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Hospital and services costs for elderly patients

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https://www.readbyqxmd.com/read/28628498/earlier-physical-therapy-input-is-associated-with-a-reduced-length-of-hospital-stay-and-reduced-care-needs-on-discharge-in-frail-older-inpatients-an-observational-study
#1
Peter J Hartley, Victoria L Keevil, Ledia Alushi, Rebecca L Charles, Eimear B Conroy, Patricia M Costello, Becki Dixon, Aida M Dolinska-Grzybek, Diana Vajda, Roman Romero-Ortuno
BACKGROUND AND PURPOSE: Pressures on hospital bed occupancy in the English National Health Service have focused attention on enhanced service delivery models and methods by which physical therapists might contribute to effective cost savings, while retaining a patient-centered approach. Earlier access to physical therapy may lead to better outcomes in frail older inpatients, but this has not been well studied in acute National Health Service hospitals. Our aim was to retrospectively study the associations between early physical therapy input and length of hospital stay (LOS), functional outcomes, and care needs on discharge...
June 16, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28593038/comprehensive-healthcare-resource-use-among-newly-diagnosed-congestive-heart-failure
#2
Lori D Bash, Dahlia Weitzman, Robert O Blaustein, Ofer Sharon, Varda Shalev, Gabriel Chodick
BACKGROUND: Congestive heart failure (CHF) is among the most common causes of hospital admissions and readmissions in the Western world. However, the burden of ambulatory care has not been as well investigated. The objective of this study was to assess the relative burden and direct medical costs of CHF including inpatient and outpatient care. METHODS: We used longitudinal clinical data from a two-million member health organization in Israel (Maccabi Healthcare Services) to identify adults with newly diagnosed CHF between January 2006 and December 2012, either in the in- or outpatient setting...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28540115/the-benefits-of-streamlined-hip-fracture-management-in-a-regional-hospital
#3
T C Mow, Jen Lukeis, A G Sutherland
INTRODUCTION: Hip fracture is an increasingly common injury in the growing elderly population. The morbidity and mortality associated with this injury can be reduced by minimizing delays to surgical treatment. We describe the impact of a regional hospital service redesign project that utilized the principles of smart simplicity, a management strategy that lays emphasis on collaboration to achieve desired goals. METHODS: Prior to the redesign, patients with hip fractures were taking an average of 72 hours for surgical treatment...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28537509/maugeri-centre-for-telehealth-and-telecare-a-real-life-integrated-experience-in-chronic-patients
#4
Simonetta Scalvini, Palmira Bernocchi, Emanuela Zanelli, Laura Comini, Michele Vitacca
Management of chronic diseases in a progressively aging population is a major issue in western industrialized countries and telehealth is one way to ensure the continuity of care in chronic illness. We describe here our personal experience in a telehealth and telecare centre in Italy. Between January 2000 and December 2015, 1635 elderly patients (71% male) with one or more comorbidities have undergone a telehealth program tailored to their specific disease: chronic obstructive pulmonary disease (COPD)/chronic respiratory insufficiency; amyotrophic lateral sclerosis/neuromuscular diseases; chronic heart failure (CHF); post-stroke; and post-cardiac surgery patients discharged from hospital after an acute event...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28512089/physician-age-and-outcomes-in-elderly-patients-in-hospital-in-the-us-observational-study
#5
Yusuke Tsugawa, Joseph P Newhouse, Alan M Zaslavsky, Daniel M Blumenthal, Anupam B Jena
Objectives To investigate whether outcomes of patients who were admitted to hospital differ between those treated by younger and older physicians.Design Observational study.Setting US acute care hospitals.Participants 20% random sample of Medicare fee-for-service beneficiaries aged ≥65 admitted to hospital with a medical condition in 2011-14 and treated by hospitalist physicians to whom they were assigned based on scheduled work shifts. To assess the generalizability of findings, analyses also included patients treated by general internists including both hospitalists and non-hospitalists...
