Abstract:
OBJECTIVES:To compare the quality of end-of-life care in Medicare Advantage (MA) and traditional Medicare (TM), specifically, receipt and length of hospice care. DESIGN:Retrospective analysis of administrative data. SETTING:Hospice care. PARTICIPANTS:Veterans dually enrolled in the Veterans Health Administration (VHA) and MA or TM who died between 2008 and 2013 (N = 1,515,441). MEASUREMENTS:Outcomes studied included use and duration of hospice care. Use of a VHA-enrolled population allowed for risk adjustment that is otherwise challenging when studying MA. RESULTS:Adjusted analyses revealed that MA beneficiaries were more likely to receive hospice than TM beneficiaries; results corroborate published non-risk-adjusted analyses. MA beneficiaries had shorter hospice duration; this is an opposite direction of effect than non-risk-adjusted analyses. Results were robust to multiple sensitivity analyses limiting the cohort to individuals in MA and TM who had equal opportunity for their comorbidities to be captured. Removing risk adjustment resulted in results that mirrored those in the existing published literature. CONCLUSION:Our work provides two important insights regarding MA that are important to consider as enrollment in this insurance mechanism grows. First, MA beneficiaries received poorer-quality end-of-life care than TM beneficiaries, as ascertained by exposure to hospice. Second, any comparisons made between MA and TM require proper risk adjustment to obtain correct directions of effect. We encourage the Centers for Medicare & Medicaid Services to make comorbidity data specific to MA enrollees available to researchers for these purposes.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Gidwani-Marszowski R,Kinosian B,Scott W,Phibbs CS,Intrator Odoi
10.1111/jgs.15434subject
Has Abstractpub_date
2018-08-01 00:00:00pages
1508-1514issue
8eissn
0002-8614issn
1532-5415journal_volume
66pub_type
杂志文章abstract::There are over 2.5 million black Americans aged 65 and over living in the United States today, including some 258,000 persons aged 85 years and over. The post-World War II baby boom within the US black population should ensure that the numbers of persons aged 65 and over will increase into the 21st Century. If present...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1992.tb04485.x
更新日期:1992-10-01 00:00:00
abstract::A prospective study was carried out to determine which social, functional, or medical factors influenced the decision to admit or not to admit aged people to a general hospital in Israel. The study also focused on characteristics of patients admitted to the geriatric ward of the medical division as distinct from those...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb05060.x
更新日期:1982-10-01 00:00:00
abstract:OBJECTIVES:To provide estimates of change in depressive symptoms and determine how changes in depressive symptom influence recovery of functional status. DESIGN:Prospective cohort study. SETTING:Eleven inpatient medical rehabilitation facilities located across the United States. PARTICIPANTS:Five hundred forty-four ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2010.03266.x
更新日期:2011-02-01 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::As life expectancy increases, so do the problems of the elderly population. One major problem is that of protein calorie malnutrition; another is the susceptibility of this population to pressure sores. The purpose of this study was to determine if a correlation exists between deteriorating nutritional status and the ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb03411.x
更新日期:1986-06-01 00:00:00
abstract:OBJECTIVES:To describe the relationship between symptom scores and mobility function measures, assess whether symptom scores and disease scores are similarly associated with mobility function, and identify clusters of symptoms that are most strongly associated with functional status in older adults. DESIGN:Secondary a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02178.x
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:To assess the validity of several equations for estimating creatinine clearance in a large sample of high-functioning, community-dwelling elderly. DESIGN:Serum and 12-hour urine samples were collected and assayed for creatinine using the Jaffe total chromagen method. Fifteen clearance-estimating equations we...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1993.tb07459.x
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVES:To analyze the costs for long-stay (>90 days) nursing home (NH) decedents with and without hospice care. DESIGN:Retrospective cohort study using a 1999-2009 data set of linked Medicare and Medicaid claims and minimum data set (MDS) assessments. SETTING:Indiana NHs. PARTICIPANTS:Long-stay NH decedents (N =...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14070
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:To examine the effect of mode of survey administration on response rates and response tendencies for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey and develop appropriate adjustments. DESIGN:Survey response data were obtained after sampling and fielding of the CAHPS Hosp...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15265
更新日期:2018-03-01 00:00:00
abstract::In reviewing the literature on treatment approaches with the psychiatric elderly, a large number of studies were found which espouse comprehensive rehabilitation programs that usually require supplementation of existing personnel and expansion of facilities. Although some agencies and institutions are fortunate in sec...
