Abstract:
OBJECTIVES:To determine whether an in-home palliative care intervention for terminally ill patients can improve patient satisfaction, reduce medical care costs, and increase the proportion of patients dying at home. DESIGN:A randomized, controlled trial. SETTING:Two health maintenance organizations in two states. PARTICIPANTS:Homebound, terminally ill patients (N=298) with a prognosis of approximately 1 year or less to live plus one or more hospital or emergency department visits in the previous 12 months. INTERVENTION:Usual versus in-home palliative care plus usual care delivered by an interdisciplinary team providing pain and symptom relief, patient and family education and training, and an array of medical and social support services. MEASUREMENTS:Measured outcomes were satisfaction with care, use of medical services, site of death, and costs of care. RESULTS:Patients randomized to in-home palliative care reported greater improvement in satisfaction with care at 30 and 90 days after enrollment (P<.05) and were more likely to die at home than those receiving usual care (P<.001). In addition, in-home palliative care subjects were less likely to visit the emergency department (P=.01) or be admitted to the hospital than those receiving usual care (P<.001), resulting in significantly lower costs of care for intervention patients (P=.03). CONCLUSION:In-home palliative care significantly increased patient satisfaction while reducing use of medical services and costs of medical care at the end of life. This study, although modest in scope, presents strong evidence for reforming end-of-life care.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Brumley R,Enguidanos S,Jamison P,Seitz R,Morgenstern N,Saito S,McIlwane J,Hillary K,Gonzalez Jdoi
10.1111/j.1532-5415.2007.01234.xsubject
Has Abstractpub_date
2007-07-01 00:00:00pages
993-1000issue
7eissn
0002-8614issn
1532-5415pii
JGS1234journal_volume
55pub_type
杂志文章,多中心研究,随机对照试验abstract::Low-income Latino immigrants are understudied in elder abuse research. Limited English proficiency, economic insecurity, neighborhood seclusion, a tradition of resolving conflicts within the family, and mistrust of authorities may impede survey research and suppress abuse reporting. To overcome these barriers, promoto...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.04025.x
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:To quantify incidence of tooth loss, prosthodontic dental restoration, and chewing difficulty onset and the effect of tooth loss and prosthodontic restoration on chewing difficulty onset. DESIGN:A prospective cohort study of oral health and related behaviors with in-person interviews and clinical examinatio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52253.x
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the effectiveness of exercise and amino acid supplementation in enhancing muscle mass and strength in community-dwelling elderly sarcopenic women. DESIGN:Randomized controlled trial. SETTING:Urban community in Tokyo, Japan. PARTICIPANTS:One hundred fifty-five women aged 75 and older were defin...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2011.03776.x
更新日期:2012-01-01 00:00:00
abstract::Falls are among the most common unwanted events in older hospital inpatients, but evidence of effective prevention is still limited compared with that in the community and in long-term care facilities. This article describes a prevention program and its effects on the incidence of falls in geriatric hospital wards. It...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01424.x
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVES:To examine the relationship between frequent falls in older drivers and motor vehicle collision (MVC) involvement. DESIGN:Cross-sectional. SETTING:North central Alabama. PARTICIPANTS:Population-based sample of 2,000 licensed drivers aged 70 and older. MEASUREMENTS:Self-reported history of falling two or ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12594
更新日期:2014-01-01 00:00:00
abstract::The purpose of this study was to assess vaccination status of adults in primary and specialty care practices in a retrospective review of medical records from 1997 to 2000 at one university medical center. Eligible patients were aged 50 and older and had two or more visits to primary and specialty care practices (N=14...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52273.x
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVES:Several studies have demonstrated that a large percentage of older people are inadequately immunized against tetanus. The aim of this study was to assess the immunity against tetanus in a group of individuals aged 69 and older and to examine the immune response to a single dose of tetanus toxoid. DESIGN:A c...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb06893.x
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVES:To test the efficacy of an individualized social activity intervention (ISAI) on decreasing daytime sleep, improving nighttime sleep, and lowering the day/night sleep ratio and to determine its cost. DESIGN:Pretest/posttest randomized with an experimental and control group. SETTING:Seven nursing homes. PA...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2005.53460.x
更新日期:2005-09-01 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:OBJECTIVES:To determine the effect of body mass index (BMI) at old age and at age 50 on short-term survival among persons age 65 and older. DESIGN:Cross-sectional, using the 4,791 respondents to the community interview of the 1994 National Long Term Care Survey (NLTCS). SETTING:United States of America. PARTICIPANTS...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.49259.x
更新日期:2001-10-01 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.15203
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVES:To investigate factors associated with lower likelihood of discharge to home from geriatric intermediate care facilities in Japan. DESIGN:Retrospective cohort study. SETTING:We used data from the nationwide long-term care (LTC) insurance claims database (April 2012-March 2014). PARTICIPANTS:Study particip...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15295
更新日期:2018-04-01 00:00:00
