Abstract:
OBJECTIVES:To assess the effects of preadmission functional impairment on Medicare costs of postacute care up to 365 days after hospital discharge. DESIGN:Longitudinal cohort study. SETTING:Health and Retirement Study (HRS). PARTICIPANTS:Nationally representative sample of 16,673 Medicare hospitalizations of 8,559 community-dwelling older adults from 2000 to 2012. MEASUREMENTS:The main outcome was total Medicare costs in the year after hospital discharge, assessed according to Medicare claims data. The main predictor was functional impairment (level of difficulty or dependence in activities of daily living (ADLs)), determined from HRS interview preceding hospitalization. Multivariable linear regression was performed, adjusted for age, race, sex, income, net worth, and comorbidities, with clustering at the individual level to characterize the association between functional impairment and costs of postacute care. RESULTS:Unadjusted mean Medicare costs for 1 year after discharge increased with severity of impairment in a dose-response fashion (P < .001 for trend); 68% had no functional impairment ($25,931), 17% had difficulty with one ADL ($32,501), 7% had dependency in one ADL ($39,928), and 8% had dependency in two or more ADLs ($45,895). The most severely impaired participants cost 77% more than those with no impairment; adjusted analyses showed attenuated effect size (33% more) but no change in trend. Considering costs attributable to comorbidities, only three conditions were more expensive than severe functional impairment (lymphoma, metastatic cancer, paralysis). CONCLUSION:Functional impairment is associated with greater Medicare costs for postacute care and may be an unmeasured but important marker of long-term costs that cuts across conditions.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Greysen SR,Stijacic Cenzer I,Boscardin WJ,Covinsky KEdoi
10.1111/jgs.14955subject
Has Abstractpub_date
2017-09-01 00:00:00pages
1996-2002issue
9eissn
0002-8614issn
1532-5415journal_volume
65pub_type
杂志文章abstract:OBJECTIVES:To review studies investigating cochlear implant (CI) outcomes in older adults, and to develop a conceptual framework demonstrating important interactions between characteristics of hearing disability, aging, and the CI intervention. DESIGN:Review of English literature with titles containing the words "coch...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2012.04150.x
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:To examine whether sleep disturbance is associated with poor physical function in older veterans in an adult day healthcare (ADHC) program. DESIGN:Cross-sectional. SETTING:One ADHC program in a Veterans Affairs Ambulatory Care Center. PARTICIPANTS:Older veterans (N = 50) enrolled in a randomized controlle...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.13527
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:To determine whether airline pilots over the age of 60 pose a hazard to aviation safety and whether risk assessment could replace age-based retirement. DATA SOURCES:A computer-assisted literature search (MEDLINE), expert consultation, and government reports. STUDY SELECTION:Original studies on flight perfor...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1992.tb02024.x
更新日期:1992-05-01 00:00:00
abstract::This study was designed to determine which elements professionals consider important for evaluation of decision-making capacity. Survey with a vignette case report of an individual with mild dementia was mailed to four groups of individuals: 1. members of the Academy of Psychosomatic Medicine, 2. chairs of Veterans Af...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2003.51412.x
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the epidemiology of insomnia, including demographic and clinical correlates, in older adults. DESIGN:Cross-sectional. SETTING:Community. PARTICIPANTS:Yale Precipitating Events Project participants (N=379; mean age 84.3; 67.8% female; 11.9% African American). MEASUREMENTS:Insomnia Severity Inde...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15414
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To measure behaviors indicative of quality of life (QOL) in patients with Alzheimer's disease and to examine correlates of patient QOL. DESIGN:Cross-sectional investigation. SETTING:Multi-center study. PARTICIPANTS:Sample of 130 diagnosed patients. PRINCIPAL OUTCOME MEASURES: Proxy ratings of (1) the frequ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.1996.tb01405.x
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVES:To use an expert consensus process to identify indicators of delirium features to help enhance bedside recognition of delirium. DESIGN:Modified Delphi consensus process to assign existing cognitive and delirium assessment items to delirium features in the Confusion Assessment Method (CAM) diagnostic algorit...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.03996.x
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Examining handgrip strength (HGS) asymmetry and weakness together may extend the predictive capacity of HGS for capturing possible health problems such as cognitive impairment. The purpose of this study was to determine the associations of HGS asymmetry and weakness on lower cognitive functioning ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16556
更新日期:2020-09-01 00:00:00
abstract::A history of systolic (greater than or equal to 160 mm Hg) or diastolic (greater than or equal to 90 mm Hg) hypertension, diabetes mellitus (fasting venous plasma glucose greater than or equal to 140 mg/dl), a history of cigarette smoking, fasting serum total cholesterol greater than or equal to 200 mg/dl and greater ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1987.tb01311.x
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:To explore the opinion of the Dutch general public and of physicians regarding euthanasia in patients with advanced dementia. DESIGN:A cross-sectional survey. SETTING:The Netherlands. PARTICIPANTS:Random samples of 1,965 citizens (response = 1,965/2,641 [75%]) and 1,147 physicians (response = 1...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16692
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:To determine the prevalence and outcomes of breathlessness in older Americans. SETTING:Community-dwelling older adults. PARTICIPANTS:Individuals aged 70 and older in the nationally representative Health and Retirement Study (2008, follow-up through 2012) (N = 3,671; mean age 78). MEASUREMENTS:Breathlessne...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14313
