Abstract:
OBJECTIVE:To identify specific characteristics of patients, physicians, and treatment settings associated with decreased receipt of essential medications in a chronically ill, older population following a Medicaid three-prescription monthly reimbursement limit (cap). DESIGN:Quasi-experiment with bivariate and multivariate regression. SETTING:Patients in the New Hampshire Medicaid program and their regular prescribing physicians. PARTICIPANTS:Three hundred and forty-three chronically ill Medicaid enrollees with regular use of essential medications for heart disease, asthma/chronic obstructive pulmonary disease, diabetes mellitus, seizure, or coagulation disorders who received an average of three or more prescriptions per month during the baseline year. MEASUREMENTS:Postcap patient-level change in standard monthly dose of essential medications compared with the baseline period, presence of 11 comorbidities (defined by regular use of specific indicator drugs), practice setting, and location of regular prescribing physician. RESULTS:The mean percentage change in standard doses of essential medications following the cap was -34.4%. Larger changes were significantly associated with several baseline measures: greater numbers of precap medications, greater numbers of comorbidities, longer hospitalizations, and greater use of ambulatory services. The three comorbidities associated with the largest relative reduction in essential drug use were psychoses/bipolar disorders, anxiety/sleep problems, and chronic pain. Patients of physicians in group practices, clinics, or hospitals tended to have smaller dose reductions than those whose physicians were in solo or small-group practice. CONCLUSIONS:Patients most at risk of reduced access to essential medications because of a reimbursement cap include those with multiple chronic illnesses requiring drug therapy, especially illnesses with a mental health component. Physicians in clinics or large group practices may have maintained patient medication regimens more effectively.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Fortess EE,Soumerai SB,McLaughlin TJ,Ross-Degnan Ddoi
10.1046/j.1532-5415.2001.49158.xsubject
Has Abstractpub_date
2001-06-01 00:00:00pages
793-7issue
6eissn
0002-8614issn
1532-5415pii
jgs49158journal_volume
49pub_type
杂志文章abstract:OBJECTIVE:Traditional mental status and psychometric assessments bottom out in the late stages of Alzheimer disease (AD). A method adapted from cognitive testing in infants, the Ordinal Scales of Psychological Development was modified (M-OSPD) and applied to a severely demented population. The concurrent validity of th...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章
doi:10.1111/j.1532-5415.1994.tb06509.x
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVES:Factors specifically affecting compliance with continuous positive airway pressure (CPAP) in older patients with obstructive sleep apnea (OSA) have not been described. The purpose of this study is to determine which factors are associated with compliance and noncompliance in older patients, a growing segment...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.49238.x
更新日期:2001-09-01 00:00:00
abstract::In this paper, we present the consensus statement from a national conference on research priorities and methodologies for studying geriatric evaluation and management (GEM) programs. These conclusions, discussion points, and recommendations resulted from discussions of plenary papers, working group deliberations, and ...
journal_title:Journal of the American Geriatrics Society
pub_type: 共识发展会议,杂志文章,评审
doi:10.1111/j.1532-5415.1991.tb05936.x
更新日期:1991-09-01 00:00:00
abstract::Arguments have been made that the culture of nursing homes (NHs) must change to improve the quality of care, and two initiatives have been designed to accomplish this goal. One initiative is to provide resident outcome information (quality indicators) to NH management and consumers via public reporting systems. This i...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52372.x
更新日期:2004-08-01 00:00:00
abstract::To help determine whether or not the elderly are at unusually high risk for hospital-related complications, a study was made of consecutive admissions involving 48 patients less than 65 years old (mean 50.3 years) and 174 patients more than 65 years old (mean 73.1 years). They were prospectively followed during their ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb02837.x
更新日期:1982-06-01 00:00:00
abstract::Oral temperature has long been used as a basis for clinical decisions. The ingestion of cold liquids such as iced water, which are frequently found at patients' bedsides or in clinic waiting areas, has been believed to potentially lower oral temperature readings. The degree and duration of this effect, however, has no...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb04245.x
更新日期:1986-07-01 00:00:00
abstract:OBJECTIVE:To study the association of two well known risk factors for breast cancer and the association of knowledge of those risk factors with mammography utilization. DESIGN:Cross sectional: two independent random telephone surveys. SETTING:Two Northeastern metropolitan communities surveyed in 1987 and in 1989. PA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1992.tb01848.x
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVES:To develop and evaluate a modification of the Fried frailty assessment using population-independent cutpoints and to determine frailty prevalence of community-dwelling elderly people in a German population. DESIGN:Cross-sectional analysis of 8-year follow-up data of a large German cohort study. SETTING:Saa...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.04192.x
更新日期:2012-11-01 00:00:00
abstract::As the complexity, prevalence and visibility of ethical dilemmas in medical care of the elderly have grown, hospitals and nursing homes have attempted to develop mechanisms for responding to these difficult ethical issues. While it is known that many hospitals rely on education and advice provided by an ethics committ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1988.tb01786.x
更新日期:1988-02-01 00:00:00
abstract:OBJECTIVES:To describe and provide baseline data from The National Pressure Ulcer Long-Term Care Study (NPULS). DESIGN:Retrospective cohort study of detailed resident characteristics, treatments, and outcomes using convenience sampling. SETTING:One hundred nine long-term care facilities throughout the United States. ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50510.x
