Abstract:
BACKGROUND/OBJECTIVES:Facing penalties for preventable 30-day hospital readmissions, many provider groups have implemented programs to remedy this problem, but the cost efficacy and value of such programs are not well delineated. The objective was to compare total cost of care over 30 days of individuals enrolled in the Mayo Clinic Care Transitions (MCCT) program and individuals not enrolled. DESIGN:Retrospective cohort study using secondary data analysis of a previously published cohort study. SETTING:Mayo Clinic, Rochester, Minnesota. PARTICIPANTS:MCCT participants (n = 363) and individuals in a propensity-matched referent cohort (n = 365). INTERVENTION:MCCT program enrollment. MEASUREMENTS:The primary outcome was total cost of care over 30 days after hospital discharge. A 2-part modeling strategy was used to analyze 30-day costs: whether individuals had non-zero costs during the 30 days after discharge and a generalized linear model for individuals who incurred costs. Potential heterogeneous effects of the MCCT program were examined according to decile of 30-day costs using quantile regression. RESULTS:Mean age was 83 in both groups. Adjusted mean 30-day cost after hospitalization was $3,363 (95% confidence interval (CI) = $2,512-4,213) in the MCCT group and $4,161 (95% CI = $3,096-5,226) in the control group (P = .25). Cost savings of $2,744 (P = .008) at the eighth decile and $3,388 (P = .20) at the ninth decile were demonstrated. Thus, the only statistically significant differences were in the post hoc subgroup analysis in the highest-cost subgroups. CONCLUSION:We did not find a difference in overall mean costs between the MCCT group and the control group, although intervention participants in the upper deciles of costs appeared to experience lower costs than controls. A larger study cohort might better determine the value of the intervention.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Hanson GJ,Borah BJ,Moriarty JP,Ransom JE,Naessens JM,Takahashi PYdoi
10.1111/jgs.15203subject
Has Abstractpub_date
2018-02-01 00:00:00pages
297-301issue
2eissn
0002-8614issn
1532-5415journal_volume
66pub_type
杂志文章abstract::The relationship between atrial natriuretic peptide (ANP) and age was studied. In elderly subjects (65 to 84 years) higher basal ANP levels were found as compared with those found in young subjects (21 to 23 years). Volume loading (750 mL 0.9% NaCl in 60 minutes) increased ANP levels only in the aged group, and plasma...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1990.tb01502.x
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:To determine the validity of the Minimum Data Set (MDS). DESIGN:MDS domain scores were correlated with a variety of independently obtained measures of basic behavioral and mental health functions of 513 nursing home residents. SETTING:All participants were residents of the Philadelphia Geriatric Center. PA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb03809.x
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVES:To assess the frequency of diagnostic errors in older adults presenting to the emergency department (ED) with symptoms suggestive of Chikungunya virus infection (CVI) and to compare the rates of misdiagnosis of older and younger adults. DESIGN:Cross-sectional study performed in the University Hospitals of M...
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abstract:OBJECTIVES:To assess the feasibility and validity of the International Dementia Alliance (IDEAL) instrument for Informal Caregivers (IDEAL-IC), which is based on the IDEAL instrument for professionals (IDEAL-P), for staging individuals with dementia. DESIGN:Cross-sectional. SETTING:Memory clinic of a university hospi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14205
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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::During 26 years of surveillance of the Framingham Study Cohort of 5,209 subjects, 176 men and 119 women developed occlusive peripheral arterial disease manifested as intermittent claudication (IC). The incidence increased sharply with age until the age of 75, with about a twofold male predominance at all ages. An inci...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1985.tb02853.x
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVES:To determine whether exercise-induced silent ischemia in older master athletes following a 3-month period of deconditioning is a predictor of future cardiovascular events. DESIGN:A longitudinal study of a cohort of master athletes. SETTING:The Geriatric Research Education and Clinical Center (GRECC), Balti...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.2000.tb04722.x
更新日期:2000-06-01 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::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
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53272.x
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Pain is a multidimensional experience that should be evaluated beyond an estimate of intensity. A multidimensional pain measure has not been developed for older persons undergoing comprehensive geriatric assessment. OBJECTIVE:To develop and evaluate validity and reliability of a multidimensional pain assess...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb03881.x
更新日期:2000-12-01 00:00:00
abstract::On September 11, 1986, the Supreme Judicial Court of Massachusetts, in a 4-3 decision, authorized removal of the artificial feeding tube. It held that the "substituted judgment" of an incompetent person in a persistent vegetative state to refuse artificially administered sustenance must be honored. The Court also refu...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:
更新日期:1987-07-01 00:00:00
