Abstract：
BACKGROUND:Empirical studies examined the associations between hospital competition and quality of care by using different methodology, measures, patient groups and geographic locations; however, results remained inconclusive. This study aimed to apply meta-analysis to evaluate the effect of hospital competition on quality of care and to explore the potential implications to care for senior patients. METHODS:A systematic review and meta-analysis combining results from various studies to obtain an overall outcome was performed. Measure of effect size, I2 test, meta-regression to find sources of heterogeneity, tests for publication bias, sensitivity analysis and cumulative analysis were performed. The mean effect size is estimated by coefficient and standard error with P values less than 0.05 which was considered statistically significant. RESULTS:Based on the selection criteria, only 11 studies were eligible for this meta-analysis. The pooled effect of hospital competition on quality of care was reported by all of the 11 included studies. Results of the meta-analysis suggested that hospital competition reduced quality of care, but the overall effect was relatively insignificant from a statistical perspective (Point estimate = 0.008, 95% CI = -0.004 ˜ 0.020, P > 0.05). CONCLUSIONS:Hospital competition slightly increased mortality rates of acute myocardial infarction, but not statistically significant. The negative impact may be lessened over time as medical technology, practices, and techniques improve. Older patients with complex care needs may be at risk for poorer quality of care related to hospital competition.
journal_name
Arch Gerontol Geriatrjournal_title
Archives of gerontology and geriatricsauthors
Shen VC,Ward WJ Jr,Chen LKdoi
10.1016/j.archger.2019.05.001subject
Has Abstractpub_date
2019-01-01 00:00:00pages
263-270eissn
0167-4943issn
1872-6976pii
S0167-4943(19)30109-8journal_volume
83pub_type
杂志文章,meta分析abstract：:We studied the change in personal ability to perform the activities of daily living (P-ADL) one year after hospitalization (T2) of patients at least 65 years old at baseline (T1). The study included 363 (175 men) medical inpatients with age range 65-98 (mean 80.2, SD 7.5) years. Information was collected at baseline a...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2013.05.008
更新日期：2013-11-01 00:00:00
abstract：:Individual differences are the hallmark of aging. Chronological age (CHA) is known that fails to provide an accurate indicator of the aging but biological age (BA) estimates the functional status of an individual in reference to his or her chronological peers on the basis of how well he or she functions in comparison ...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2007.08.009
更新日期：2008-09-01 00:00:00
abstract：:The effects of oxazepam on coordination and maximal seizure were compared between young (6-month-old) and old (24-month-old) BDF1 mice by using a rotorod test and a pentylenetetrazole (PTZ)-induced seizure test, respectively. The apparent sensitivity to oxazepam's anticonvulsant effect, as examined by its effect on PT...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章,评审
doi：10.1016/0167-4943(89)90022-8
更新日期：1989-07-01 00:00:00
abstract：OBJECTIVE:To estimate the incidence of traffic accidents and find related factors among the older population. METHODS:We used the cross-sectional data from the Korean Community Health Survey (KCHS), which was conducted between 2008 and 2010 and completed by 680,202 adults aged 19 years or more. And we used individuals...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2015.01.015
更新日期：2015-05-01 00:00:00
abstract：:An augmented home help service was set up in the Rhondda Valley in South Wales in order to facilitate discharge from hospital of elderly subjects who were kept in hospital because of mainly social problems. Patients were allocated to the new service or the pre-existing services according to their date of birth. The ex...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/0167-4943(88)90023-4
更新日期：1988-03-01 00:00:00
abstract：:This study was aimed to determine the pain, physical performance and balance conditions of the elderly hospitalized in university hospital geriatric wards. The reasons for hospitalization and co-morbid diseases were recorded. Severity of pain was assessed on a visual analogue scale. Activity independence ability was t...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2010.08.002
更新日期：2011-05-01 00:00:00
abstract：:The demands of long-term care facilities (LTCFs) residents are complex which usually require a range of professionals and caregivers to provide treatment and care. To reduce this fragmentation of care, integrated care models are developed in modern health care system, and a gradual change from traditional LTCF care to...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.archger.2009.05.004
更新日期：2010-05-01 00:00:00
abstract：:An example of multidimensional assessment procedure applied to the study of treatment effects in a type of pathological aging is presented in this paper. Data discussed here come from a clinical trial performed to evaluate the effects of an ergot derivate, dihydroergocristine, in CCVD memory deficits. The multidimensi...