abstract::The objective of this study was to use performance-based measurements to identify, in a population of community-dwelling American Indians aged 55 and older, the prevalence and correlates of lower body functioning. Data were collected as part of a cross-sectional study of disability from members of a tribe in the south...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03869.x
更新日期:2012-03-01 00:00:00
abstract::The field has progressed to the point where a genetic investigation of the aging processes in Drosophila can be viewed as constituting both a serious and a feasible research program. There now exists at least one single gene mutant which yields an accelerated aging phenotype, at least two single gene null mutants affe...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1989.tb02240.x
更新日期:1989-08-01 00:00:00
abstract::The hypochondriacal attitudes of 53 aged community residents were studied. No significant correlations were found with situational stress, sex, or ethnicity (English-speaking vs Spanish-speaking). The levels of hypochondriasis appeared to be inversely related to self-evaluation of memory ability. There was no indicati...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1981.tb02392.x
更新日期:1981-01-01 00:00:00
abstract::Patients aged 70 years and older who were admitted to a coronary care unit in 1976 with documented acute myocardial infarction were followed to April 30, 1982. At that time, of the 46 patients who had survived initial hospitalization, 28 had died, 16 were still living, and two were lost to follow up. The actuarial sur...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1983.tb03714.x
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVE:To describe the total cost of pressure ulcer prevention, component costs of each intervention, and the relationship of costs to subjects' risk level. DESIGN:3-month cohort trial. SETTING:A 600-bed, state-supported, long-term care facility. PATIENTS:A total of 539 war veterans, 83% of whom were male; mean a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb06095.x
更新日期:1995-05-01 00:00:00
abstract::Available strategies to increase influenza vaccination rates in the elderly have not been tested in the private sector where most elderly receive care. We performed a randomized controlled trial of a postcard reminder in the three private general internal medicine practices. The observed vaccination rates of 55% in ex...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.1987.tb06354.x
更新日期:1987-08-01 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.1532-5415.1984.tb02009.x
更新日期:1984-03-01 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:OBJECTIVES:To estimate the number of caregivers providing assistance to community-dwelling older persons with and without dementia and with or without substantial disability; to describe the characteristics of caregivers and care recipients in these groups; to characterize the health-related tasks that caregivers provi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14910
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVES:To examine the prevalence of mobility device use in community-dwelling older adults in the United States and to investigate the incidence of falls and worry about falling according to type and number of mobility devices used. DESIGN:Analysis of cross-sectional and longitudinal data from the 2011-12 National...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13393
更新日期:2015-05-01 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.12651
更新日期:2014-02-01 00:00:00
abstract::Cerebral blood flow (CBF) was measured by the 133Xe inhalation method in patients with multi-infarct dementia (MID, N = 26), Alzheimer's dementia (AD, N = 19), and among age-matched, neurologically normal, healthy volunteers (N = 26). Cognitive performance was assessed in all subjects using the Cognitive Capacity Scre...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb04318.x
更新日期:1986-05-01 00:00:00
abstract:OBJECTIVE:To determine whether mortality is independently associated with urinary incontinence. DESIGN:6-year prospective study that started in 1983/84. SETTING:A Midwestern County. PARTICIPANTS:Probability sample of 1956 community-residing persons 60 years of age and older in 1983/84. MEASUREMENTS:The independent ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb01749.x
更新日期:1994-03-01 00:00:00
abstract::After a one-year interval, a structured interview designed to assess the quality of life was again conducted with most of the tenants in a single-room occupancy hotel in New York City. Comparisons was made between the two sets of findings. During the year, a program had been in effect to provide social, psychiatric, r...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1975.tb00316.x
更新日期:1975-06-01 00:00:00
abstract:OBJECTIVES:To determine whether older adults with the hepatitis C virus (HCV) achieve a sustained viral response (SVR) after treatment with direct-acting antiviral therapy. PARTICIPANTS:Individuals aged 80 and older with chronic HCV infection (N = 253; n = 213 with cirrhosis, n = 40 with advanced fibrosis). MEASUREME...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15140
更新日期:2018-01-01 00:00:00
abstract::Chief residents (CRs) play a crucial role in training residents and students but may have limited geriatrics training or formal preparation for their CR role. A 2-day off-site chief resident immersion training (CRIT) addressed these challenges. Objectives were to foster collaboration between disciplines in the managem...
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:OBJECTIVES:To compare the cost-effectiveness of four influenza vaccines available in the United States for persons aged 65 and older: trivalent inactivated influenza vaccine (IIV3), quadrivalent inactivated influenza vaccine (IIV4), a more-expensive high-dose IIV3, and a newly approved adjuvanted IIV3. DESIGN:Cost-eff...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14323
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:To investigate whether atherosclerosis of the ascending aorta, internal carotid arteries, and coronary arteries is predictive of postoperative delirium in subjects undergoing coronary artery bypass graft (CABG) surgery. DESIGN:Prospective cohort study. SETTING:Boston Veterans Affairs Healthcare System. PA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53165.x
更新日期:2005-03-01 00:00:00