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Hospital and services costs for elderly patients

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https://www.readbyqxmd.com/read/28965536/effect-of-an-ageing-population-on-services-for-the-elderly-in-the-northern-territory
#1
Michael Lowe, Pasqualina Coffey
Objective The aim of the present study was to describe the elderly population of the Northern Territory (NT), explore the challenges of delivering aged care services to this population and implications for the acute care sector.Methods Data gathered from a variety of sources were used to describe the demographic and health profile of elderly Territorians, the aged care structure and services in the NT, and admission trends of elderly patients in NT hospitals. Information regarding NT community and residential aged care services was sourced from government reports...
October 2, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28929932/one-year-health-and-care-costs-after-hip-fracture-for-home-dwelling-elderly-patients-in-norway-results-from-the-trondheim-hip-fracture-trial
#2
RANDOMIZED CONTROLLED TRIAL
Liv Faksvåg Hektoen, Ingvild Saltvedt, Olav Sletvold, Jorunn L Helbostad, Hilde Lurås, Vidar Halsteinli
AIM: The aim of this study was to estimate the one-year health and care costs related to hip fracture for home-dwelling patients aged 70 years and older in Norway, paying specific attention to the status of the patients at the time of fracture and cost differences due to various patient pathways after fracture. METHODS: Data on health and care service provision were extracted from hospital and municipal records and from national registries; data on unit costs were collected from the municipalities, hospital administrations and previously published studies...
December 2016: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/28898930/impact-and-experiences-of-delayed-discharge-a-mixed-studies-systematic-review
#3
REVIEW
Antonio Rojas-García, Simon Turner, Elena Pizzo, Emma Hudson, James Thomas, Rosalind Raine
BACKGROUND: The impact of delayed discharge on patients, health-care staff and hospital costs has been incompletely characterized. AIM: To systematically review experiences of delay from the perspectives of patients, health professionals and hospitals, and its impact on patients' outcomes and costs. METHODS: Four of the main biomedical databases were searched for the period 2000-2016 (February). Quantitative, qualitative and health economic studies conducted in OECD countries were included...
September 12, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28890528/association-between-economic-status-and-discharge-destination-among-elderly-patients-from-acute-care-hospitals
#4
Nobuo Sakata, Yasuyuki Okumura, Yasuyuki Shirakawa
Objective The aim of this study was to investigate the association between economic status and discharge destination of elderly patients from acute care hospitals.Method We conducted a case-control study using data from a survey of elderly discharged patients conducted under the subsidy program of the Japanese Ministry of Health, Labour and Welfare. The questionnaires were mailed to 1,068 acute care hospitals located in the Kanto and Kansai region. The survey asked medical social workers or nurses, who were responsible for the discharge planning, to answer questions about the discharge of elderly patients from their hospitals...
2017: [Nihon Kōshū Eisei Zasshi] Japanese Journal of Public Health
https://www.readbyqxmd.com/read/28836493/developing-a-multidisciplinary-rehabilitation-package-following-hip-fracture-and-testing-in-a-randomised-feasibility-study-fracture-in-the-elderly-multidisciplinary-rehabilitation-femur
#5
Nefyn H Williams, Jessica L Roberts, Nafees Ud Din, Joanna M Charles, Nicola Totton, Michelle Williams, Kevin Mawdesley, Claire A Hawkes, Val Morrison, Andrew Lemmey, Rhiannon T Edwards, Zoe Hoare, Aaron W Pritchard, Robert T Woods, Swapna Alexander, Catherine Sackley, Pip Logan, Clare Wilkinson, Jo Rycroft-Malone
BACKGROUND: Proximal femoral fracture is a major health problem in old age, with annual UK health and social care costs of £2.3B. Rehabilitation has the potential to maximise functional recovery and maintain independent living, but evidence of clinical effectiveness and cost-effectiveness is lacking. OBJECTIVES: To develop an enhanced community-based rehabilitation package following surgical treatment for proximal femoral fracture and to assess acceptability and feasibility for a future definitive randomised controlled trial (RCT) and economic evaluation...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28817444/strategies-for-reducing-population-surgical-costs-in-medicare-local-referrals-to-low-cost-hospitals
#6
Hari Nathan, Jyothi R Thumma, Edward C Norton, Justin B Dimick
OBJECTIVE: We sought to assess hospital cost variation for elective inpatient surgical procedures within small geographic areas. SUMMARY BACKGROUND DATA: Previous studies have documented cost variation for inpatient surgical procedures on a national basis, suggesting opportunities for savings. Cost variation within small geographic areas is more relevant to policymakers, providers, and patients, but it has not been studied. METHODS: Using Medicare payment data, we identified elderly patients undergoing 1 of 7 elective inpatient surgical procedures during 2010-2012...
August 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28728807/the-impact-of-team-based-primary-care-on-health-care-services-utilization-and-costs-quebec-s-family-medicine-groups
#7
Erin Strumpf, Mehdi Ammi, Mamadou Diop, Julie Fiset-Laniel, Pierre Tousignant
We investigate the effects on health care costs and utilization of team-based primary care delivery: Quebec's Family Medicine Groups (FMGs). FMGs include extended hours, patient enrolment and multidisciplinary teams, but they maintain the same remuneration scheme (fee-for-service) as outside FMGs. In contrast to previous studies, we examine the impacts of organizational changes in primary care settings in the absence of changes to provider payment and outside integrated care systems. We built a panel of administrative data of the population of elderly and chronically ill patients, characterizing all individuals as FMG enrollees or not...
September 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28703869/early-supported-discharge-services-for-people-with-acute-stroke
#8
REVIEW
Peter Langhorne, Satu Baylan
BACKGROUND: People with stroke conventionally receive a substantial part of their rehabilitation in hospital. Services have now been developed that offer people in hospital an early discharge with rehabilitation at home (early supported discharge: ESD). OBJECTIVES: To establish if, in comparison with conventional care, services that offer people in hospital with stroke a policy of early discharge with rehabilitation provided in the community (ESD) can: 1) accelerate return home, 2) provide equivalent or better patient and carer outcomes, 3) be acceptable satisfactory to patients and carers, and 4) have justifiable resource implications use...
July 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28693565/two-year-post-discharge-costs-of-care-among-patients-treated-with-transcatheter-or-surgical-aortic-valve-replacement-in-germany
#9
Klaus Kaier, Frederike von Kampen, Hardy Baumbach, Constantin von Zur Mühlen, Philip Hehn, Werner Vach, Manfred Zehender, Christoph Bode, Jochen Reinöhl
BACKGROUND: This study presents data on post-discharge costs of care among patients treated with transcatheter or surgical aortic valve replacement over a two year period. METHODS: Based on a prospective clinical trial, post-discharge utilization of health services and status of assistance were collected for 151 elderly patients via 2250 monthly telephone interviews, valued using standardized unit costs and analysed using two-part regression models. RESULTS: At month 1 post-discharge, total costs of care are substantially elevated (monthly mean: €3506...
July 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28661842/innovative-care-model-to-improve-clinical-quality-and-safety-of-transitional-care-early-outcomes
#10
Brooke Roeper, Eric Beck, Daniel Castillo, J Brent Myers, Brandy Sparkman, Jonathan Cox, Scott Bourn
One in five elderly patients returns to the hospital within 30 days of leaving. These rehospitalizations are a common and costly occurrence. A program developed to address problems in post-acute transitional care seems to be effective in reducing 30-day readmission rates for some Medicare fee-for-service beneficiaries.
June 2017: Managed Care
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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