Abstract：
OBJECTIVES:To determine to what extent demographic, social support, socioeconomic, geographic, medical, and End-of-Life (EOL) planning factors explain racial and ethnic variation in Medicare spending during the last 6 months of life. DESIGN:Retrospective cohort study. SETTING:Health and Retirement Study (HRS). PARTICIPANTS:Decedents who participated in HRS between 1998 and 2012 and previously consented to survey linkage with Medicare claims (N = 7,105). MEASUREMENTS:Total Medicare expenditures in the last 180 days of life according to race and ethnicity, controlling for demographic factors, social supports, geography, illness burden, and EOL planning factors, including presence of advance directives, discussion of EOL treatment preferences, and whether death had been expected. RESULTS:The analysis included 5,548 (78.1%) non-Hispanic white, 1,030 (14.5%) non-Hispanic black, and 331 (4.7%) Hispanic adults and 196 (2.8%) adults of other race or ethnicity. Unadjusted results suggest that average EOL Medicare expenditures were $13,522 (35%, P < .001) more for black decedents and $16,341 (42%, P < .001) more for Hispanics than for whites. Controlling for demographic, socioeconomic, geographic, medical, and EOL-specific factors, the Medicare expenditure difference between groups fell to $8,047 (22%, P < .001) more for black and $6,855 (19%, P < .001) more for Hispanic decedents than expenditures for non-Hispanic whites. The expenditure differences between groups remained statistically significant in all models. CONCLUSION:Individuals-level factors, including EOL planning factors do not fully explain racial and ethnic differences in Medicare spending in the last 6 months of life. Future research should focus on broader systemic, organizational, and provider-level factors to explain these differences.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Byhoff E,Harris JA,Langa KM,Iwashyna TJdoi
10.1111/jgs.14263subject
Has Abstractpub_date
2016-09-01 00:00:00pages
1789-97issue
9eissn
0002-8614issn
1532-5415journal_volume
64pub_type
杂志文章abstract：OBJECTIVES:The ability of older people to estimate their own memory, often referred to as "metamemory," has been evaluated in previous studies with conflicting reports regarding accuracy. Some studies have suggested that an older person's metamemory is mostly accurate, whereas others have demonstrated little relationsh...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.2000.tb02634.x
更新日期：2000-11-01 00:00:00
abstract：OBJECTIVE:Acute myocardial infarction (AMI) is an important cause of mortality and morbidity in older patients. The aim of this study was to determine the proportion of unselected admissions with AMI that is older than 75 years and to examine management and outcomes in this group. DESIGN:An historical cohort study of ...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1999.tb02991.x
更新日期：1999-03-01 00:00:00
abstract：:Urinary incontinence and other lower urinary tract symptoms exert a major influence on the health and independence of frail older people. Detrusor underactivity (DU) is defined as a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or a failure to achieve complete bladder emp...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章,评审
doi：10.1111/j.1532-5415.2006.00917.x
更新日期：2006-12-01 00:00:00
abstract：OBJECTIVES:To examine the effect of homebound status of older persons in Israel on mortality, mental health and function, future homebound status, and institutionalization. DESIGN:Cross-sectional and longitudinal analysis using existing data sets of a national survey. SETTING:A national survey. PARTICIPANTS:The anal...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.2010.03172.x
更新日期：2010-12-01 00:00:00
abstract：:Evidence of poor performance in the evaluation and management of common geriatric conditions suggests the need for changing physician behavior in these areas. Traditional lecture-style continuing medical education (CME) has not been shown to be effective. Expert faculty initially trained 60 nonexpert peer educators to...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.2007.01205.x
更新日期：2007-08-01 00:00:00
abstract：OBJECTIVES:To test the applicability and safety of a standardized diagnostic algorithm in geriatric departments and to define the prevalence of different causes of syncope in older patients. DESIGN:Multicenter cross-sectional observational study. SETTING:In-hospital geriatric acute care departments and outpatient cli...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章,多中心研究
doi：10.1111/j.1532-5415.2006.00891.x
更新日期：2006-10-01 00:00:00
abstract：OBJECTIVES:To explore the associations between self-reported hearing problems and physical performance and self-reported difficulties in mobility and activities of daily living (ADLs) in community-dwelling older adults. DESIGN:Cross-sectional cohort study. SETTING:Community. PARTICIPANTS:Men and women aged 75 to 90 ...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/jgs.13381
更新日期：2015-06-01 00:00:00
abstract：OBJECTIVES:Lower than recommended doses of direct-acting oral anticoagulants are often prescribed to older adults with nonvalvular atrial fibrillation (NVAF). Our goal was to determine the consequences of lower than recommended dosing on plasma apixaban concentrations during the clinical care of older adults with NVAF....
