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Inquiry: a Journal of Medical Care Organization, Provision and Financing

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https://www.readbyqxmd.com/read/30015533/examination-of-the-new-short-stay-nursing-home-quality-measures-rehospitalizations-emergency-department-visits-and-successful-returns-to-the-community
#1
Debra Saliba, David L Weimer, Yuxi Shi, Dana B Mukamel
In 2016, the Centers for Medicare & Medicaid Services (CMS) introduced 3 new quality measures (QMs) to its report card, Nursing Home Compare (NHC). These measures-rehospitalizations, emergency department visits, and successful discharges to the community-focus on short-stay residents. We offer a first analysis of nursing homes' performance in terms of these new measures. We examined their properties and distribution across nursing homes using descriptive statistics and regression models. We found that, similar to other QMs, performance varies across the country, and that there is very minimal correlation between these 3 new QMs as well as between these QMs and other NHC QMs...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30015532/culture-change-in-nursing-homes-what-is-the-role-of-nursing-home-resources
#2
Latarsha Chisholm, Ning J Zhang, Kathryn Hyer, Rohit Pradhan, Lynn Unruh, Feng-Chang Lin
Quality of care has been a long-standing issue in US nursing homes. The culture change movement attempts to transition nursing homes from health care institutions to person-centered homes. While the adoption of culture change has been spreading across nursing homes, barriers to adoption persist. Nursing homes that disproportionately serve minority residents may have additional challenges implementing culture change compared with other facilities due to limited financial and staffing resources. The objective of this study was to examine how nursing home characteristics are associated with culture change adoption in Central Florida nursing homes...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30015529/related-variables-of-behavioral-and-emotional-problems-and-personal-growth-of-hospitalized-children-s-siblings-mothers-and-other-main-caregivers-perspectives
#3
Kazuteru Niinomi, Minae Fukui
The psychological well-being of the siblings of hospitalized children is at risk. This study examined the variables related to siblings' internalizing problems and personal growth during hospitalization from the perspectives of mothers and other main caregivers who temporarily assumed the main caregiver role to the siblings of hospitalized children in place of mothers in the period of children's hospitalization. A cross-sectional, exploratory survey conducted in Japan examined 113 mothers' and 90 other main caregivers' perspectives regarding the psychological state of 2- to 18-year-old siblings of hospitalized children...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29998776/hospital-vertical-integration-into-subacute-care-as-a-strategic-response-to-value-based-payment-incentives-market-factors-and-organizational-factors-a-multiple-case-study
#4
Tory H Hogan, Christy Harris Lemak, Nataliya Ivankova, Larry R Hearld, Jack Wheeler, Nir Menachemi
This study explores the extent to which payment reform and other factors have motivated hospitals to adopt a vertical integration strategy. Using a multiple-case study research design, we completed case studies of 3 US health systems to provide an in-depth perspective into hospital adoption of subacute care vertical integration strategies across multiple types of hospitals and in different health care markets. Three major themes associated with hospital adoption of vertical integration strategies were identified: value-based payment incentives, market factors, and organizational factors...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29923440/care-choices-in-europe-to-each-according-to-his-or-her-needs
#5
Dörte Heger, Thorben Korfhage
Growing long-term care (LTC) needs represent a major challenge for our aging societies. Understanding how utilization patterns of different types of care are influenced by LTC policies or changes in the population composition such as age patterns or health can provide helpful insight on how to adequately prepare for this situation. To this aim, this paper explores how individuals choose between different forms of LTC. We exploit variation between countries as well as between individuals within countries using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE)...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29888677/nursing-home-implementation-of-health-information-technology-review-of-the-literature-finds-inadequate-investment-in-preparation-infrastructure-and-training
#6
Michelle Ko, Laura Wagner, Joanne Spetz
Health information technology (HIT) is increasingly adopted by nursing homes to improve safety, quality of care, and staff productivity. We examined processes of HIT implementation in nursing homes, impact on the nursing home workforce, and related evidence on quality of care. We conducted a literature review that yielded 46 research articles on nursing homes' implementation of HIT. To provide additional contemporary context to our findings from the literature review, we also conducted semistructured interviews and small focus groups of nursing home staff (n = 15) in the United States...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29888626/how-do-the-hospital-prices-paid-by-medicare-advantage-plans-and-commercial-plans-compare-with-medicare-fee-for-service-prices
#7
Jared Lane K Maeda, Lyle Nelson