abstract::This study was undertaken to identify the demographic characteristics of patients aged 55 or older in a drug-overdose group admitted to the Emergency Department of Arizona Health Sciences Center during the 3-year period, August 1975-July 1978. Of the 646 overdose patients observed, 60 (9.5 percent) were aged 55 or old...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb00004.x
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was fourfold; to determine the rate of delirium among hospitalized older persons, to contrast the clinical outcomes of patients with and without delirium, to identify clinical predictors of delirium, and to validate the predictive model in an independent sample of patients. DESIGN:T...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb06551.x
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVES:To examine recent trends in discharge disposition after hospitalization for hip fracture. DESIGN:Retrospective observational study using data from the 5% random sample of Medicare claims data from 2001 to 2005 that the Centers for Medicare and Medicaid Services makes available for research purposes. SETTIN...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.01688.x
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To determine how physical activity at various ages over the life course is associated with cognitive impairment in late life. DESIGN:Cross-sectional study. SETTING:Four U.S. sites. PARTICIPANTS:Nine thousand three hundred forty-four women aged 65 and older (mean 71.6) who self-reported teenage, age 30, age...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2010.02903.x
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVES:To test the effect of an adapted U.S. model of pharmaceutical care on prescribing of inappropriate psychoactive (anxiolytic, hypnotic, and antipsychotic) medications and falls in nursing homes for older people in Northern Ireland (NI). DESIGN:Cluster randomized controlled trial. SETTING:Nursing homes rando...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2009.02617.x
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:The literature suggests that Medicare health maintenance organization (HMO) patients may have poorer outcomes with formal home-health care than do fee-for-service (FFS) patients, but it is unclear whether this is related to case-mix or quality. Our objective was to compare the home-health care outcomes for HM...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb01083.x
更新日期:1998-05-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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doi:10.1111/jgs.16343
更新日期:2020-05-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb03001.x
更新日期:1999-03-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1988.tb04260.x
更新日期:1988-09-01 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.1532-5415.1977.tb00648.x
更新日期:1977-07-01 00:00:00
abstract:OBJECTIVES:To determine whether resting heart rate is associated with several types of osteoporotic fractures, mortality, and cause-specific mortality in older women. DESIGN:A prospective cohort study. SETTING:Four communities across the United States. PARTICIPANTS:We prospectively assessed resting pulse rate in 9,7...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50110.x
更新日期:2002-03-01 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
abstract:OBJECTIVES:To estimate the prevalence of prefrailty, frailty, comorbidity, and disability in the youngest old and to identify chronic diseases associated with individual frailty criteria. DESIGN:Population-based cohort study of noninstitutionalized elderly adults at baseline; cross-sectional analysis. SETTING:Lausann...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.04113.x
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVES:To develop and validate a picture-based memory impairment screen (PMIS) for the detection of dementia. DESIGN:Cross-sectional. SETTING:Outpatient clinics, Baby Memorial Hospital, Kozhikode city in the southern Indian state of Kerala. PARTICIPANTS:Three hundred four community-residing adults aged 55 to 94 ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.04191.x
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVES:To determine whether brief cognitive screening tests perform as well as a longer screening test in diagnosis of cognitive impairment, no dementia (CIND) or dementia. DESIGN:A cross-sectional comparison of cognitive screening tests to an independent criterion standard evaluation using Diagnostic and Statisti...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.03967.x
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:To determine the effect of four vitamin D supplement doses on falls risk in elderly nursing home residents. DESIGN:Secondary data analysis of a previously conducted randomized clinical trial. SETTING:Seven hundred twenty-five-bed long-term care facility. PARTICIPANTS:One hundred twenty-four nursing home r...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2007.01048.x
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To investigate whether a marked decrease in postprandial systolic blood pressure correlates with a higher incidence of falls, syncope, new coronary events, new stroke, and total mortality at long-term follow-up in older nursing home residents. DESIGN:In a prospective study of 499 nursing home residents aged ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1997.tb05965.x
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVES:To evaluate the association between insulin resistance (IR) and executive dysfunction in a large, population-based study of older persons without diabetes mellitus (DM) or dementia. DESIGN:Cross-sectional study. SETTING:Outpatient clinic in Greve in Chianti and Bagno a Ripoli, Italy. PARTICIPANTS:A total ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52466.x
更新日期:2004-10-01 00:00:00