Health care utilization and costs in a Medicare population by fall status.

Abstract:

OBJECTIVES:The economic impact of trauma in older persons is a matter of increasing concern to public health practitioners and planners, yet it is an issue that has not been widely studied. Available evidence does suggest, however, that falls are the costliest category of injury among older persons. METHODS:This study used data from the Health Care Financing Administration and the Connecticut Long-Term Care Registry to isolate the effects of fall severity on hospital, nursing home, home health, and emergency room costs. Multivariate and logistic regression methods were used to control for the influence of a number of clinical and demographic factors believed to be independently related to health care costs. Health care costs of fallers were tracked for 1 year after the fall. The cost experience of this cohort was compared with nonfallers during the same time period. RESULTS:The results provide strong evidence that falls are associated with increased health care costs, and that this relation increases monotonically with the frequency and severity of falls. Incurring one or more injurious falls was associated with increased annual hospital costs of $11,042 (1996), nursing home costs of $5,325, and total health care costs of $19,440. Incurring two or more noninjurious falls increased costs substantially as well. CONCLUSIONS:The health care costs of falls are pervasive and substantial, and they increase with fall frequency and severity.

journal_name

Med Care

journal_title

Medical care

authors

Rizzo JA,Friedkin R,Williams CS,Nabors J,Acampora D,Tinetti ME

doi

10.1097/00005650-199808000-00006

subject

Has Abstract

pub_date

1998-08-01 00:00:00

pages

1174-88

issue

8

eissn

0025-7079

issn

1537-1948

journal_volume

36

pub_type

杂志文章
  • Quality-adjusted Life Years (QALY) for 15 Chronic Conditions and Combinations of Conditions Among US Adults Aged 65 and Older.

    abstract:BACKGROUND:Although the life expectancy for the US population has increased, a high proportion of this population has lived with ≥1 chronic conditions. We have quantified the burden of disease associated with 15 chronic conditions and combinations of conditions by estimating quality-adjusted life years (QALYs) for olde...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000943

    authors: Jia H,Lubetkin EI,Barile JP,Horner-Johnson W,DeMichele K,Stark DS,Zack MM,Thompson WW

    更新日期:2018-08-01 00:00:00

  • Healthcare utilization in community-acquired pneumonia episodes of care: a comparison across the continuum of managed care.

    abstract:OBJECTIVE:Compare healthcare utilization and total payments for community-acquired pneumonia (CAP) episodes-of-care among 5 health plan designs spanning the continuum of managed care. RESEARCH DESIGN:Medical and prescription claims analysis of CAP episodes among enrollees of employer-sponsored health plans. Episode ch...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e3181a8116d

    authors: Landsman PB,Smith DG,Fendrick AM

    更新日期:2009-10-01 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 association of registered nurse staffing levels and patient outcomes: systematic review and meta-analysis.

    abstract:OBJECTIVE:To examine the association between registered nurse (RN) staffing and patient outcomes in acute care hospitals. STUDY SELECTION:Twenty-eight studies reported adjusted odds ratios of patient outcomes in categories of RN-to-patient ratio, and met inclusion criteria. Information was abstracted using a standardi...

    journal_title:Medical care

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/MLR.0b013e3181468ca3

    authors: Kane RL,Shamliyan TA,Mueller C,Duval S,Wilt TJ

    更新日期:2007-12-01 00:00:00

  • Alcoholism treatment and potential health care cost saving.

    abstract::In 1979, MEDICAL CARE published a supplement that summarized and evaluated existing research on changes in health care patterns associated with mental health, alcoholism, and drug abuse treatment. This paper, limited to alcoholism treatment, reviews research that has been completed since the 1979 supplement. Considera...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/00005650-198701000-00007

    authors: Holder HD

    更新日期:1987-01-01 00:00:00

  • The influence of proxy perspective on patient-proxy agreement in the evaluation of health-related quality of life: an empirical study.

    abstract:AIMS:There are situations in which patient self-reported health-related quality of life must be substituted by proxy assessments. Pickard and Knight recently delineated 2 proxy perspectives that may influence the nature of proxy measurements: the "proxy-patient" (the proxy's assessment from the patient's perspective) a...

