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Nursing home predictors

Tomohiko Kamo, Hideaki Ishii, Keisuke Suzuki, Yuusuke Nishida
Sarcopenia is an important predictor of adverse outcomes in elderly people. Based on a common clinical experience, sarcopenia may be associated with activities of daily living (ADL). To our knowledge, no study has investigated the association between sarcopenia and ADL in nursing home residents requiring long-term care. This cross-sectional study included 250 nursing home residents. Nutritional status, physical function, ADL and cognitive function were assessed using Mini Nutritional Assessment-Short Form (MNA-SF), Short Physical Performance Battery (SPPB), Barthel Index (BI) and Mini-Mental State Examination (MMSE)...
March 16, 2018: Geriatric Nursing
Yunli Zhao, Yunxia Zhang, Qiukui Hao, Meiling Ge, Birong Dong
AIM: This systematic review was conducted to explore the associations between sarcopenia, hospitalization and length of stay in the old people. METHODS: Pubmed, Embase, Medline and Cochrane Central Register of Controlled Trails from January 2009 to October 2017 were searched in this review. We included prospective studies, which had the clear definition of sarcopenia and reported the hospitalization or length of stay as one of outcomes. Adjusted Odd ratios (aORs), hazard ratios (aHRs) or relative risks (aRRs) extracted from the studies were combined to synthesize pooled effect measures...
March 16, 2018: Aging Clinical and Experimental Research
Jonathan G Shaw, Monica Farid, Claire Noel-Miller, Neesha Joseph, Ari Houser, Steven M Asch, Jay Bhattacharya, Lynda Flowers
Objectives: Evaluate objective isolation and loneliness' impact on Medicare spending and outcomes. Methods: We linked Health and Retirement Study data to Medicare claims to analyze objective isolation (scaled composite of social contacts and network) and loneliness (positive response to 3-item loneliness scale) as predictors of subsequent Medicare spending. In multivariable regression adjusting for health and demographics, we determined marginal differences in Medicare expenditures...
October 2017: Journal of Aging and Health
Javier de Miguel-Diez, Ana Lopez-de-Andres, Valentin Herandez-Barrera, Isabel Jimenez-Trujillo, Luis Puente-Maestu, Alicia Cerezo-Lajas, Rodrigo Jimenez-Garcia
Background: Chronic obstructive pulmonary disease (COPD) is a major cause of disability and death worldwide. Consequently, COPD patients are frequent users of health and social resources. Therefore, they are highly vulnerable to decreases in investment in healthcare services. We aimed to describe the utilization of health and home care services among Spanish COPD patients during the economic crisis to identify factors independently associated with changes in the utilization of these services and to study the time trends from 2009 to 2014...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Kali S Thomas, Jessica A Ogarek, Joan M Teno, Pedro L Gozalo, Vincent Mor
Purpose: To develop a score to predict mortality using the Minimum Data Set 3.0 (MDS 3.0) that can be readily calculated from items collected during nursing home (NH) residents' admission assessments. Participants: We developed a training cohort of Medicare beneficiaries newly admitted to U.S. NHs during 2012 (N=1,426,815) and a testing cohort from 2013 (N=1,160,964). Methods: Data came from the MDS 3.0 assessments linked to the Medicare Beneficiary Summary File...
March 5, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Medard Beyanga, Benson R Kidenya, Lisa Gerwing-Adima, Eleanor Ochodo, Stephen E Mshana, Christa Kasang
BACKGROUND: Tuberculosis (TB) contact tracing is a key strategy for containing TB and provides addition to the passive case finding approach. However, this practice has not been implemented in Tanzania, where there is unacceptably high treatment gap of 62.1% between cases estimated and cases detected. Therefore calls for more aggressive case finding for TB to close this gap. We aimed to determine the magnitude and predictors of bacteriologically-confirmed pulmonary TB among household contacts of bacteriologically-confirmed pulmonary TB index cases in the city of Mwanza, Tanzania...
March 6, 2018: BMC Infectious Diseases
John B Ammori, Suparna Navale, Nicholas Schiltz, Siran M Koroukian
BACKGROUND: The objective of this study is to identify risk factors associated with readmission after gastrectomy to potentially identify potential areas for targeted improvements. Hospital readmission after surgery is a topic of interest in health-care policy among hospitals, payers, and providers. Readmissions are associated with increased costs, morbidity, and mortality. Readmission rates have been proposed as a quality metric for hospitals and quality indicator of individual surgeon's performance...