The prices that private insurers pay hospitals have received considerable attention in recent years, but most of that literature has focused on the commercially insured population. Although nearly one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, little is known about the prices paid to hospitals by the private insurers that administer such plans. More information on the hospital prices paid by MA plans would provide additional insights into whether MA prices are more closely tied to Medicare fee-for-service (FFS) prices or commercial prices...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29865969/implementation-of-text-messaging-and-social-media-strategies-in-a-multilevel-childhood-obesity-prevention-intervention-process-evaluation-results
#8
Ivory H Loh, Teresa Schwendler, Angela C B Trude, Elizabeth T Anderson Steeves, Lawrence J Cheskin, Sarah Lange, Joel Gittelsohn
Social media and text messaging show promise as public health interventions, but little evaluation of implementation exists. The B'more Healthy Communities for Kids (BHCK) was a multilevel, multicomponent (wholesalers, food stores, recreation centers) childhood obesity prevention trial that included social media and text-messaging components. The BHCK was implemented in 28 low-income areas of Baltimore City, Maryland, in 2 waves. The texting intervention targeted 241 low-income African American caregivers (of 283), who received 3 texts/week reinforcing key messages, providing nutrition information, and weekly goals...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29808748/population-characteristics-and-needs-of-informal-caregivers-associated-with-the-risk-of-perceiving-a-high-burden-a-cross-sectional-study
#9
Lotte Prevo, KlaasJan Hajema, Evelyne Linssen, Stef Kremers, Rik Crutzen, Francine Schneider
This study explored the population characteristics and needs of informal caregivers reporting a low or high burden. A cross-sectional study was conducted in the Netherlands to explore the associations between the characteristics and needs of informal caregivers and the burden they perceive and to assess the variance in perceived burdens that is explained by these variables. Three thousand sixty-seven adult informal caregivers and 1936 senior informal caregivers participated, almost 15% of whom perceived a high burden...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29806532/comparing-the-hospital-acquired-condition-reduction-program-and-the-accreditation-of-cancer-program-a-cross-sectional-study
#10
Aaron Spaulding, Rachel Paul, Dorin Colibaseanu
Under the Hospital-Acquired Condition Reduction Program (HACRP), introduced by the Affordable Care Act, the Centers for Medicare and Medicaid must reduce reimbursement by 1% for hospitals that rank among the lowest performing quartile in regard to hospital-acquired conditions (HACs). This study seeks to determine whether Accredited Cancer Program (ACP) hospitals (as defined by the American College of Surgeons) score differently on the HACRP metrics than nonaccredited cancer program hospitals. This study uses data from the 2014 American Hospital Association Annual Survey database, the 2014 Area Health Resource File, the 2014 Medicare Final Rule Standardizing File, and the FY2017 HACRP database (Medicare Hospital Compare Database)...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29806527/nursing-home-infection-control-program-characteristics-cms-citations-and-implementation-of-antibiotic-stewardship-policies-a-national-study
#11
Patricia W Stone, Carolyn T A Herzig, Mansi Agarwal, Monika Pogorzelska-Maziarz, Andrew W Dick
Recently, the Centers for Medicare & Medicaid Services (CMS) final rule required that nursing homes (NHs) develop an infection control program that includes an antibiotic stewardship component and employs a trained infection preventionist (IP). The objectives of this study were to provide a baseline assessment of (1) NH facility and infection control program characteristics associated with having an infection control deficiency citation and (2) associations between IP training and the presence of antibiotic stewardship policies, controlling for NH characteristics...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29756503/social-relationships-and-suicidal-ideation-among-the-elderly-who-live-alone-in-republic-of-korea-a-logistic-model
#12
Hyun-Jung Kwon, Ji-Ung Jeong, Mihyang Choi
With population aging and change in family structure, the number of the elderly who live alone is rapidly increasing in Korea. The aim of this study was to explore the association between social relationships-especially newly formed formal social relationships (FSRs)-and suicidal ideation among Korean elderly who live alone. The elderly who live alone (N = 2509) from the 2014 Survey of Living Conditions and Welfare Needs of Older Koreans were analyzed using logistic regression. This study found that informal social relationships (ISRs) (eg, children, friends and neighbors) of the elderly who live alone had statistically significant association with suicidal ideation, whereas FSRs (eg, formal helper and social participation) did not have significant association with suicidal ideation...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29749287/a-qualitative-exploration-of-weight-bias-and-quality-of-health-care-among-health-care-professionals-using-hypothetical-patient-scenarios
#13
Justine Seymour, Jennifer L Barnes, Julie Schumacher, Rachel L Vollmer
The purpose of this study was to determine whether weight bias exhibited by health care professionals (HCPs) impacts quality of health care provided to individuals with obesity. HCPs (n = 220; 88% female, 87% nurses) in the Midwest region of the United States were recruited to complete an online survey. In this within-subjects study design, participants completed the Attitudes Towards Obese Persons (ATOP) scale to assess weight bias and responded to 2 (1 person with obesity and 1 person without obesity) hypothetical patient scenarios to evaluate quality of care...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29745284/regional-and-temporal-variations-in-comorbidity-among-us-dialysis-patients-a-longitudinal-study-of-medicare-claims-data
#14
Yi Mu, Andrew I Chin, Abhijit V Kshirsagar, Yi Zhang, Heejung Bang