更新日期:2016-10-01 00:00:00
abstract::This study involved a 1st generation of 194 aged residents at the Philadelphia Geriatric Center plus 2nd and 3rd generations of 357 and 306 offspring, respectively. Serum cholesterol levels (including type of abnormality) and triglyceride levels were determined. The results suggest that hyperlipidemia at all ages is r...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1975.tb00896.x
更新日期:1975-11-01 00:00:00
abstract:BACKGROUND:Frailty in older vascular surgery patients is associated with increased mortality, hospital stay, and morbidity. The association of frailty with hospital-acquired geriatric syndromes such as delirium and functional decline has not been well studied. OBJECTIVES:To investigate the association between frailty ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16907
更新日期:2020-11-05 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: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:OBJECTIVES:To determine the effects of cognitive training on cognitive abilities and everyday function over 10 years. DESIGN:Ten-year follow-up of a randomized, controlled single-blind trial (Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE)) with three intervention groups and a no-contact control...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.12607
更新日期:2014-01-01 00:00:00
abstract::Although the field of frailty research has expanded rapidly, it is still a nascent concept within the clinical specialties. Frailty, conceptualized as greater vulnerability to stressors because of significant depletion of physiological reserves, predicts poorer outcomes in several medical specialties, including cardio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14902
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:To determine the internal validity of the physical activity index (PAI). DESIGN:Three time periods over a 26-year period (1965/68 examination, n = 7911; 1980/82 examination, n = 2054; 1991/93 examination, n = 3425). SETTING:Honolulu, Hawaii. PARTICIPANTS:Middle-aged to older Japanese-American men. MEASURE...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb05564.x
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVES:To validate the Executive Interview (EXIT25) as a screening instrument for executive cognitive dysfunction in patients with mild dementia. DESIGN:Validation using group comparison and correlation studies. SETTING:The Copenhagen University Hospital Memory Clinic, a multidisciplinary outpatient clinic based ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53470.x
更新日期:2005-09-01 00:00:00
abstract::The stage of a cancer at diagnosis is multiply determined, theoretically depending on such disparate factors as tumor biology, patient education, and physician behaviors. Data from all Hispanic and non-Hispanic white residents of New Mexico diagnosed with a malignancy from 1969 through 1982 were analyzed to determine ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb06335.x
更新日期:1986-01-01 00:00:00
abstract::The authors compared the demographic and clinical characteristics and treatment recommendations for elderly (greater than or equal to 60 years) and younger patients (17 to 59 years) seen for an emergency psychiatric consultation in a teaching general hospital. Findings revealed 11 distinctive characteristics that diff...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb05474.x
更新日期:1986-02-01 00:00:00
abstract:OBJECTIVES:To determine the trajectory of handgrip strength (HGS) from age 70 to 90 and its association with mood, cognition, functional status, and mortality. DESIGN:Prospective follow-up of an age-homogenous representative community-dwelling cohort (born 1920-21) in the Jerusalem Longitudinal Cohort Study (1990-2015...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14509
更新日期:2017-03-01 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:OBJECTIVE:To estimate the prevalence of urinary incontinence and to assess care-seeking behavior for urinary symptoms among community-dwelling people. DESIGN:A community-based cross-sectional study. SETTING:Randomly selected men and women from Olmsted County, Minnesota. PARTICIPANTS:Two cohorts, one comprised of bot...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb02468.x
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVES:To analyze baseline data from the Ginkgo Evaluation of Memory (GEM) study, in which information was collected on the use of all dietary supplements. DESIGN:Cross-sectional regression analysis. SETTING:GEM study sites in California, Maryland, North Carolina, and Pennsylvania. PARTICIPANTS:The GEM study enr...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2006.00942.x
更新日期:2006-11-01 00:00:00
abstract::Contemporary, systematic approaches to injury prevention are presented as guides for considering needless death and disability of older people because of falls, burns, and vehicular crashes. Injury results from an unfavorable relationship between etiologic agent and host within a particular environment setting. Abnorm...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb07102.x
更新日期:1982-04-01 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::Medication errors and adverse drug events are common in older adults, but locating literature addressing these issues is often challenging. The objective of this article is to summarize recent studies addressing medication errors and adverse drug events in a single location to improve accessibility for individuals wor...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.13922
更新日期:2016-02-01 00:00:00
abstract::Generalist physicians provide most primary care for older people. Increasingly, undergraduate clinical education occurs in community sites. Hence, community-based generalist faculty members need continuing education in geriatrics to support clinical practice and teaching. The Geriatrics Scholars Program provided conti...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01050.x
更新日期:2007-02-01 00:00:00
abstract::Twenty-five geriatric patients with severe motor urge incontinence were treated with terodiline and meladrazine separately and in combination. Because of poor general state of health and serious concomitant diseases the frequency of dropouts was high. Separate administration of the drugs improved the majority of the p...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章
doi:10.1111/j.1532-5415.1985.tb02856.x
更新日期:1985-01-01 00:00:00