    journal_title:Medical care

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/MLR.0b013e318158af13

    authors: Gundy CM,Aaronson NK

    更新日期:2008-02-01 00:00:00

  • Access to inpatient or residential substance abuse treatment among homeless adults with alcohol or other drug use disorders.

    abstract:OBJECTIVES:We conducted a theoretically guided study of access to inpatient or residential treatment among a probability sample of homeless adults with alcohol or drug use disorders in Houston, Texas. METHODS:This study used a cross-sectional, retrospective design with data collected from a multistage random sample of...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-200111000-00003

    authors: Wenzel SL,Audrey Burnam M,Koegel P,Morton SC,Miu A,Jinnett KJ,Greer Sullivan J

    更新日期:2001-11-01 00:00:00

  • Differences in Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey Scores by Recency of the Last Visit: Implications for Comparability of Periodic and Continuous Sampling.

    abstract:BACKGROUND:Patient experience data can be collected by sampling patients periodically (eg, patients with any visits over a 1-year period) or sampling visits continuously (eg, sampling any visit in a monthly interval). Continuous sampling likely yields a sample with more frequent and more recent visits, possibly affecti...

    journal_title:Medical care

    pub_type: 社论

    doi:10.1097/MLR.0000000000001134

    authors: Setodji CM,Burkhart Q,Hays RD,Quigley DD,Skootsky SA,Elliott MN

    更新日期:2019-12-01 00:00:00

  • Complete Versus Staged Repair for Neonates With Tetralogy of Fallot: Establishment and Validation of a Cohort of 2235 Patients Using Detailed Surgery Sequence Review of Health Care Administrative Data.

    abstract:BACKGROUND:The surgical strategy for neonates with tetralogy of Fallot (TOF) consists of complete or staged repair. Assessing the comparative effectiveness of these approaches is facilitated by a large multicenter cohort. We propose a novel process for cohort assembly using the Pediatric Health Information System (PHIS...

    journal_title:Medical care

    pub_type: 杂志文章,多中心研究

    doi:10.1097/MLR.0000000000000846

    authors: Savla JJ,Fisher BT,Faerber JA,Huang YV,Mercer-Rosa L

    更新日期:2018-11-01 00:00:00

  • Lifetime earnings for physicians across specialties.

    abstract:BACKGROUND:Earlier studies estimated annual income differences across specialties, but lifetime income may be more relevant given physicians' long-term commitments to specialties. METHODS:Annual income and work hours data were collected from 6381 physicians in the nationally representative 2004-2005 Community Tracking...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e318268ac0c

    authors: Leigh JP,Tancredi D,Jerant A,Romano PS,Kravitz RL

    更新日期:2012-12-01 00:00:00

  • Family violence and the evaluation of behavioral concerns in a pediatric primary care clinic.

    abstract::The goals of this study were to determine 1) the prevalence of exposure to intrafamilial violence among children attending a pediatric primary care clinic; 2) the prevalence of psychosocial distress among mothers bringing their children to the clinic; 3) the extent to which pediatricians are aware of family violence a...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199205001-00013

    authors: Wissow LS,Wilson ME,Roter D,Larson S,Berman HI

    更新日期:1992-05-01 00:00:00

  • Racial variations in postoperative outcomes of carotid endarterectomy: evidence from the Veterans Affairs National Surgical Quality Improvement Program.

    abstract:CONTEXT:Black patients and Hispanic patients receive carotid endarterectomy (CEA) at lower rates than white patients. It is unclear whether worse surgical outcomes are influencing clinical decision-making regarding use of the operation among minority group patients. OBJECTIVE:To determine if there are racial differenc...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:

    authors: Horner RD,Oddone EZ,Stechuchak KM,Grambow SC,Gray J,Khuri SF,Henderson WG,Daley J

    更新日期:2002-01-01 00:00:00

  • Portal Use Among Patients With Chronic Conditions: Patient-reported Care Experiences.

