Abstract:
OBJECTIVES:To describe the time to first acute care use (e.g., emergency department (ED) use without hospitalization or rehospitalization) for older adults discharged to home after receiving postacute care in skilled nursing facilities (SNFs); to identify predictors of first acute care use. DESIGN:Retrospective cohort study using administrative claims data. SETTING:SNFs providing postacute care for patients in North and South Carolina (N = 1,474). PARTICIPANTS:A cohort of Medicare beneficiaries aged 65 and older (N = 55,980) who were hospitalized and then transferred to a SNF for postacute care and subsequently discharged home (January 1, 2010, to August 31, 2011). MEASUREMENTS:Medicare institutional claims data (Parts A and B) and Medicare enrollment data were used; facility-level variables were obtained from CMS Nursing Home Compare. Survival from SNF discharge to first acute care use was explored. Cox proportional hazards regression models were used to describe individual-, home care-, and nursing facility-level predictors. RESULTS:After discharge from SNF to home, 22.1% of older adults had an episode of acute care use within 30 days, including 7.2% with an ED visit without hospitalization and 14.8% with a rehospitalization; 37.5% of older adults had their first acute care use within 90 days. Male sex, dual eligibility status, higher Charlson comorbidity score, certain primary diagnoses at index hospitalization (neoplasms and respiratory disease), and care in SNFs with for-profit ownership or fewer licensed practical nurses hours per patient-day were associated with greater likelihood of acute care use. CONCLUSION:Medicare beneficiaries have a high use of acute care services after discharge from SNFs, and several factors associated with acute care use are potentially modifiable. Findings suggest the need for interventions to support beneficiaries as they transition from SNFs to home.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Toles M,Anderson RA,Massing M,Naylor MD,Jackson E,Peacock-Hinton S,Colón-Emeric Cdoi
10.1111/jgs.12602subject
Has Abstractpub_date
2014-01-01 00:00:00pages
79-85issue
1eissn
0002-8614issn
1532-5415journal_volume
62pub_type
杂志文章abstract::To prevent falls effectively, one must first understand the underlying reasons. Although environmental factors are sometimes to blame, the fundamental cause is a decline in postural control which is partly age-related and partly due to pathologic changes in the central nervous system. Dizziness is a common complaint a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb01125.x
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abstract:OBJECTIVES:To determine whether obese older adults who qualify for nursing home (NH) placement are as likely as nonobese adults to be admitted to NHs that provide adequate quality of care. DESIGN:Retrospective study. SETTING:NHs in New York State. PARTICIPANTS:Individuals aged 65 and older newly admitted to a NH in ...
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journal_title:Journal of the American Geriatrics Society
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb02596.x
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVES:To determine the relationship between apolipoprotein E (APOE) epsilon4 and Alzheimer's disease (AD) in the Mexican Mestizo population, as well as its effects on the cognitive profile of AD and elderly Mestizos without dementia. DESIGN:Cross-sectional analysis of a cohort study. SETTING:Evaluations were con...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01606.x
更新日期:2008-04-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.2008.01848.x
更新日期:2008-09-01 00:00:00
abstract::In this study an attempt was made to determine the relationship between cerebral amyloid angiopathy (AA) and other cerebrovascular lesions in the aged. The brains of 128 autopsy patients over 60 years of age were examined by both light and electron microscopy. The frequency of cerebral AA increased with age and was 58...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1981.tb01757.x
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doi:10.1111/j.1532-5415.2000.tb03871.x
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journal_title:Journal of the American Geriatrics Society
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doi:10.1111/jgs.15469
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16467
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1993.tb06177.x
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doi:10.1111/j.1532-5415.2010.03134.x
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pub_type: 杂志文章
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doi:10.1111/j.1532-5415.1998.tb02746.x
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journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1982.tb05662.x
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doi:10.1111/j.1532-5415.1979.tb01673.x
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1977.tb00648.x
更新日期:1977-07-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2019-11-01 00:00:00
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abstract:OBJECTIVE:To assess the experience of Minnesota nursing homes with methicillin-resistant Staphylococcus aureus (MRSA) and the policies and procedures used for its control. DESIGN:A 12-question survey, with primarily categorical responses, was mailed to the Directors of Nursing of all Minnesota long-term-care facilitie...
journal_title:Journal of the American Geriatrics Society
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更新日期:1991-11-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1976.tb04294.x
更新日期:1976-04-01 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
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更新日期:2015-10-01 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.15420
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