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/jgs.15982
更新日期：2019-09-01 00:00:00
abstract：:Older adults with advanced chronic kidney disease (CKD) experience functional impairment that can complicate CKD management. Failure to recognize functional impairment may put these individuals at risk of further functional decline, nursing home placement, and missed opportunities for timely goals-of-care conversation...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/jgs.14262
更新日期：2016-10-01 00:00:00
abstract：OBJECTIVES:To ascertain the association between self-report of low mood and unobtrusively measured behaviors (walking speed, time out of residence, frequency of room transitions, and computer use) in community-dwelling older adults using novel monitoring technologies. DESIGN:Longitudinal cohort study of older adults w...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/jgs.12744
更新日期：2014-04-01 00:00:00
abstract：OBJECTIVES:To compare the effectiveness of acute geriatric unit care, based on all or part of the Acute Care for Elders (ACE) model and introduced in the acute phase of illness or injury, with that of usual care. DESIGN:Systematic review and meta-analysis of 13 randomized controlled and quasi-experimental trials with ...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章,meta分析,评审
doi：10.1111/jgs.12028
更新日期：2012-12-01 00:00:00
abstract：:Although increased numbers of psychogeriatric patients have been placed in proprietary nursing homes in recent years, many facilities have not been able to accommodate the behavioral problems involved. This study summarizes the results of a behavior management program for improving the social functioning and social be...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1981.tb01236.x
更新日期：1981-02-01 00:00:00
abstract：OBJECTIVE:To determine the excess mortality associated with obesity (defined by body mass index (BMI)) in older people, with and without adjustment for other risk factors associated with mortality and for demographic factors. DESIGN:Retrospective cohort analysis of the Longitudinal Study of Aging (LSOA). SETTING:Nati...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1046/j.1532-5415.2001.49189.x
更新日期：2001-07-01 00:00:00
abstract：:Recurrent Clostridium difficile infection (CDI) is a common nosocomial infection that has a large effect on morbidity and quality of life in older adults in hospitals and long-term care facilities. Because antibiotics are often unsuccessful in curing this disease, fecal transplantation has emerged as a second-line the...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章,评审
doi：10.1111/jgs.12378
更新日期：2013-08-01 00:00:00
abstract：OBJECTIVES:To determine the prevalence and predictors of adverse postoperative outcomes in older surgical patients undergoing noncardiac surgery. DESIGN:Prospective cohort study of consecutive patients undergoing noncardiac surgery in 1997. SETTING:A medical school-affiliated teaching community hospital. PARTICIPANT...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1046/j.1532-5415.2001.49212.x
更新日期：2001-08-01 00:00:00
abstract：OBJECTIVES:To evaluate changes in acute health services use of Senior PharmAssist participants. DESIGN:Retrospective analysis. SETTING:Community-based, nonprofit program in Durham County, North Carolina. PARTICIPANTS:Adults aged 60 and older with income of 200% of the federal poverty level or less who enrolled in th...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/jgs.15617
更新日期：2018-12-01 00:00:00
abstract：OBJECTIVE:To determine the prevalence of diabetes and examine its association with food intake, anthropometric and metabolic variables, and other coronary risk factors in urban and rural older Mexican populations. DESIGN:A cross-sectional study. SETTING:Three Mexican communities (urban areas of medium and low income ...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1998.tb06005.x
更新日期：1998-11-01 00:00:00
abstract：:Investigations of the natural history of blood pressure have generally evaluated mean systolic and diastolic pressure changes. While information, this information is not directly applicable to clinical practice settings, in which patients are usually classified as normotensive or hypertensive. We measured the actual i...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1989.tb02267.x
