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https://www.readbyqxmd.com/read/28918103/rasch-analysis-dimensionality-and-scoring-of-the-neuropsychiatric-inventory-npi-irritability-and-aggression-subscales-in-individuals-with-traumatic-brain-injury
#1
James F Malec, Timothy E Stump, Patrick O Monahan, Jacob Kean, Dawn Neumann, Flora M Hammond
OBJECTIVE: To develop, for versions completed by individuals with traumatic brain injury (TBI) and an observer, a more precise metric for the Neuropsychiatric Inventory (NPI) Irritability and Aggression scales using all behavioral item ratings for use with individuals with TBI and address the dimensionality of the represented behavioral domains. DESIGN: Rasch and confirmatory factor analyses of retrospective baseline NPI data from three treatment studies. SETTING: Postacute rehabilitation clinic...
September 13, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28918102/the-minimal-clinically-important-difference-for-the-rasch-neuropsychiatric-inventory-irritability-and-aggression-scale-for-traumatic-brain-injury
#2
James F Malec, Flora M Hammond
OBJECTIVE: To determine the Minimal Clinically Important Difference (MCID) for a Rasch measure derived from the Irritability/Lability and Agitation/Aggression subscales of the Neuropsychiatric Inventory (NPI-TBI-IA). DESIGN: Distribution-based statistical methods were applied to retrospective data to determine candidates for the MCID. These candidates were evaluated by anchoring the NPI-TBI-IA to Global Impression of Change (GIC) ratings by participants, significant others, and a supervising physician...
September 13, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28903163/myocardial-infarction-and-postacute-care-does-one-size-fit-all
#3
Anna Kucharska-Newton
No abstract text is available yet for this article.
September 13, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28874480/corporate-investors-increased-common-ownership-in-hospitals-and-the-postacute-care-and-hospice-sectors
#4
Annabelle C Fowler, David C Grabowski, Robert J Gambrel, Haiden A Huskamp, David G Stevenson
The sharing of investors across firms is a new antitrust focus because of its potential negative effects on competition. Historically, the ability to track common investors across the continuum of health care providers has been limited. Thus, little is known about common investor ownership structures that might exist across health care delivery systems and how these linkages have evolved over time. We used data from the Provider Enrollment, Chain, and Ownership System of the Centers for Medicare and Medicaid Services to identify common investor ownership linkages across the acute care, postacute care, and hospice sectors within the same geographic markets...
September 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28865892/comparison-of-readmission-rates-after-acute-myocardial-infarction-in-3-patient-age-groups-18-to-44-45-to-64-and-%C3%A2-65-years-in-the-united-states
#5
Rohan Khera, Snigdha Jain, Ambarish Pandey, Vijay Agusala, Dharam J Kumbhani, Sandeep R Das, Jarett D Berry, James A de Lemos, Saket Girotra
Postacute myocardial infarction (AMI) readmissions are common among Medicare beneficiaries (≥65 years) and are associated with significant resource utilization. However, patterns of AMI readmissions for younger age groups in the United States are not known. In the Nationwide Readmissions Database, a nationally representative all-payer database of inpatient hospitalizations, we identified 212,171 index AMI hospitalizations in January to November 2013, weighted to represent 478,247 hospitalizations nationally (mean age 66...
August 4, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28863012/critical-care-organizations-business-of-critical-care-and-value-performance-building
#6
Sharon Leung, Sara R Gregg, Craig M Coopersmith, A Joseph Layon, John Oropello, Daniel R Brown, Stephen M Pastores, Vladimir Kvetan
OBJECTIVE: New, value-based regulations and reimbursement structures are creating historic care management challenges, thinning the margins and threatening the viability of hospitals and health systems. The Society of Critical Care Medicine convened a taskforce of Academic Leaders in Critical Care Medicine on February 22, 2016, during the 45th Critical Care Congress to develop a toolkit drawing on the experience of successful leaders of critical care organizations in North America for advancing critical care organizations (Appendix 1)...