    abstract:BACKGROUND:Personal health records offer patients access to view their own health information and to manage their care online through secure patient portal tools. Little is known about the patient-reported experience in using health portals to manage chronic conditions. OBJECTIVE:In a patient-centered research study, ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001178

    authors: Reed ME,Huang J,Millman A,Graetz I,Hsu J,Brand R,Ballard DW,Grant R

    更新日期:2019-10-01 00:00:00

  • The utility of severity of illness information in assessing the quality of hospital care. The role of the clinical trajectory.

    abstract::This research explored whether differentiating patients whose severity of illness worsened, improved, or remained the same over the hospital stay is a good screen for quality of care. The hypothesis was that substandard care is more likely to occur among patients who have worsened. Severity was measured using the Comp...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199205000-00005

    authors: Iezzoni LI,Restuccia JD,Shwartz M,Schaumburg D,Coffman GA,Kreger BE,Butterly JR,Selker HP

    更新日期:1992-05-01 00:00:00

  • 27. CPHA patient care data system for long-term care facilities.

    abstract::Earlier efforts of the Commission on Professional and Hospital Activities (CPHA) to develop a patient care data system for long-term care facilities were discontinued for lack of user interest and shortage of funds; however, the facilities were encouraged to participate in the hospital data system (PAS) and to use opt...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-197605001-00033

    authors: Slee VN

    更新日期:1976-05-01 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

  • The structure of critical care transfer networks.

    abstract:RATIONALE:Moving patients from low-performing hospitals to high-performing hospitals may improve patient outcomes. These transfers may be particularly important in critical care, where small relative improvements can yield substantial absolute changes in survival. OBJECTIVE:To characterize the existing critical care n...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e318197b1f5

    authors: Iwashyna TJ,Christie JD,Moody J,Kahn JM,Asch DA

    更新日期:2009-07-01 00:00:00

  • An Economic Analysis of the Implementation of Team-based Collaborative Care in Outpatient General Mental Health Clinics.

    abstract:BACKGROUND:Collaborative Chronic Care Models represent an evidence-based way to structure care for chronic conditions, including mental health conditions. Few studies, however, have examined the cost implications of collaborative care for mental health. OBJECTIVE:We aimed to conduct an economic analysis of implementin...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001372

    authors: Miller CJ,Griffith KN,Stolzmann K,Kim B,Connolly SL,Bauer MS

    更新日期:2020-10-01 00:00:00

  • Health care and insurance loss of working AFDC recipients.

    abstract::The federal Omnibus Budget Reconciliation Act of 1981 (OBRA) produced substantial changes in the Aid to Families With Dependent Children (AFDC) program. The main effect of the changes has been the denial of assistance and hence Medicaid coverage to many AFDC recipients with jobs. Our analysis of the health care and in...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198705000-00005

    authors: Moscovice I,Davidson G

    更新日期:1987-05-01 00:00:00

  • Mobile health services: a study in cost-effectiveness.

    abstract::The techniques of cost-effectiveness are employed to simplify resource allocation decisions concerned with the use of land and air transport systems in the health services of a developing country. Outcome classifications are produced for patients seen by mobile and fixed primary care units. The mobile services examine...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-197704000-00001

    authors: Walker G,Gish O

    更新日期:1977-04-01 00:00:00

  • Outcomes are Worse in US Patients Undergoing Surgery on Weekends Compared With Weekdays.

    abstract:BACKGROUND:Increasing surgical access to previously underserved populations in the United States may require a major expansion of the use of operating rooms on weekends to take advantage of unused capacity. Although the so-called weekend effect for surgery has been described in other countries, it is unknown whether US...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000532

    authors: Glance LG,Osler T,Li Y,Lustik SJ,Eaton MP,Dutton RP,Dick AW

    更新日期:2016-06-01 00:00:00

  • Format review: evaluating implementation of the problem-oriented medical record.