Medicare claims data are commonly used to query comorbidities for case-mix adjustment in research of patients with end-stage renal disease (ESRD) in the United States. These adjustments may affect reimbursement and quality rating through comparative profiling and ranking of dialysis facilities. We studied regional and temporal variations in comorbidity from claims data in the United States Renal Data System. Patients with a previous 1-year Medicare history who initiated dialysis therapy between 2006 and 2009 were examined with a follow-up period until 2012...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29730971/racial-ethnic-disparities-in-readmissions-in-us-hospitals-the-role-of-insurance-coverage
#15
Jayasree Basu, Amresh Hanchate, Arlene Bierman
We examine differences in rates of 30-day readmissions across patients by race/ethnicity and the extent to which these differences were moderated by insurance coverage. We use hospital discharge data of patients in the 18 years and above age group for 5 US states, California, Florida, Missouri, New York, and Tennessee for 2009, the latest year prior to the start of Centers for Medicare & Medicaid Services' Hospital Compare program of public reporting of hospital performance on 30-day readmissions. We use logistic regression models by state to estimate the association between insurance status, race, and the likelihood of a readmission within 30 days of an index hospital admission for any cause...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29717616/neighborhood-environment-and-disparities-in-health-care-access-among-urban-medicare-beneficiaries-with-diabetes-a-retrospective-cohort-study
#16
Miriam Ryvicker, Sridevi Sridharan
Older adults' health is sensitive to variations in neighborhood environment, yet few studies have examined how neighborhood factors influence their health care access. This study examined whether neighborhood environmental factors help to explain racial and socioeconomic disparities in health care access and outcomes among urban older adults with diabetes. Data from 123 233 diabetic Medicare beneficiaries aged 65 years and older in New York City were geocoded to measures of neighborhood walkability, public transit access, and primary care supply...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29701115/medium-term-health-of-seniors-following-exposure-to-a-natural-disaster
#17
Oscar Labra, Danielle Maltais, Gabriel Gingras-Lacroix
The article aims to describe the medium-term impacts of a major earthquake event (Chile, February 27, 2010) on 26 seniors. The authors adopted a qualitative study approach. Data obtained using the Impact of Event Scale-Revised (IES-R) show the presence of manifestations of posttraumatic stress in the majority of respondents. In addition, data collected in interviews demonstrated a progressive deterioration of the health of respondents over a period of 4 years following the disaster. Seniors are particularly vulnerable to the effects of material loss, emotional stress, and postdisaster health complications...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29633899/predictors-of-nursing-facility-entry-by-medicaid-only-older-adults-and-persons-with-disabilities-in-california
#18
Michelle Ko, Robert J Newcomer, Charlene Harrington, Denis Hulett, Taewoon Kang, Andrew B Bindman
Nearly one-third of adult Medicaid beneficiaries who receive long-term services and supports (LTSS) consist of older adults and persons with disabilities who are not eligible for Medicare. Beneficiaries, advocates, and policymakers have all sought to shift LTSS to home and community settings as an alternative to institutional care. We conducted a retrospective cohort study of Medicaid-only adults in California with new use of LTSS in 2006-2007 (N = 31 849) to identify unique predictors of entering nursing facilities versus receiving Medicaid home and community-based services (HCBS)...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29591540/comprehensive-support-for-family-caregivers-of-post-9-11-veterans-increases-veteran-utilization-of-long-term-services-and-supports-a-propensity-score-analysis
#19
Megan Shepherd-Banigan, Valerie A Smith, Karen M Stechuchak, Katherine E M Miller, Susan Nicole Hastings, Gilbert Darryl Wieland, Maren K Olsen, Margaret Kabat, Jennifer Henius, Margaret Campbell-Kotler, Courtney Harold Van Houtven
Family caregivers are an important component of the long-term services and supports (LTSS) system. However, caregiving may have negative consequences for caregiver physical and emotional health. Connecting caregivers to formal short-term home- and community-based services (HCBS), through information resources and referrals, might alleviate family caregiver burden and delay nursing home entry for the patient. The aim of this study was to evaluate the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) (established by P...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29591539/reducing-high-users-visits-to-the-emergency-department-by-a-primary-care-intervention-for-the-uninsured-a-retrospective-study
#20
Meng-Han Tsai, Sudha Xirasagar, Scott Carroll, Charles S Bryan, Pamela J Gallagher, Kim Davis, Edward C Jauch
Reducing avoidable emergency department (ED) visits is an important health system goal. This is a retrospective cohort study of the impact of a primary care intervention including an in-hospital, free, adult clinic for poor uninsured patients on ED visit rates and emergency severity at a nonprofit hospital. We studied adult ED visits during August 16, 2009-August 15, 2011 (preintervention) and August 16, 2011-August 15, 2014 (postintervention). We compared pre- versus post-mean annual visit rates and discharge emergency severity index (ESI; triage and resource use-based, calculated Agency for Healthcare Research and Quality categories) among high-users (≥3 ED visits in 12 months) and occasional users...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
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