August 31, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28857794/reductions-in-average-lengths-of-stays-for-surgical-procedures-between-the-2008-and-2014-united-states-national-inpatient-samples-were-not-associated-with-greater-incidences-of-use-of-postacute-care-facilities
#7
Franklin Dexter, Richard H Epstein
BACKGROUND: Diagnosis-related group (DRG) based reimbursement creates incentives for reduction in hospital length of stay (LOS). Such reductions might be accomplished by lesser incidences of discharges to home. However, we previously reported that, while controlling for DRG, each 1-day decrease in hospital median LOS was associated with lesser odds of transfer to a postacute care facility (P = .0008). The result, though, was limited to elective admissions, 15 common surgical DRGs, and the 2013 US National Readmission Database...
August 29, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28842511/assessment-model-to-identify-patients-with-stroke-with-a-high-possibility-of-discharge-to-home-a-retrospective-cohort-study
#8
Takahiro Itaya, Yusuke Murakami, Akiko Ota, Eiichi Nomura, Tomoko Fukushima, Masakazu Nishigaki
BACKGROUND AND PURPOSE: Discharge planning for inpatients with acute stroke can enhance reasonable use of healthcare resources, as well as improve clinical outcomes and decrease financial burden of patients. Especially, prediction for discharge destination is crucial for discharge planning. This study aimed to develop an assessment model to identify patients with a high possibility of discharge to home after an acute stroke. METHODS: We reviewed the electronic medical records of 3200 patients with acute stroke who were admitted to a stroke center in Japan between January 1, 2011, and December 31, 2015...
August 25, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28832865/drivers-of-payment-variation-in-90-day-coronary-artery-bypass-grafting-episodes
#9
Vinay Guduguntla, John D Syrjamaki, Chad Ellimoottil, David C Miller, Richard L Prager, Edward C Norton, Patricia Theurer, Donald S Likosky, James M Dupree
Importance: Coronary artery bypass grafting (CABG) is scheduled to become a mandatory Medicare bundled payment program in January 2018. A contemporary understanding of 90-day CABG episode payments and their drivers is necessary to inform health policy, hospital strategy, and clinical quality improvement activities. Furthermore, insight into current CABG payments and their variation is important for understanding the potential effects of bundled payment models in cardiac care. Objective: To examine CABG payment variation and its drivers...
August 23, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28822255/malnutrition-in-postacute-geriatric-care-basic-espen-diagnosis-and-etiology-based-diagnoses-analyzed-by-length-of-stay-in-hospital-mortality-and-functional-rehabilitation-indexes
#10
Dolores Sánchez-Rodríguez, Ester Marco, Cédric Annweiler, Natalia Ronquillo-Moreno, Andrea Tortosa, Olga Vázquez-Ibar, Ferran Escalada, Xavier Duran, Josep M Muniesa
OBJECTIVE: To determine the relationships between malnutrition and nutrition-related conditions according to the European Society of Clinical Nutrition and Metabolism (ESPEN) consensus and guidelines and clinical outcomes in postacute rehabilitation. METHODS: Of 102 eligible inpatients, 95 (84.5 years old, 63.2% women) fulfilled inclusion criteria: aged ≥70 years, body mass index <30kg/m(2), admission for rehabilitation. Mini-Nutritional Assessment-Short Form (MNA-SF≤11) identified patients "at risk" and ESPEN basic and etiology based definitions were applied...