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::The Geriatric Pharmacy elective course at the University of Kentucky College of Pharmacy uses a simulated medication adherence project to increase awareness of adherence concerns facing older adults who take multiple medications. This study evaluated the effect of this project. Students enrolled in this 3-credit hour ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02364.x
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVES:To determine the utility of hypodermoclysis in the management of dehydration in nursing home residents and to review the recent literature on the use of clysis in older adults. DESIGN:A retrospective chart review. SETTING:Two continuing care retirement community nursing home units in Cincinnati. PARTICIPA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1996.tb01870.x
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVES:To determine the association of dehydroepiandrosterone sulfate (DHEAS), body composition, and physical fitness in independent community-dwelling men and women aged 60 to 80 years. DESIGN:Cross sectional analysis. PARTICIPANTS:Independent men and women, 60 years of age and older, living in urban and suburba...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb01036.x
更新日期:1998-03-01 00:00:00
abstract::The Physician Orders for Life-Sustaining Treatment (POLST) form is a palliative care tool that contains standardized, actionable medical orders. It is designed to ensure that patient treatment preferences are elicited, communicated, and honored throughout the healthcare system. A systematic review of the literature wa...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.13248
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVES:To test whether a decision aid improves quality of decision-making about feeding options in advanced dementia. DESIGN:Cluster randomized controlled trial. SETTING:Twenty-four nursing homes in North Carolina. PARTICIPANTS:Residents with advanced dementia and feeding problems and their surrogates. INTERVEN...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1532-5415.2011.03629.x
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:To test whether Stepping On, a multifaceted community-based program using a small-group learning environment, is effective in reducing falls in at-risk people living at home. DESIGN:A randomized trial with subjects followed for 14 months. SETTING:The interventions were conducted in community venues, with a...
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.1532-5415.2004.52411.x
更新日期:2004-09-01 00:00:00
abstract::Falls are a leading cause of fatal and nonfatal injuries among the elderly in the United States. Despite the importance of fall injuries, epidemiological studies of falls among the elderly have identified neither their causes nor the methods to prevent them. Therefore, we established a community-based surveillance sys...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1988.tb04371.x
更新日期:1988-11-01 00:00:00
abstract:OBJECTIVES:To use a simple measure of activities of daily living, wounds, and indwelling devices (urinary catheter, feeding tube) to predict prevalent, new, and intermittent multidrug-resistant organism (MDRO) acquisition in nursing home (NH) residents. DESIGN:Secondary analysis, prospective cohort study. SETTING:Sou...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13353
更新日期:2015-04-01 00:00:00
abstract::Despite recent gains in establishing academic sections, divisions, and departments of geriatrics in medical schools, much remains to be done to meet the medical needs of an aging population. To better understand how medical schools are educating students in geriatric-related topics, all U.S. allopathic and osteopathic...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53023.x
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVES:To characterize a comprehensive outline of the oral microflora related to pneumonia in older adults. DESIGN:Prospective and retrospective longitudinal study. SETTING:Community. PARTICIPANTS:Long-term hospitalized patients and people in nursing homes (343 subjects, aged > or =65). MEASUREMENTS:Subjects we...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02867.x
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:To study the relationship between subjective memory complaints, cognitive functioning, and clinical diagnosis of dementia. DESIGN:Cross-sectional, total-population survey. MEASUREMENTS:A two-phase study was done. All 2368 were screened by Mini-Mental State Examination (MMSE). Then the 314 who screened posit...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1993.tb06478.x
更新日期:1993-12-01 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:OBJECTIVE:To determine if home environmental hazards increase the risk of fall injury events among community-dwelling older persons. DESIGN:Population-based case-control study. SETTING:South Miami Beach, Florida. PARTICIPANTS:270 persons aged 65 years and older who sought treatment at six area hospitals for injuries...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb03799.x
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVES:To identify risk factors for new-onset geriatric epilepsy that may trigger clinicians to consider a differential diagnosis of epilepsy at symptom onset. DESIGN:Retrospective cohort study. SETTING:National Veterans Affairs (VA) databases. PARTICIPANTS:Veterans aged 66 and older in fiscal year 2000 (FY00) w...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.02124.x
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To review (1) Changes in cardiac impulse generation, conduction, and ventricular filling in normal aging and disease; (2) Pacemaker technology and nomenclature; (3) Expert guidelines about pacemaker use; (4) Studies of pacemaker effectiveness and utilization. DESIGN:Articles were identified through a Medline...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1994.tb01760.x
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVES:To examine the effect of religion and spirituality on social support, psychological functioning, and physical health in medically ill hospitalized older adults. DESIGN:Cross-sectional survey. SETTING:Duke University Medical Center. PARTICIPANTS:A research nurse interviewed 838 consecutively admitted patie...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52161.x
更新日期:2004-04-01 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 assess whether catheter replacement is associated with better clinical outcomes in individuals with long-term urinary catheters. DESIGN:Prospective, noninterventional study. PARTICIPANTS:Individuals (mean age 79.2±11.5) who had had an indwelling urinary catheter for longer than 7 days and a symptomatic ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15517
更新日期:2018-09-01 00:00:00
abstract::In experience with total joint replacement in the lower extremity, to date, total hip arthroplasty has been the most successful. Total arthroplasty operations as applied to the knee and ankle are giving promising results. These methods offer new avenues for relief of pain and deformity and stabilization of arthritic j...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1977.tb00232.x
更新日期:1977-02-01 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