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elderly inpatients

Somdeth Bodhisane, Sathirakorn Pongpanich
PURPOSE: Community-based health insurance (CBHI) targets independent worker (self-employed) is currently struggling with inadequate size of risk pooling, low enrollment, and high dropout rate as well as financial sustainability. The objective of this study is to find out the factors that significantly affect the CBHI enrollment incentive. The study applied cross-sectional study design to perform situation analysis, in which the Andersen behavioral model was used as a guideline to identify preliminary characteristics that involved with enrolling incentive...
December 14, 2018: International Journal of Health Planning and Management
Narushi Sugii, Hiroyuki Fujimori, Naoaki Sato, Akira Matsumura
Objective: This study aimed to evaluate the regular medications prescribed to elderly neurosurgical inpatients in community hospitals in Japan. Materials and Methods: Elderly patients (aged ≥ 65 years) who had been admitted to neurosurgery departments from April 2015 to March 2017 were enrolled in this study. We collected data on regular medications at the time of admission and discharge. Furthermore, we retrospectively analyzed factors associated with potentially inappropriate medications (PIMs). PIMs were defined as polypharmacy (≥ 6 medications used concurrently) or taking any of the unfavorable medications on the "list of drugs to be prescribed with special caution" in the "Guidelines for Medical Treatment and Its Safety in the Elderly 2015"...
November 2018: Journal of Rural Medicine: JRM
Teresa M Waters, Cameron M Kaplan, Ilana Graetz, Mary M Price, Laura A Stevens, Barbara L McAneny
PURPOSE: We examined whether the Community Oncology Medical Home (COME HOME) program, a medical home program implemented in seven community oncology practices, was associated with changes in spending and care quality. PATIENTS AND METHODS: We compared outcomes from elderly fee-for-service Medicare beneficiaries diagnosed between 2011 and 2015 with breast, lung, colorectal, thyroid, or pancreatic cancer, lymphoma, or melanoma and served by COME HOME practices before and after program implementation versus similar beneficiaries served by other geographically proximate oncologists...
December 5, 2018: Journal of Oncology Practice
Aisha F Badr, Sawsan Kurdi, Samah Alshehri, Claire McManus, Jeannie Lee
Background: Hospitalization can contribute to insomnia in many patients and is usually treated symptomatically. However, sedative/hypnotic misuse is associated with complications in this population, especially in the elderly. Such complications include dizziness, falls and over-sedation. Due to the implicit dangers, widespread use of these drugs for insomnia, particularly in older patients, has been discouraged by many hospitals. The aim of this study was to review and evaluate prescribing patterns and to optimize the use of the sedative/hypnotic agents through daily pharmacy interventions at a community hospital...
December 2018: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
Abdelrahman Ahmed, Emmanuel Akintoye, Oluwole Adegbala, Ahmed Yassin, Ahmed Subahi, Lamin Bangura, Hossam Abubakar, Mahir Elder, Mohamed Shokr, Luis Afonso
BACKGROUND: Periprocedural outcomes of transcatheter mitral valve repair (TMVR) with Mitraclip in patients with pulmonary hypertension (PH) are not well studied. METHODS: Patients who underwent TMVR with Mitraclip between 2011 and 2015 were identified using the National Inpatient Sample (NIS). All missing variables were excluded from the analysis and therefore, complete case analysis was performed. RESULTS: A total of 1,037 patients underwent TMVR with Mitraclip between 2011 and 2015...
December 2, 2018: Catheterization and Cardiovascular Interventions
Cheryl Warren, Amy A Lemieux, Nancy Phoenix Bittner
PURPOSE/OBJECTIVE: The Community-based Care Transitions Program (CCTP) defined a broad spectrum of interventions and services for elderly patients at high risk of hospital readmission. The purposes for a CCTP as developed by the Centers for Medicare & Medicaid Services are to improve transitions of beneficiaries from the inpatient hospital setting to other care settings, to improve quality of care, to reduce readmissions for high-risk beneficiaries, and to document measurable savings...