August 2, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28815180/assessing-cognitive-estimation-and-its-effects-on-community-integration-in-people-with-acquired-brain-injury-undergoing-rehabilitation
#11
Dónal G Fortune, Helen L Richards
The purpose of the present study was to examine the convergent and divergent validity of the Biber Cognitive Estimation Test (BCET) in individuals with ABI undergoing postacute rehabilitation and to assess the measure's ability to account for unique variance in community integration following rehabilitation. Participants with ABI referred for postacute rehabilitation (N = 201) were assessed on the BCET and a number of other neuropsychological tests that have been demonstrated to rely on aspects of executive processing (Trail-Making Test, Modified Six Elements Test, and verbal fluency measures) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28814419/chronic-cough-postacute-respiratory-illness-in-children-a-cohort-study
#12
Kerry-Ann F O'Grady, Benjamin J Drescher, Vikas Goyal, Natalie Phillips, Jason Acworth, Julie M Marchant, Anne B Chang
OBJECTIVE: Data on the aetiology of persistent cough at the transitional stage from subacute to chronic cough (>4 weeks duration) are scarce. We aimed to (1) identify the prevalence of chronic cough following acute respiratory illness (ARI) and (2) determine the diagnostic outcomes of children with chronic cough. DESIGN: Prospective cohort study. SETTING: A paediatric emergency department (ED) in Brisbane, Australia. PATIENTS: Children aged <15 years presenting with an ARI with cough...
August 16, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28809645/screening-for-functional-cognition-in-postacute-care-and-the-improving-medicare-post-acute-care-transformation-impact-act-of-2014
#13
Gordon Muir Giles, Dorothy Farrar Edwards, M Tracy Morrison, Carolyn Baum, Timothy J Wolf
Occupational therapists have a long history of assessing functional cognition, defined as the ability to use and integrate thinking and performance skills to accomplish complex everyday activities. In response to passage of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (Pub. L. 113-185), the American Occupational Therapy Association has been advocating that the Centers for Medicare and Medicaid Services consider functional cognition for inclusion in routine patient assessment in postacute care settings, with important implications for occupational therapy...
September 2017: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
https://www.readbyqxmd.com/read/28804011/functional-outcomes-subsequent-healthcare-utilization-and-mortality-of-stroke-postacute-care-patients-in-taiwan-a-nationwide-propensity-score-matched-study
#14
Li-Ning Peng, Wan-Hsuan Lu, Chih-Kuang Liang, Ming-Yueh Chou, Chih-Ping Chung, Shu-Ling Tsai, Zhi-Jun Chen, Fei-Yuan Hsiao, Liang-Kung Chen
OBJECTIVE: To evaluate the benefits of the national stroke postacute care (PAC) program on clinical outcomes and subsequent healthcare utilization. DESIGN: Propensity score-matched case-control study using the National Health Insurance data. PARTICIPANTS: A total of 1480 stroke cases receiving PAC services and 3159 matched controls with similar stroke severity but without PAC services. MEASUREMENTS: Demographic characteristics, functional outcomes (modified Rankin Scale, Barthel Index, Lawton-Brody Instrumental Activities of Daily Living, Functional Oral Intake Scale, Mini-Nutritional Assessment, Berg Balance Test, Usual Gait Speed Test, 6-Minute Walk Test, Fugl-Meyer Assessment (modified sensation and motor), Mini-Mental State Examination, Motor Activity Log, and the Concise Chinese Aphasia Test), subsequent healthcare utilization (90-day stroke re-admission and emergency department visits), and 90-day mortality...
August 10, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28801975/trends-in-aging-related-services-during-nephrectomy-implications-for-surgery-in-an-aging-population
#15
Hung-Jui Tan, Mark S Litwin, Karim Chamie, Debra Saliba, Jim C Hu
OBJECTIVES: To characterize the extent to which geriatric and related healthcare services are provided to older adults undergoing surgery for kidney cancer, a potential growth area in geriatrics and oncology. DESIGN: Population-based observational study. SETTING: Surveillance, Epidemiology, and End Results cancer data linked with Medicare claims. PARTICIPANTS: Adults aged 65 and older with kidney cancer treated surgically from 2000 to 2009 (N = 19,129)...