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:To describe the differences between healthy young and older women in regards to trunk elevation and hip pivot motions when rising from a supine to a seated position. DESIGN:Cross-sectional comparison. SETTING:University laboratory. PARTICIPANTS:Two groups of healthy female volunteers: young adult female co...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb05804.x
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVES:To compare the longitudinal changes in maximal aerobic capacity (VO2max) in healthy middle aged and older athletes and sedentary men. DESIGN:A cohort study with mean follow-up of 8.7 years (range 4.0-12.8). SETTING:Outpatient research at a tertiary hospital. PARTICIPANTS:Forty-two healthy, middle aged, an...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.t01-1-49276.x
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVES:To examine the effect of interventions to optimize medication use on adverse drug reactions (ADRs) in older adults. DESIGN:Systematic review and meta-analysis. EMBASE, PubMed, OVID, Cochrane Library, Clinicaltrials.gov, and Google Scholar were searched through April 30, 2017. SETTING:Randomized controlled ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,meta分析
doi:10.1111/jgs.15195
更新日期:2018-02-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1997.tb03092.x
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:To identify a set of geriatric conditions as optimal targets for quality improvement to be used in a quality measurement system for vulnerable older adults. DESIGN:Discussion and two rounds of ranking of conditions by a panel of geriatric clinical experts informed by literature reviews. METHODS:A list of 78...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb04691.x
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVES:To explore the effect of inflammation and undernutrition on the association between hypocholesterolemia and higher overall mortality in high-functioning older persons. DESIGN:Prospective cohort study. SETTING:Three U.S. communities. PARTICIPANTS:A cohort of 870 participants from the MacArthur Studies of S...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1034/j.1601-5215.2002.51014.x
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVES:To apply diagnostic criteria for mild cognitive impairment (MCI) to a geographically representative sample, to estimate the prevalence of MCI, and to estimate 10-year trajectories of incident disability for cognitively intact participants and subgroups with MCI. DESIGN:Prospective cohort; 10 years of follow...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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更新日期:2005-11-01 00:00:00
abstract:OBJECTIVES:To determine the effect of new oral anticoagulants (NOACs) on prescribing practices in older adults with atrial fibrillation (AF). DESIGN:Retrospective observational cohort study. SETTING:Academic medical center in St. Louis, Missouri. PARTICIPANTS:Individuals aged 75 and older with AF admitted to the hos...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15058
更新日期:2017-11-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.01710.x
更新日期:2008-06-01 00:00:00
abstract::The Integrated Memory Care Clinic (IMCC) is a patient-centered medical home as defined by the National Committee for Quality Assurance directed by advanced practice registered nurses (APRNs) caring for persons living with dementia (PLWD); physicians provide specialty consultation but do not direct care or care plannin...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15528
更新日期:2018-12-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15740
更新日期:2019-03-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章
doi:10.1111/j.1532-5415.1995.tb07402.x
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:Based on the Canadian Study of Health and Aging (CSHA), to determine the importance of cognitive status, sociodemographic factors, functional status, and other health related factors as predictors of 5-year overall mortality in older Canadians. DESIGN, SETTING AND PARTICIPANTS:Two partially overlapping group...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.1999.tb05207.x
更新日期:1999-10-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14297
更新日期:2016-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/jgs.14813
更新日期:2017-07-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2007-06-01 00:00:00
abstract::Differing concepts of aging, i.e., a normative versus a pathologic process, are presented in historical perspective and are traced through selected writings from ancient China, India, Egypt, and Greece into more modern times. These is no consistent shift across epochs from one to the other perspective, and mixed persp...
journal_title:Journal of the American Geriatrics Society
pub_type: 历史文章,杂志文章
doi:10.1111/j.1532-5415.1982.tb07104.x
更新日期:1982-04-01 00:00:00
abstract::The objectives of this study were to examine the prevalence of assistive technology (AT) use, type of assistance used for each activity of daily living (ADL) limitation, and correlates of AT use among Native Indian aged 55 and older. Data were collected as part of a cross-sectional study of disability with 505 members...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.03140.x
更新日期:2010-11-01 00:00:00
abstract::After a 2-week washout period, 30 elderly hypertensive patients were treated with pindolol (a beta-adrenergic blocker) for 3 weeks. In 13 patients the reduction in blood pressure was satisfactory and treatment with pindolol was continued for another 4 weeks. In 17 patients the subsequent treatment was supplemented wit...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1978.tb03680.x
更新日期:1978-08-01 00:00:00
abstract:OBJECTIVES:To understand the natural history of frailty after an aggressive surgical intervention, kidney transplantation (KT). DESIGN:Prospective cohort study (December 2008-March 2014). SETTING:Baltimore, Maryland. PARTICIPANTS:Kidney transplantation recipients (N = 349). MEASUREMENTS:The Fried frailty score was ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13657
更新日期:2015-10-01 00:00:00