January 2019: Professional Case Management
Aukelien Scheffelaar, Nanne Bos, Michelle Hendriks, Sandra van Dulmen, Katrien Luijkx
BACKGROUND: The quality of a care relationship between a client and a care professional is seen as fundamental if high-quality care is to be delivered. This study reviews studies about the determinants of the quality of the client-professional relationship in long-term care. METHODS: A systematic review was performed using the electronic databases of Medline, Psycinfo, CINAHL and Embase. The review focused on three client groups receiving long-term care: physically or mentally frail elderly, people with mental health problems and people with physical or intellectual disabilities...
November 28, 2018: BMC Health Services Research
Luca Pasina, Lorenzo Colzani, Laura Cortesi, Mauro Tettamanti, Antonella Zambon, Alessandro Nobili, Andrea Mazzone, Paolo Mazzola, Giorgio Annoni, Giuseppe Bellelli
BACKGROUND: Delirium is a neuropsychiatric syndrome which occurs on average in one out of five hospitalized older patients. It is associated with a number of negative outcomes, including worsening of cognitive and functional status, increasing the burden on patients and caregivers, and elevated mortality. Medications with anticholinergic effect have been associated with the clinical severity of delirium symptoms in older medical inpatients, but this association is still debated. OBJECTIVE: The aim was to assess the association between delirium and anticholinergic load according to the hypothesis that the cumulative anticholinergic burden increases the risk of delirium...
November 27, 2018: Drugs & Aging
Bassel Bashjawish, Shreya Patel, Suat Kılıç, Peter F Svider, Wayne D Hsueh, James K Liu, Soly Baredes, Jean Anderson Eloy
BACKGROUND: Elderly patients with multiple comorbidities may be at higher risk of postoperative complications. With an increasingly aging population, more data assessing for predisposing factors are needed in this at-risk group. In this study, we analyzed the effect of elderly status on relative comorbidities and complications of sinonasal cancer (SNC) patients receiving surgery. METHODS: A retrospective database analysis was performed using cases from the Nationwide Inpatient Sample (NIS) from 2003 to 2012...
November 23, 2018: International Forum of Allergy & Rhinology
Ahmed Subahi, Ahmad Munir, Hossam Abubakar, Emmanuel Akintoye, Ahmed S Yassin, Oluwole Adegbala, Mohamed Chadi Alraies, Mahir Elder, Tamam Mohamad, Amir Kaki, Theodore Schreiber
BACKGROUND: The concomitant presence of atrial fibrillation (AF) in the setting of Transcatheter Mitral Valve Repair (TMVR) represents a clinical challenge. Despite the high AF burden in patients presenting for the TMVR procedure, there are no studies that evaluate the impact of AF on in-hospital outcomes of TMVR in a nationally representative United States sample reflecting real practice. Therefore, we sought to study the outcomes of AF patients undergoing TMVR. METHODS AND RESULTS: The study included 1026 patients from the National Inpatient Sample (NIS) registry...
November 19, 2018: Journal of Interventional Cardiology
C Shen, A Dasari, Y Xu, S Zhou, D Gu, Y Chu, D M Halperin, Y T Shih, J C Yao
The incidence and prevalence of neuroendocrine tumors (NETs) are continually increasing. While it is known that NET symptoms often predate diagnosis, their prevalence and impact on resource utilization and costs are largely unknown. We identified 9,319 elderly patients diagnosed with NETs between 1/2003 and 12/2011 from the Surveillance, Epidemiology and End Results (SEER)-Medicare. We examined the patients' conditions potentially associated with NET, resource utilization and costs during the year before diagnosis...
November 15, 2018: Scientific Reports
Stephanie L Stephens, J Brian Cassel, Danielle Noreika, Egidio Del Fabbro
The US population of inmates continues to increase along with a rapid escalation in the number of elderly prisoners. Previous studies have demonstrated multiple barriers to providing palliative care for seriously ill inmates. The aim of this study was to assess the frequency of palliative care consultation and nature of consultation requests for inmates who died while hospitalized at a large tertiary care hospital. A retrospective chart review of all inmate decedents over a 10-year time period was conducted...
November 14, 2018: American Journal of Hospice & Palliative Care
Melanie T Gentry, Maria I Lapid, Teresa A Rummans
Telemental health (TMH) for older patients has the potential to increase access to geriatric specialists, reduce travel times for patients and providers, and reduce ever growing healthcare costs. This systematic review article examines the literature regarding psychiatric assessment and treatment via telemedicine for geriatric patients. English language literature was searched using Ovid Medline, PubMed, and PsycINFO with search terms including telemedicine, telemental health, aging, and dementia. Abstracts were reviewed for relevance based on inclusion criteria...