更新日期：1989-09-01 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：:Patients with diabetes mellitus and an underlying mixed axonal and demyelinating polyneuropathy are particularly prone to compression neuropathies with consequent axonal degeneration and a poor prognosis for recovery. This hazard should be taken into account whenever a prolonged surgical procedure is contemplated. An ...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1980.tb00515.x
更新日期：1980-04-01 00:00:00
abstract：:Self-administered questionnaires were sent to all faculty and staff members of the departments of internal medicine and psychiatry in a school of medicine. The questionnaires asked for information about personal characteristics, practice characteristics, and interest in teaching geriatrics. Included also were measures...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1982.tb03703.x
更新日期：1982-01-01 00:00:00
abstract：OBJECTIVES:To map the extent, range, and nature of research on the effectiveness, level of use, and perceptions about electronic medication administration records (eMARs) in long-term care facilities (LTCFs) and identify gaps in current knowledge and priority areas for future research. DESIGN:Scoping review of quantit...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章,评审
doi：10.1111/jgs.15384
更新日期：2018-07-01 00:00:00
abstract：OBJECTIVES:To identify variables associated with diagnosing dementia in poor older adults by comparing older people with dementia who were diagnosed by their primary care physicians (PCPs) with those not diagnosed by their PCP. DESIGN:Observational study. SETTING:Community-based, in-home cognitive assessment program....
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.2007.01417.x
更新日期：2007-11-01 00:00:00
abstract：BACKGROUND/OBJECTIVES:Behavioral problems in individuals with Alzheimer's disease (AD) impose major management challenges. Current prevention strategies are anchored to cognitive outcomes, but behavioral outcomes may provide another, clinically relevant opportunity for preemptive therapy. We sought to determine whether...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/jgs.15182
更新日期：2018-04-01 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：OBJECTIVE:To determine if Staphylococcus aureus and Staphylococcus epidermidis, etiologic bacterial agents to late prosthetic joint infections (LPJI), are more prevalent in the oral flora of older individuals with rheumatoid arthritis (RA) than in an age and gender-matched nonarthritic control population (NA). DESIGN:...
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：:The enzyme glucose-6-phosphate dehydrogenase (G6PD) was assayed in the circulating erythrocytes of 38 20-to 30-year-old subjects and 29 80- to 90-year-old subjects. The red blood cell G6PD activity of an aged-unbiased erythrocyte population in the young group was found to be significantly higher than in the older grou...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1983.tb06281.x
更新日期：1983-01-01 00:00:00
abstract：OBJECTIVES:To describe the circumstances of falls resulting in hip fractures among older people and to determine whether the circumstances differ by gender, age, and residential status. DESIGN:Cross-sectional study. SETTING:Two hospitals in Auckland, New Zealand, in which all individuals aged 60 years or older with a...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1997.tb05975.x
更新日期：1997-09-01 00:00:00
abstract：OBJECTIVES:To identify differences in cognitive function between elderly adults with sleep apnea syndrome (SAS) and healthy controls. DESIGN:Cross-sectional. SETTING:Sleep laboratory at Seoul National University Bundang Hospital. PARTICIPANTS:Sixty-three elderly adults (26 female; mean age 68.2 ± 4.8) without cognit...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.2012.03961.x
更新日期：2012-06-01 00:00:00
abstract：:Hip fractures in older adults are a common event, leading to substantial morbidity and mortality. Hip fractures have been previously described as a "geriatric, rather than orthopedic disease." Patients with this condition have a high prevalence of comorbidity and a high risk of complications from surgery, and for this...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.2008.01770.x
更新日期：2008-07-01 00:00:00