    abstract::As interest in the problem-oriented medical record (POMR) develops, and more medical settings begin to implement the system, many observers are expressing a desire to know how well the system is being used and accepted. Moreover, settings currently using the POMR system have a need to document the effectiveness of the...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-197610000-00006

    authors: Hammett WH,Sandlow LJ,Bashook PG

    更新日期:1976-10-01 00:00:00

  • Quality-of-life weights for the US population: self-reported health status and priority health conditions, by demographic characteristics.

    abstract:BACKGROUND:Many of the large ongoing national surveys of the US population contain a question that asks for the respondent's self-reported health status: "excellent," "very good," "good," "fair," or "poor." These surveys could be used to conduct cost-utility analyses of health care policies, treatments or other interve...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e31803dce05

    authors: Nyman JA,Barleen NA,Dowd BE,Russell DW,Coons SJ,Sullivan PW

    更新日期:2007-07-01 00:00:00

  • Racial disparities in treatment preferences for rheumatoid arthritis.

    abstract:BACKGROUND:Data suggest that differences in patient preferences may account for racial disparities in the use of medical interventions. Racial disparities have also been noted in outcomes and the delivery of healthcare services in chronic disease. Whether treatment preferences in chronic disease differ by race is not k...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e31818af829

    authors: Constantinescu F,Goucher S,Weinstein A,Fraenkel L

    更新日期:2009-03-01 00:00:00

  • The measurement of expenditures for outpatient physician and dental services: methodological findings from the health insurance study.

    abstract::Survey data measuring outpatient health expenditure are evaluated for item nonresponse, measurement error, and bias. Item nonresponse is high for persons whose health care is financed through the public sector, but is otherwise manageable. Estimates of mean total and out-of-pocket physician and dental expenditure from...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-197611000-00002

    authors: Marquis KH,Marquis MS,Newhouse JP

    更新日期:1976-11-01 00:00:00

  • Physician's extenders' performance in Air Force clinics.

    abstract::We evaluated the quality of care of physician's extenders (PEs: 23 physician's assistants, 7 primary care nurse practitioners) in Air Force primary medicine clinics, as part of an evaluation of PEs' assuming a considerable portion of the care, formerly provided by physicians in the military medical system. Physician's...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198109000-00007

    authors: Goldberg GA,Jolly DM,Hosek S,Chu DS

    更新日期:1981-09-01 00:00:00

  • Patient noncompliance in the managed care setting. The case of medical therapy for glaucoma.

    abstract:OBJECTIVES:The authors identify demographic and clinical characteristics associated with noncompliance in patients beginning medical therapy for the treatment of glaucoma in a managed care setting. METHODS:The authors describe a retrospective cohort study in a group-model health maintenance organization in Massachuset...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199803000-00012

    authors: Gurwitz JH,Yeomans SM,Glynn RJ,Lewis BE,Levin R,Avorn J

    更新日期:1998-03-01 00:00:00

  • Using health status measures in the hospital setting: from acute care to 'outcomes management'.

    abstract::In recent years, employers, insurers, and government purchasers have paid increased attention to the measurement of patient outcomes and health status. Such interest is stimulated less by policy or quality concerns than by the need to reduce health care expenditures. Any expected benefits which might accrue from healt...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199205001-00006

    authors: Lansky D,Butler JB,Waller FT

    更新日期:1992-05-01 00:00:00

  • Innovations: components of bundles.

    abstract::Acceptance by target populations of new programs funded by government is a phenomenon which one should be able to explain with existing innovation theory. In a study of a newly formed group health practice, funded in part by OEO, it is found that a commonly used set of predictors has little utility in explaining indi...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-197904000-00008

    authors: Koontz VL

    更新日期:1979-04-01 00:00:00

  • Benefits and obstacles of health status assessment in ambulatory settings. The clinician's point of view. The Dartmouth Primary Care COOP Project.

    abstract::In the past decade physicians have identified the need to expand patient assessment to include global function and quality of life. During the same period, the busy clinic has evolved into the location where this assessment seems most appropriate. Integrating functional health assessment into a busy clinical practice ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199205001-00004

    authors: Wasson J,Keller A,Rubenstein L,Hays R,Nelson E,Johnson D

    更新日期:1992-05-01 00:00:00