August 11, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28772084/inpatient-palliative-care-consultation-and-30-day-readmissions-in-oncology
#16
Lisa D DiMartino, Bryan J Weiner, Laura C Hanson, Morris Weinberger, Sarah A Birken, Katherine Reeder-Hayes, Justin G Trogdon
BACKGROUND: Prior research indicates that hospice and palliative care delivered in outpatient settings are associated with reduced hospital readmissions for cancer patients. However, little is known about how inpatient palliative care affects readmissions in oncology. OBJECTIVE: To examine associations among inpatient palliative care consultation, hospice use (discharge), and 30-day readmissions among patients with solid tumor cancers. METHODS: We identified all live discharges from a large tertiary cancer hospital between 2010 and 2016...
August 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28742704/racial-ethnic-disparities-in-longer-term-outcomes-among-emergency-general-surgery-patients-the-unique-experience-of-universally-insured-older-adults
#17
Cheryl K Zogg, Wei Jiang, Taylor D Ottesen, Shahid Shafi, Kevin Schuster, Robert Becher, Kimberly A Davis, Adil H Haider
OBJECTIVES: To determine whether racial/ethnic disparities in 30/90/180-day mortality, major morbidity, and unplanned readmissions exist among universally insured older adult (≥65 years) emergency general surgery patients; vary by diagnostic category; and can be explained by variations in geography, teaching status, age-cohort, and a hospital's percentage of minority patients. SUMMARY OF BACKGROUND DATA: As the US population ages and discussions surrounding the optimal method of insurance provision increasingly enter into national debate, longer-term outcomes are of paramount concern...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28712798/region-and-insurance-plan-type-influence-discharge-disposition-after-hip-and-knee-arthroplasty-evidence-from-the-privately-insured-us-population
#18
Marina Soley-Bori, Rene Soria-Saucedo, Bora Youn, Alex B Haynes, Ryan Macht, Colleen M Ryan, Jeffrey C Schneider, Lewis E Kazis
BACKGROUND: Little is known about regional variation in the use of postacute care services after elective procedures, such as total hip or knee arthroplasty (THA/TKA), and how insurance type may influence it. The goal of this study is to assess the influence of region and insurance arrangements on discharge disposition. METHODS: A representative sample of the privately insured US population with THA or TKA in 2009 or 2010 was obtained from the MarketScan database applying individual-level weights from the Medical Expenditure Panel Survey...
June 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28707110/what-factors-are-associated-with-90-day-episode-of-care-payments-for-younger-patients-with-total-joint-arthroplasty
#19
Shweta Pathak, Cecilia M Ganduglia, Samir S Awad, Wenyaw Chan, John M Swint, Robert O Morgan
BACKGROUND: Total joint arthroplasty (TJA) has been identified as a procedure with substantial variations in inpatient and postacute care payments. Most studies in this area have focused primarily on the Medicare population and rarely have characterized the younger commercially insured populations. Understanding the inpatient and postdischarge care service-component differences across 90-day episodes of care and factors associated with payments for younger patients is crucial for successful implementation of bundled payments in TJA in non-Medicare populations...
July 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28688730/use-of-medical-orders-for-scope-of-treatment-for-heart-failure-patients-during-postacute-care-in-skilled-nursing-facilities
#20
Hillary Lum, Oluyomi Obafemi, Joanna Dukes, Molly Nowels, Kristina Samon, Rebecca S Boxer
BACKGROUND: Individuals with heart failure (HF) who are hospitalized and admitted to skilled nursing facilities (SNFs) are at high risk for rehospitalization and death. The care preferences of this high-risk population have not been studied. OBJECTIVES: To describe care preferences of patients with HF admitted to SNFs for rehabilitation based on Medical Orders for Scope of Treatment (MOST) documentation, and evaluate goal-concordant care based on MOST documentation, emergency department (ED) visits, and hospitalization...
July 6, 2017: Journal of the American Medical Directors Association
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