April 2018: Journal of Surgical Research
Anne van der Zon, Roland B Wetzels, Hans Bor, Sytse U Zuidema, Raymond T C M Koopmans, Debby L Gerritsen
OBJECTIVE: To assess the course of quality of life (QoL) in nursing home residents with dementia and to study its predictors. METHODS: This longitudinal, multicenter, observational cohort study with a 2-year follow-up looked at 290 residents with dementia, who lived in 14 dementia special care units in nine nursing homes in the Netherlands. QoL was assessed with the Qualidem, providing a total score and QoL profile with nine subscales. Residents were assessed at five assessments: every 6 months during 2 years...
February 2, 2018: American Journal of Geriatric Psychiatry
Sarah T Stahl, Richard Schulz
This prospective study examined predictors and correlates of restorative activities in recently bereaved caregivers and their relation to post-bereavement adjustment, namely complicated grief. Participants included 89 caregivers (CGs) age 32-87 (M age - 63 years) whose care recipients recently died in a long-term care facility (M time since loss = 107 days). Our findings show that being prepared prior to death enables CGs the opportunity to engage in restorative activities post death. Restorative activities partially mediated the relationship between preparedness prior to death and complicated grief, but this association was attenuated in multivariable models...
February 21, 2018: Geriatric Nursing
Melissa K James, R Jonathan Robitsek, Syed M Saghir, Patricia A Gentile, Marylin Ramos, Frances Perez
BACKGROUND: Falls can result in injuries that require rehabilitation and long-term care after hospital discharge. Identifying factors that contribute to prediction of discharge disposition is crucial for efficient resource utilization and reducing cost. Several factors may influence discharge location after hospitalization for a fall. The aim of this study was to examine clinical and non-clinical factors that may predict discharge disposition after a fall. We hypothesized that age, injury type, insurance type, and functional status would affect discharge location...
February 14, 2018: Injury
Kathleen T Unroe, Jennifer L Carnahan, Susan E Hickman, Greg A Sachs, Zachary Hass, Greg Arling
OBJECTIVES: To describe the relationship between nursing facility resident risk conditions and signs and symptoms at time of acute transfer and diagnosis of conditions associated with potentially avoidable acute transfers (pneumonia, urinary tract infection, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) or asthma, dehydration, pressure sores). DESIGN: As part of a demonstration project to reduce potentially avoidable hospital transfers, Optimizing Patient Transfers, Impacting Medical Quality, Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project clinical staff collected data on residents who transferred to the emergency department (ED) or hospital...
February 13, 2018: Journal of the American Geriatrics Society
Hélène Ouellette-Kuntz, Lynn Martin, Katherine McKenzie
PURPOSE: To identify factors associated with the rate of deficit accumulation in a population of adults with intellectual and developmental disabilities (IDD). METHODS: A longitudinal analysis of administratively held clinical data collected at routine home care assessments across Ontario (Canada) using the Resident Assessment Instrument for Home Care (RAI-HC) was conducted using a cohort comprised of 5074 adults with IDD 18-99 years of age who had at least two home care assessments between April 1, 2003 and March 31, 2015...
January 31, 2018: Annals of Epidemiology
Jessell M Owens, John J Callaghan, Kyle R Duchman, Nicholas A Bedard, Jesse E Otero
BACKGROUND: The benefits of discharge to a skilled nursing facility (SNF) in Medicare-eligible patients after total joint arthroplasty (TJA) have recently been scrutinized. The purpose of this study was to determine short-term complication and readmission rates for SNF versus home discharge in patients eligible for Medicare and SNF discharge. METHODS: Patients who underwent TJA between 2012 and 2013 were identified in the National Surgical Quality Improvement Project database...
January 11, 2018: Journal of Arthroplasty
Lixia Chen, Jing Zhang, Wei Fu
OBJECTIVE: The aims are to assess the health-promoting lifestyle status of nursing assistants in nursing homes in China and explore the roles of demographic, health conception, perceived health behavior self-efficacy, and job satisfaction in health-promoting lifestyles. METHOD: Using a cross-sectional descriptive design and convenience sampling, 285 nursing assistants from different nursing homes in Hangzhou were investigated using the Health-Promoting Lifestyle Profile II, Self-Rated Abilities for Health Practice Scale, Health Conception Scale, Minnesota Satisfaction Questionnaire, and a demographic questionnaire to measure their health-promoting lifestyle status...