May 16, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28422775/a-contemporary-assessment-of-acute-mechanical-ventilation-in-beijing-description-costs-and-outcomes
#6
Yanping Ye, Bo Zhu, Li Jiang, Qi Jiang, Meiping Wang, Lin Hua, Xiuming Xi
OBJECTIVE: To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China. DESIGN: A prospective observational cohort study. SETTING: Fourteen ICUs among 13 hospitals in Beijing, China. PATIENTS: Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay. INTERVENTION: None...
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28195682/access-to-palliative-care-services-during-the-terminal-hospital-episode-reduces-intervention-rates-and-hospital-costs-a-database-study-of-19707-elderly-patients-dying-in-hospital-2011-2015
#7
Anthony W Ireland
BACKGROUND: The burden of healthcare costs for persons approaching death is of increasing concern. This study examines cost savings associated with access to palliative care (PC) during the hospital episode ending in death for a large sample of elderly patients. METHODS: A retrospective cohort study of administrative data for Department of Veterans' Affairs clients identified patient demographics, hospital characteristics, utilisation data and component costs for the hospital terminal episode for patients aged ≥ 70 years who died in hospital between July 2011 and June 2015...
February 14, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28167723/longer-periods-of-hospice-service-associated-with-lower-end-of-life-spending-in-regions-with-high-expenditures
#8
Shiyi Wang, Sylvia H Hsu, Siwan Huang, Pamela R Soulos, Cary P Gross
Hospice use is expected to decrease end-of-life expenditures, yet evidence for its financial impact remains inconclusive. One potential explanation is that the use of hospice may produce differential cost-savings effects by region because of geographic variation in end-of-life spending patterns. We examined 103,745 elderly Medicare fee-for-service beneficiaries in the Surveillance, Epidemiology, and End Results Program Medicare database who died from cancer in 2004-11. We created quintiles by the adjusted mean end-of-life expenditures per hospital referral region (HRR), and we examined HRR-level variation in the association between length of hospice service and expenditures across quintiles...
February 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28122500/costs-of-care-at-the-end-of-life-among-elderly-patients-with-chronic-kidney-disease-patterns-and-predictors-in-a-nationwide-cohort-study
#9
Bradley Chen, Victoria Y Fan, Yiing-Jenq Chou, Chin-Chi Kuo
BACKGROUND: Despite the urgent need for evidence to guide the end-of-life (EOL) care for patients with chronic kidney disease (CKD), we have limited knowledge of the costs and intensity of EOL care in this population. The present study examined patterns and predictors for EOL care intensity among elderly patients with CKD. METHODS: We conducted a retrospective nationwide cohort study utilizing the Taiwan National Health Insurance (NHI) Research Database. A total of 65,124 CKD patients aged ≥ 60 years, who died in hospitals or shortly after discharge between 2002 and 2012 were analyzed...
January 26, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/27978419/-why-didn
#10
Michele Levinson, Amber Mills, Jonathan Barrett, Gaya Sritharan, Anthea Gellie
Objective The aim of the present study was to understand the reasons for the delivery of non-beneficial cardiopulmonary resuscitation (CPR) attempts in a tertiary private hospital over 12 months. We determined doctors' expectations of survival after CPR for their patient, whether they had considered a not-for-resuscitation (NFR) order and the barriers to completion of NFR orders.Methods Anonymous questionnaires were sent to the doctors primarily responsible for a given patient's care in the hospital within 2 weeks of the unsuccessful CPR attempt...