journal_title：Archives of gerontology and geriatrics
pub_type： 临床试验,杂志文章
doi：10.1016/0167-4943(87)90041-0
更新日期：1987-04-01 00:00:00
abstract：:It is important to develop an accurate method of measuring controlled force exertion. This study examined the age differences between the controlled force exertion measured by a sinusoidal waveform and a bar chart display. The participants comprised 175 right-handed male adults aged 20-86 years. The participants were ...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2013.02.002
更新日期：2013-07-01 00:00:00
abstract：:Studies on the relationship between behavioral competence, such as the competence of exerting out-of-home behavior (OOHB), and well-being in older adults have rarely addressed cognitive status as a potentially moderating factor. We included 35 persons with early-stage dementia of the Alzheimer's type (DAT), 76 individ...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2014.03.015
更新日期：2014-07-01 00:00:00
abstract：:Our aim was to compare the prevalence of sarcopenia in men and women with hip fracture. We studied 591 of 630 hip fracture inpatients consecutively admitted to our Rehabilitation ward. All the patients underwent a Dual-Energy X-Ray Absorptiometry (DXA) scan 18.4 ± 8.7 (mean ± SD) days after hip fracture occurrence. Sa...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2012.05.002
更新日期：2012-09-01 00:00:00
abstract：:Leisure time represents an important part of the so-called 'successful aging' and contributes to overcome the problems related to the reduction of the social roles, favoring a better subjective adaptation to old age. In this work we observed the elderly population frequenting our Day Hospital, by estimating the affect...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/s0167-4943(01)00111-x
更新日期：2001-09-01 00:00:00
abstract：BACKGROUND:Although previous studies showed that frail older adults are more susceptible to develop cardiovascular diseases, the underlying effect of frailty on heart rate dynamics is still unclear. The goal of the current study was to measure heart rate changes due to normal speed and rapid walking among non-frail and...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2020.104323
更新日期：2020-12-11 00:00:00
abstract：OBJECTIVES:Various healthcare interventions have been launched targeting the growing population of older people. The objective of this study was to investigate the of a case management intervention for frail old people (aged 65+ years) effects on healthcare utilization. MATERIALS AND METHODS:The study was conducted in...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.archger.2014.10.009
更新日期：2015-01-01 00:00:00
abstract：:The personal and societal impact of age-related cognitive decline supports the development of effective interventions. While some strategies, such as cognitive training, exercise or socio-intellectual engagement, appear beneficial, few studies have examined the association between personality and intervention efficacy...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2019.103992
更新日期：2020-01-01 00:00:00
abstract：:Hyperhomocysteinemia (HHcy) has been suggested as a predictive factor of cognitive alterations. Brazil has one of the highest aging dementia rates among the world's emerging countries. The objective of this study was to assess the influence of Hcy levels on the cognitive performance of low-income elderly. This cross-s...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2007.12.002
更新日期：2009-03-01 00:00:00
abstract：:Because of chronicity and poor environments, elderly leprosy survivors might be at greater risk of developing obesity and sarcopenia than healthy individuals. This study aimed to investigate whether body composition and the prevalence of obesity and sarcopenia among elderly leprosy survivors with no or mild physical i...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2013.07.013
更新日期：2014-01-01 00:00:00
abstract：:Frailty is an age-related condition, characterized by a decreased homeostatic reserve and increased vulnerability to stressful events, with high risk of adverse outcomes. The aim of this study was to compare the evaluation of the frailty by the means of the MCPS and the Rockwood criteria. We enrolled 98 patients (mean...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2012.11.004
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Hearing impairment (HI) is a major global health concern. In addition, social networks are important for healthy aging. This study aimed to examine the association between HI and social relationships. RESEARCH DESIGN AND METHODS:This study was conducted by the National Institute for Longevity...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2019.03.004