October 30, 2018: American Journal of Geriatric Psychiatry
Irma Tzur, Shimon Izhakian, Oleg Gorelik
OBJECTIVES: Most studies of orthostatic hypotension (OH) have focused on community-dwelling and institutionalized patient populations. Less is known about OH in hospitalized patients. Moreover, a comprehensive review of OH in internal medicine wards has not been published in the English literature. Our purpose is to provide current information regarding OH in internal medicine inpatients. METHODS: A comprehensive search of medical databases was performed for potentially relevant articles, using the following keywords: postural or orthostatic hypotension, with the combination of hospitalization or internal medicine...
November 9, 2018: Current Medical Research and Opinion
Seung-Hak Cho, Young-Bin Yu, Je-Seop Park, Keun-Dol Yook, Young-Kwon Kim
Objectives: Imported systemic mycoses is a severe fungal infection that can cause diseases in healthy people. However, there is a serious lack of epidemiological data about imported systemic mycoses. Therefore, an epidemiological characterization of imported systemic mycoses in Korea was performed. Methods: We collected health insurance data between 2008 and 2012 from the Health Insurance Corporation and analyzed the data to determine the prevalence and treatment management of imported systemic mycoses...
October 2018: Osong Public Health and Research Perspectives
Rikinkumar S Patel, Shristi Shrestha, Hina Saeed, Sanjeetha Raveendranathan, Ehinor E Isidahome, Virendrasinh Ravat, Mary O Fakorede, Viralkumar Patel
Objective To evaluate the demographic predictors of major depressive disorder (MDD) in hospitalized congestive heart failure (CHF) patients and measure the differences in hospital stay and cost per comorbidities and the associated risk of in-hospital mortality. Methods This retrospective cross-sectional study used nationwide inpatient data from the healthcare cost and utilization project (HCUP). We identified patients with CHF as the primary diagnosis and MDD as the secondary diagnosis using ICD-9-CM codes and compared with the CHF patient without MDD...
August 23, 2018: Curēus
Anca Drăgănescu, Oana Săndulescu, Dragoş Florea, Ovidiu Vlaicu, Anca Streinu-Cercel, Dan Oţelea, Victoria Aramă, Monica Luminiţa Luminos, Adrian Streinu-Cercel, Maria Niţescu, Alina Ivanciuc, Rodica Bacruban, Daniela Piţigoi
BACKGROUND: Influenza continues to drive seasonal morbidity, particularly in settings with low vaccine coverage. OBJECTIVES: To describe the influenza cases and viral circulation among hospitalized patients. METHODS: A prospective study based on active surveillance of inpatients with influenza-like illness from a tertiary hospital in Bucharest, Romania, in the season 2016/17. RESULTS: A total of 446 patients were tested, with a balanced gender distribution...
October 31, 2018: Brazilian Journal of Infectious Diseases
Shailvi Gupta, Justin A Perry, Rosemary Kozar
Elderly patients are at increased risk for morbidity and mortality after injury or surgery in both the inpatient and postdischarge settings. The importance of discharge destination after the index hospitalization is increasingly recognized as a determinant of long-term survival, with discharge to a post-acute care facility portending a worse prognosis. Efforts to minimize discharge to post-acute care facilities should include early discharge planning. Communication among a multidisciplinary care team sets the groundwork for effective discharge planning and transitions of care...
February 2019: Clinics in Geriatric Medicine
Aaron Desai, Yazan Kherallah, Cheryl Szabo, Rohit Marawar
Gabapentin (GBP) and pregabalin (PGB) are FDA approved for adjunctive treatment of partial seizures and for treatment of post-herpetic neuralgia. Both drugs are primarily eliminated by renal excretion. However, PGB or GBP induced myoclonus has only been reported infrequently in case reports/series. It is not discussed with patients and its sudden occurrence can lead to anxiety because of "seizure-like" nature. In addition, first-contact physicians might treat it as seizures, leading to unnecessary tests and aggressive management...
October 28, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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