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Hospital and services costs for elderly patients

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https://www.readbyqxmd.com/read/29228992/maccabi-proactive-telecare-center-for-chronic-conditions-the-care-of-frail-elderly-patients
#1
Avi Porath, Angela Irony, Avital Segal Borobick, Shuruk Nasser, Ateret Malachi, Naama Fund, Galit Kaufman
BACKGROUND: In 2012, Maccabi Healthcare Services founded Maccabi Telecare Center (MTC), a multi-disciplinary healthcare service providing telemedical care to complex chronic patients. The current paper describes the establishment and operation of the MTC center, from the identification of the need for the service, through the design of its solution elements, to outcomes in several areas of care. We analyze the effects of the program on elderly frail patients, a growing population with complex and costly needs...
December 11, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/29211163/perception-of-hearing-loss-use-of-the-subjective-faces-scale-to-screen-hearing-among-the-elderly
#2
Letícia Pimenta Costa-Guarisco, Daniela Dalpubel, Ludimila Labanca, Marcos Hortes Nisihara Chagas
Presbycusis is a disorder present among the elderly. However, it is under-diagnosed, making it important to develop and enhance simple screening tools. OBJECTIVE: The subjective faces scale has been proposed as a method to assess auditory self-perception among the elderly, and its correlation with audiological tests. METHODS: We looked at elderly patients referred to the audiology service of a reference center for the care of the elderly in a public university hospital between February and November 2013...
November 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/29186782/forging-a-frailty-ready-healthcare-system-to-meet-population-ageing
#3
Wee Shiong Lim, Sweet Fun Wong, Ian Leong, Philip Choo, Weng Sun Pang
The beginning of the 21st century has seen health systems worldwide struggling to deliver quality healthcare amidst challenges posed by ageing populations. The increasing prevalence of frailty with older age and accompanying complexities in physical, cognitive, social and psychological dimensions renders the present modus operandi of fragmented, facility-centric, doctor-based, and illness-centered care delivery as clearly unsustainable. In line with the public health framework for action in the World Health Organization's World Health and Ageing Report, meeting these challenges will require a systemic reform of healthcare delivery that is integrated, patient-centric, team-based, and health-centered...
November 24, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29171828/analysis-of-postdischarge-costs-following-emergent-general-surgery-in-elderly-patients
#4
Gilgamesh J Eamer, Fiona Clement, Jenelle L Pederson, Thomas A Churchill, Rachel G Khadaroo
BACKGROUND: As populations age, more elderly patients will undergo surgery. Frailty and complications are considered to increase in-hospital cost in older adults, but little is known on costs following discharge, particularly those borne by the patient. We examined risk factors for increased cost and the type of costs accrued following discharge in elderly surgical patients. METHODS: Acute abdominal surgery patients aged 65 years and older were prospectively enrolled...
December 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29170333/36%C3%A2-frailty-flying-squad-an-emergency-department-focussed-acute-care-of-the-elderly-service-dr-genevieve-robson-royal-united-hospital-nhs-foundation-trust
#5
Samantha Ballham, Scott Buxton, Rosa Camacho, Adrianna Sinclair, Chris Dyer, Nicola Jakeman
INTRODUCTION: The over 75 s make up 20% of our ED attendances. The greatest increase has been in the over 85 s. This very elderly cohort are more likely to be frail and are 10X more likely to require admission than 20-40 year olds and once in hospital have longer stays. There is evidence that multidisciplinary care and early Comprehensive Geriatric Assessment (CGA) improves outcomes for older patients, reducing readmissions, long term care, greater satisfaction and lower costs. The aim of this project was to improve the acute care provided to our older patients at the Front Door of the hospital...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29150794/shunt-surgery-in-idiopathic-normal-pressure-hydrocephalus-is-cost-effective-a-cost-utility-analysis
#6
Mats Tullberg, Josefine Persson, Jakob Petersen, Per Hellström, Carsten Wikkelsø, Åsa Lundgren-Nilsson
BACKGROUND: The objective was to evaluate the cost-effectiveness of shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS: Health-related quality of life was evaluated before and 6 months after surgery using the EQ-5D-3 L (EuroQOL group five-dimensions health survey) in 30 patients (median age, 71 years; range, 65-89 years) diagnosed with iNPH. The costs associated with shunt surgery were assessed by a detailed survey with interviews and extraction of register data concerning the cost of hospital care, primary care, residential care, home-care service and informal care...
November 17, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29096710/putting-research-in-place-an-innovative-approach-to-providing-contextualized-evidence-synthesis-for-decision-makers
#7
Stephen Bornstein, Rochelle Baker, Pablo Navarro, Sarah Mackey, David Speed, Melissa Sullivan
BACKGROUND: The Contextualized Health Research Synthesis Program (CHRSP), developed in 2007 by the Newfoundland and Labrador Centre for Applied Health Research, produces contextualized knowledge syntheses for health-system decision makers. The program provides timely, relevant, and easy-to-understand scientific evidence; optimizes evidence uptake; and, most importantly, attunes research questions and evidence to the specific context in which knowledge users must apply the findings. METHODS: As an integrated knowledge translation (KT) method, CHRSP: Involves intensive partnerships with senior healthcare decision makers who propose priority research topics and participate on research teams; Considers local context both in framing the research question and in reporting the findings; Makes economical use of resources by utilizing a limited number of staff; Uses a combination of external and local experts; and Works quickly by synthesizing high-level systematic review evidence rather than primary studies...
November 2, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29090032/the-psychological-abuse-of-the-elderly-a-silent-factor-of-cardiac-decompensation
#8
Adina Carmen Ilie, Anca Iuliana Pîslaru, Ioana Dana Alexa, Adriana Pancu, Ovidiu Gavrilovici, Aliona Dronic
Abuse of the elderly is a major issue debated worldwide. The most commonly identified form of abuse is the physical abuse. It is also the most frequently studied in the medical literature. However, at least six types of elder abuse are identified, and physical abuse is found in a small proportion of the cases. The consequences of abuse are frequent and, by prolonging hospitalizations, they will be associated with high costs of medical services, and patient's lack of self-confidence which, in time, may lead to social isolation, somatization, anxiety, depression, and suicide attempts...
June 2017: Mædica
https://www.readbyqxmd.com/read/28965536/effect-of-an-ageing-population-on-services-for-the-elderly-in-the-northern-territory
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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