February 2018: Applied Nursing Research: ANR
Alvisa Palese, Luca Grassetti, Davide Bandera, Ranieri Zuttion, Barbara Ferrario, Sandra Ponta, Mark Hayter, Roger Watson
OBJECTIVES: An increased amount of functional dependence has been reported among residents living in nursing homes. Among others, feeding dependence is one of the most complex needs to satisfy: behind the attempt to personalise meals with individual preferences and clinical regimens, all residents require help at the same moment and for long periods of time, three or more times a day. With the intent of debating policy implications, the aims of this study were to advance the knowledge in the field of feeding dependence prevalence and predictors in Italy, a country where life expectancy is among the highest in the World...
February 2, 2018: Health Policy
Thanuja R De Silva, Olga Theou, Bruno Vellas, Matteo Cesari, Renuka Visvanathan
OBJECTIVES: To investigate the ability of the fatigue, resistance, ambulation, incontinence or illness, loss of weight, nutritional approach, and help with dressing (FRAIL-NH) tool to predict mortality. DESIGN: The Incidence of Pneumonia and Related Consequences in Nursing Home Residents (INCUR) study database was used. This was an observational cohort study in French nursing homes conducted over 12 months in 2012. PARTICIPANTS: A total of 788 residents aged 60 years or older, from 13 randomly selected French nursing homes...
February 2, 2018: Journal of the American Medical Directors Association
Janina Wilmskoetter, Annie N Simpson, Sarah L Logan, Kit N Simpson, Heather S Bonilha
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) feeding tubes are commonly placed in acute stroke patients with a need for enteral nutrition. However, PEG tubes are associated with medical complications and a decrease in quality of life. We compared the 1-year care trajectory of stroke patients with and without PEG tube placement to enhance knowledge about the long-term impact of PEG tube placement. METHODS: We conducted a retrospective analysis of commercially insured stroke patients included in the Truven Health MarketScan Research Databases of 2011...
February 3, 2018: Nutrition in Clinical Practice
Floor J Van Deudekom, Jelle De Gelder, Jacinta A Lucke, Anneleen Oostendorp-Lange, Sander Anten, Gerard J Blauw, Bas De Groot, Simon P Mooijaart
OBJECTIVES: Self-rated health (SRH) is an important patient-reported outcome, but little is known about SRH after a visit to the emergency department (ED). We investigated the determinants of decline in SRH during 3 months after an ED visit in older patients. DESIGN: This was a multicenter prospective cohort study including acutely presenting older (≥70 years) patients in the ED (the Netherlands). Patients were asked to self-rate their health between 0 and 10...
January 30, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Insa Koné, Bettina Zimmermann, Tenzin Wangmo, Silvia Richner, Markus Weber, Bernice Elger
AIM OF THE STUDY: Switzerland introduced the SwissDRG in 2012. The goal of this reimbursement system was to promote cost containment and efficiency in hospital care. To ensure that patients with care needs are not released prematurely because of constraints under the new hospital financing system, the Swiss law on Acute and Transitional Care (ATC) was introduced one year earlier. The objective of the present study was to investigate the impact of ATC and its effects on discharge of patients with persisting care needs after hospitalisation...
January 29, 2018: Swiss Medical Weekly
Samuel T Edwards, Christian D Helfrich, David Grembowski, Elizabeth Hulen, Walter L Clinton, Gordon B Wood, Linda Kim, Danielle E Rose, Greg Stewart
PURPOSE: Appropriate delegation of clinical tasks from primary care providers (PCPs) to other team members may reduce employee burnout in primary care. However, (1) the extent to which delegation occurs within multidisciplinary teams, (2) factors associated with greater delegation, and (3) whether delegation is associated with burnout are all unknown. METHODS: We performed a national cross-sectional survey of Veterans Affairs (VA) PCP-nurse dyads in Department of VA primary care clinics, 4 years into the VA's patient-centered medical home initiative...
January 2018: Journal of the American Board of Family Medicine: JABFM
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