December 16, 2016: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/27923343/feasibility-and-cost-effectiveness-of-a-multidisciplinary-home-telehealth-intervention-programme-to-reduce-falls-among-elderly-discharged-from-hospital-study-protocol-for-a-randomized-controlled-trial
#11
RANDOMIZED CONTROLLED TRIAL
Alessandro Giordano, Gian Pietro Bonometti, Fabio Vanoglio, Mara Paneroni, Palmira Bernocchi, Laura Comini, Amerigo Giordano
BACKGROUND: Fall incidents are the third cause of chronic disablement in elderly according to the World Health Organization (WHO). Recent meta-analyses shows that a multifactorial falls risk assessment and management programmes are effective in all older population studied. However, the application of these programmes may not be the same in all National health care setting and, consequently, needs to be evaluated by cost-effectiveness studies before to plan this intervention in regular care...
December 7, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27884118/burden-of-clostridium-difficile-associated-disease-among-patients-residing-in-nursing-homes-a-population-based-cohort-study
#12
Holly Yu, Onur Baser, Li Wang
BACKGROUND: Clostridium difficile (C. difficile) infection (CDI) is the leading cause of nosocomial diarrhea in the United States. This study aimed to examine the incidence of CDI and evaluate mortality and economic burden of CDI in an elderly population who reside in nursing homes (NHs). METHODS: This was a population-based retrospective cohort study focusing on US NHs by linking Medicare 5% sample, Medicaid, Minimum Data Set (MDS) (2008-10). NH residents aged ≥65 years with continuous enrollment in Medicare and/or Medicaid Fee-for-Service plan for ≥12 months and ≥2 quarterly MDS assessments were eligible for the study...
November 25, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27847675/an-orthopedic-hospitalist-comanaged-hip-fracture-service-reduces-inpatient-length-of-stay
#13
Daniel N Bracey, Tunc C Kiymaz, David C Holst, Kamran S Hamid, Johannes F Plate, Erik C Summers, Cynthia L Emory, Riyaz H Jinnah
INTRODUCTION: Hip fractures are common in the elderly patients with an incidence of 320 000 fractures/year in the United States, representing a health-care cost of US$9 to 20 billion. Hip fracture incidence is projected to increase dramatically. Hospitals must modify clinical models to accommodate this growing burden. Comanagement strategies are reported in the literature, but few have addressed orthopedic-hospitalist models. An orthopedic-hospitalist comanagement (OHC) service was established at our hospital to manage hip fracture patients...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/27707828/fracture-in-the-elderly-multidisciplinary-rehabilitation-femur-a-phase-ii-randomised-feasibility-study-of-a-multidisciplinary-rehabilitation-package-following-hip-fracture
#14
Nefyn H Williams, Jessica L Roberts, Nafees Ud Din, Nicola Totton, Joanna M Charles, Claire A Hawkes, Val Morrison, Zoe Hoare, Michelle Williams, Aaron W Pritchard, Swapna Alexander, Andrew Lemmey, Robert T Woods, Catherine Sackley, Pip Logan, Rhiannon T Edwards, Clare Wilkinson
OBJECTIVE: To conduct a rigorous feasibility study for a future definitive parallel-group randomised controlled trial (RCT) and economic evaluation of an enhanced rehabilitation package for hip fracture. SETTING: Recruitment from 3 acute hospitals in North Wales. Intervention delivery in the community. PARTICIPANTS: Older adults (aged ≥65) who received surgical treatment for hip fracture, lived independently prior to fracture, had mental capacity (assessed by clinical team) and received rehabilitation in the North Wales area...
October 5, 2016: BMJ Open
https://www.readbyqxmd.com/read/27616961/outcome-indicators-on-interprofessional-collaboration-interventions-for-elderly
#15
Giannoula Tsakitzidis, Olaf Timmermans, Nadine Callewaert, Veronique Verhoeven, Maja Lopez-Hartmann, Steven Truijen, Herman Meulemans, Paul Van Royen
BACKGROUND: Geriatric care increasingly needs more multidisciplinary health care services to deliver the necessary complex and continuous care. The aim of this study is to summarize indicators of effective interprofessional outcomes for this population. METHOD: A systematic review is performed in the Cochrane Library, Pubmed (Medline), Embase, Cinahl and Psychinfo with a search until June 2014. RESULTS: Overall, 689 references were identified of which 29 studies met the inclusion criteria...
