTS:A total of 4402 individuals at high risk or having knee osteoarthritis free from frailty at bas...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.02.009
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVES:Green House and other small nursing home (NH) models are considered "nontraditional" due to their size (10-12 beds), universal caregivers, and other home-like features. They have garnered great interest regarding their potential benefit to limit Coronavirus Disease 2019 (COVID-19) infections due to fewer peo...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2021.01.069
更新日期:2021-01-26 00:00:00
abstract::Memantine is approved for treatment of moderate to severe Alzheimer disease (AD) but is also investigated as a treatment option for a number of different conditions, and even though there are reports of a number of adverse effects, including new-onset seizures and psychosis, it is considered to be generally well toler...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2013.01.010
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVES:To test different adherent strategies aimed at improving hip protector use among nursing care facility residents. DESIGN, SETTING AND PARTICIPANTS:A cluster randomized controlled trial with 234 residents older than 75 years from 9 units of 7 nursing care facilities in the Northern Sydney region, Australia. ...
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.2010.02.010
更新日期:2011-01-01 00:00:00
abstract::Nutritional problems are frequent in nursing homes including undernutrition, obesity, and diabetes mellitus, mainly related to disability and behavior troubles. Adequate nutritional care relies both on the quality of menus for regular and modified diet (texture-modified and enriched food) and on the staff knowledge of...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2009.04.003
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVES:To assess relationships between low skeletal muscle mass (SMM) and functional decline in community-dwelling elderly women. DESIGN:Secondary analysis of data from EPIDOS, a French prospective observational multicenter cohort study of osteoporosis epidemiology. SETTING:One center in France between 1992 and 1...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jamda.2012.12.002
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:Falls are common in nursing homes and cause a high burden of injuries. The objective of this study was to analyze factors associated with serious consequences of falls in nursing home residents. DESIGN:Prospective observational study. SETTING:Falls were recorded over 1 year, covering all resident...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.03.015
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVES:In the United States, home health agencies (HHAs) provide essential services for patients recovering from post-acute care and older adults who are aging in place. During the COVID-19 pandemic, HHAs may face additional challenges caring for these vulnerable patients. Our objective was to explore COVID-19 prep...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jamda.2020.06.002
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The subject of estrogen in regard to short-term memory is controversial. There is support in the medical literature for estrogen improving short-term memory in women, but there are few data on this subject pertaining to genetic men. OBJECTIVE:To examine the effects of supplemental estrogen on short-term mem...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2000-01-01 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:To determine the prevalence and characteristics of advance care planning (ACP) among persons dying in long-term care (LTC) facilities, and to examine the relationship between respondent, facility, decedent, and family characteristics and ACP. DESIGN:After-death interviews of family members of decedents and ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2008.10.015
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVES:We sought to examine the associations of osteosarcopenia with physical performance, balance, and falls and fractures in community-dwelling older adults. Additionally, we aimed to determine which clinical outcomes are associated with specific components of osteosarcopenia. DESIGN:Cross-sectional study. SETT...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.09.005
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVES:Because they are potentially modifiable and may coexist, we evaluated the combined occurrence of a reduced forced expiratory volume in 1 second (FEV1) and peripheral artery disease (PAD), including its association with exertional symptoms, physical inactivity, and impaired mobility, in sedentary elders with ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.05.008
更新日期:2014-09-01 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:OBJECTIVE:To systematically review the risks for aspiration pneumonia in frail older people and the contribution of bad oral health among the risk factors. DESIGN:Systematic literature review. SETTING:PubMed (Medline), Web of Science, Cochrane Library, EMBASE, and CINAHL were searched for eligible studies, published ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2010.12.099
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Inappropriate antipsychotic prescribing is a key quality indicator by which clinical outcomes might be monitored and improved in long-term care (LTC), but limited evidence exists on the most effective strategies for reducing inappropriate antipsychotic use. OBJECTIVES:The objective of the study was to evalu...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.07.025
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:From 2013 to 2016, the Centers for Medicare and Medicaid Services Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents ("the Initiative") tested a series of clinical interventions and care models, through organizations called Enhanced Care and Coordination Providers (ECCPs), with ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.01.002
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Poor gait performance predicts risk of developing dementia. No structured critical evaluation has been conducted to study this association yet. The aim of this meta-analysis was to systematically examine the association of poor gait performance with incidence of dementia. METHODS:An English and French Medli...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jamda.2015.12.092
更新日期:2016-06-01 00:00:00