更新日期：2019-01-01 00:00:00
abstract：:Simple reaction time, the Berg balance scale, the Activities-specific Balance Confidence (ABC) scale and postural sway were studied in order to determine cut-off scores as well as develop a model used in the prevention of fallers within the elderly community. One hundred and twenty-five subjects, 45 fallers and 80 non...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/s0167-4943(03)00082-7
更新日期：2004-01-01 00:00:00
abstract：:Seventy-eight persons (51 females, 29 males) of an average age of slightly higher than 65 yr were studied, suffering mostly from cardiovascular diseases or various degrees of osteo-arthropathies. The so-called compacta index was calculated from the values of the external and internal diameters measured radiologically ...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/0167-4943(83)90002-x
更新日期：1983-12-01 00:00:00
abstract：:The aim of the present study was to explore the effect of baseline physical activity on hospitalization over one year in a representative sample of older adults in Taiwan. We conducted a prospective study of persons aged 65 and above (N = 2064) participating in the National Health Interview Survey in Taiwan, 2001. A t...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.archger.2010.09.014
更新日期：2011-09-01 00:00:00
abstract：:Age-related changes of the hippocampal mossy fibre system were studied in rats of different ages (4, 12, and 24 months) using the Timm's histochemical technique for the detection of tissue stores of zinc and heavy transitional metals. Quantitative image analysis and microdensitometry techniques were applied for the ev...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/0167-4943(89)90071-x
更新日期：1989-01-01 00:00:00
abstract：OBJECTIVE:To investigate the association between frailty and a summary cardiovascular risk measure (Framingham Risk Score, FRS) in a sample of older adults from different epidemiologic contexts participating in the multicenter International Mobility in Aging Study (IMIAS). MATERIAL AND METHODS:This cross-sectional stu...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2020.104279
更新日期：2021-01-01 00:00:00
abstract：:Pre-exposure to 3-hydroxy-3-methylgutaryl-coenzyne A reductase inhibitors (statins) appears to improve outcomes in patients with acute ischemic stroke (AIS). Whether this extends to patients over 80 is not known. Patients ≥80 years of age with AIS were retrospectively reviewed from the stroke registry of a tertiary st...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2013.05.007
更新日期：2013-11-01 00:00:00
abstract：OBJECTIVE:To investigate the effect of a tailored education program using home floor plans on falls prevention in discharged older patients. DESIGN:A single-center, parallel, pragmatic, pilot randomized controlled trial with equal allocation to the intervention and control groups. SETTING:Discharged hospital patients...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.archger.2017.02.010
更新日期：2017-07-01 00:00:00
abstract：:Long-stay refers to a long visit abroad by retired middle-aged and older people. This study describes the attitudes/opinions of elderly Japanese long-staying subjects and healthcare providers in Thailand. Two cross-sectional questionnaire surveys were conducted in Chiang Mai Province, Thailand. Questionnaires were sen...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2010.08.007
更新日期：2011-09-01 00:00:00
abstract：:This study aimed to evaluate the physical frailty status of vulnerable older adults as classified in the Japanese LTCI system and to compare this with Fried's definition. A total of 444 older adults were classified based on the LTCI system as independent, vulnerable, or dependent, and 400 of these participants also fi...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/j.archger.2011.10.004
更新日期：2012-09-01 00:00:00
abstract：:This is a physician's office-based retrospective study of 161 dementia patients with (94) and without (67) behavioral symptoms. Those with disturbed behavior were subdivided into patients with behavior changes at initial evaluation and those encountered in existing dementia. The two main groups and the subgroups were ...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/s0167-4943(01)00082-6
更新日期：2001-02-01 00:00:00
abstract：:The management of advanced cancer in the older person is variable. In some patients with common malignancies chemotherapy may palliate symptoms and prolong survival, while in other patients chemotherapy is a cause of overwhelming toxicity and supportive care is the preferred form of treatment. We explored the principl...
journal_title：Archives of gerontology and geriatrics
pub_type： 杂志文章
doi：10.1016/0167-4943(90)90015-x
更新日期：1990-03-01 00:00:00