2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/27557644/elderly-hospitalization-and-the-new-type-rural-cooperative-medical-scheme-ncms-in-china-multi-stage-cross-sectional-surveys-of-jiangxi-province
#16
Bingbing Pan, Zhaokang Yuan, Jiaojiao Zou, Daniel M Cook, Wei Yang
BACKGROUND: Studies assessing the impacts of China's New-type Rural Cooperative Medical Scheme (NCMS) reform of 2003 among rural elderly have been limited. METHOD: Multistage stratified cluster sampling household surveys of 1838, 1924, 1879, 1888, 1890 and 1896 households from 27 villages in Jiangxi province were conducted in 2003/2004, 2006, 2008, 2010, 2012 and 2014. Data from older adults age 65 and above were analyzed. Weighted logistic regression was applied to find factors of elderly hospitalization services...
2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27462845/-morbidity-profile-and-hospital-expenses-with-elderly-patients-in-paran%C3%A3-state-brazil-2008-2012
#17
Clarice da Luz Kernkamp, Cassia Kely Favoretto Costa, Ely Mitie Massuda, Eraldo Schunk Silva, Mirian Ueda Yamaguchi, Marcelo Picinin Bernuci
Growth in the elderly population has increased both the demand for health services and healthcare expenses, with relevant consequences for economic stability. The current study aimed to analyze the morbidity profile and hospital expenses with elderly patients in relation to socioeconomic and demographic conditions in Paraná State, Brazil, from 2008 to 2012, applying principal components analysis and groupings. Regions with higher and lower economic and human development showed high prevalence of hospitalizations and costs pertaining to the circulatory and respiratory systems and cardiac diseases for males and females...
July 21, 2016: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/27459659/nephrotoxic-medication-exposure-in-u-s-adults-with-predialysis-chronic-kidney-disease-health-services-utilization-and-cost-outcomes
#18
Mary Lynn Davis-Ajami, Jeffery C Fink, Jun Wu
BACKGROUND: Nephrotoxic medication exposure increases risks for acute kidney injury, permanent renal function loss, and costly preventable adverse drug events. Exposure to medications associated with inducing acute tubular nephritis or tubular toxicity versus nonexposure among those with predialysis renal disease-a population vulnerable to increased risk of kidney injury-may affect health services utilization and cost outcomes. Few studies quantify nephrotoxic medication exposure in chronic kidney disease (CKD) and associated costs...
August 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27399381/101%C3%A2-medicare-expenditures-for-elderly-patients-undergoing-surgical-clipping-or-endovascular-intervention-for-subarachnoid-hemorrhage
#19
Kimon Bekelis, Dan Gottlieb, Todd MacKenzie, Giuseppe Lanzino, Michael T Lawton, Stavropoula I Tjoumakaris, Pascal Jabbour
INTRODUCTION: The impact of treatment method (surgical clipping or endovascular coiling) on the cost of care of patients with aneurysmal subarachnoid hemorrhage (SAH) is debated. We investigated the association of treatment method with long-term Medicare expenditures in elderly patients with aneurysmal SAH. METHODS: We performed a cohort study of 100% of Medicare fee-for-service claims data for elderly patients, who underwent treatment for ruptured cerebral aneurysms from 2007 to 2012...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27330890/progress-in-ambient-assisted-systems-for-independent-living-by-the-elderly
#20
Riyad Al-Shaqi, Monjur Mourshed, Yacine Rezgui
One of the challenges of the ageing population in many countries is the efficient delivery of health and care services, which is further complicated by the increase in neurological conditions among the elderly due to rising life expectancy. Personal care of the elderly is of concern to their relatives, in case they are alone in their homes and unforeseen circumstances occur, affecting their wellbeing. The alternative; i.e. care in nursing homes or hospitals is costly and increases further if specialized care is mobilized to patients' place of residence...
2016: SpringerPlus
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