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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
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28682456/how-hospital-clinicians-select-patients-for-skilled-nursing-facilities
#4
Robert E Burke, Emily Lawrence, Amy Ladebue, Roman Ayele, Brandi Lippmann, Ethan Cumbler, Rebecca Allyn, Jacqueline Jones
OBJECTIVE: To understand how hospital-based clinicians evaluate older adults in the hospital and decide who will be transferred to a skilled nursing facility (SNF) for postacute care. DESIGN: Semistructured interviews paired with a qualitative analytical approach informed by Social Constructivist theory. SETTING: Inpatient care units in three hospitals. Purposive sampling was used to maximize variability in hospitals, units within hospitals, and staff on those units...
July 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28682444/selecting-a-skilled-nursing-facility-for-postacute-care-individual-and-family-perspectives
#5
Emily A Gadbois, Denise A Tyler, Vincent Mor
OBJECTIVES: To describe individuals' experiences during the hospital discharge planning and skilled nursing facility (SNF) selection process. DESIGN: Semistructured interviews focusing on discharge planning and nursing facility selection, including how facilities were chosen, who was involved, and what factors were important in decision-making. SETTING: 14 SNFs in five cities across the United States. PARTICIPANTS: Newly admitted, previously community-dwelling SNF residents (N = 98) and their family members...
July 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28679805/medicare-beneficiaries-with-advanced-lung-cancer-experience-diverse-patterns-of-care-from-diagnosis-to-death
#6
Megan S Schuler, Nina R Joyce, Haiden A Huskamp, Elizabeth B Lamont, Laura A Hatfield
Characterizations of average end-of-life care for people with cancer can obscure important differences in patients' experiences. Using Medicare claims data for 14,257 patients diagnosed with extensive-stage small-cell lung cancer in the period 1995-2009, we used latent class analysis to identify classes of people with different care patterns. We characterized care trajectories from diagnosis to death using time spent in five care settings-home, hospital inpatient unit (acute), hospital intensive care unit (ICU), postacute skilled nursing facility, and hospice-and transitions across these settings...
July 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28671934/older-adult-attendance-in-cardiac-rehabilitation-impact-of-functional-status-and-postacute-care-after-acute-myocardial-infarction-in-63-092-medicare-beneficiaries
#7
Melissa D Zullo, Mary A Dolansky, Richard A Josephson, Vinay K Cheruvu
PURPOSE: Older adults who use postacute care (PAC) after hospitalization for myocardial infarction (MI) are often overlooked as cardiac rehabilitation (CR) candidates because of physical limitations. This research describes the impact of functional status and PAC, including inpatient rehabilitation facility (IRF), skilled nursing facility (SNF), or home health care (HHC), on CR initiation in Medicare beneficiaries discharged from the hospital following an index MI. METHODS: The Chronic Condition Warehouse database of Medicare beneficiaries discharged to PAC following index MI in 2008 (n = 63 092) was used for this retrospective study...
June 30, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28669568/modeling-the-potential-economic-impact-of-the-medicare-comprehensive-care-for-joint-replacement-episode-based-payment-model
#8
Omar Z Maniya, Richard C Mather, David E Attarian, Bipin Mistry, Aneesh Chopra, Matt Strickland, Kevin A Schulman
BACKGROUND: The Medicare program has initiated Comprehensive Care for Joint Replacement (CJR), a bundled payment mandate for lower extremity joint replacements. We sought to determine the degree to which hospitals will invest in care redesign in response to CJR, and to project its economic impacts. METHODS: We defined 4 potential hospital management strategies to address CJR: no action, light care management, heavy care management, and heavy care management with contracting...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28641378/staff-perceptions-of-key-factors-guiding-nursing-home-search-and-selection-within-the-veterans-health-administration
#9
Edward Alan Miller, Stefanie Gidmark, Emily Gadbois, James L Rudolph, Orna Intrator
Background and Objectives: Veterans enter nursing homes (NHs) for short-term postacute, rehabilitation, respite, or end-of-life care. They also enter NHs on a long-term basis due to frailty, disability, functional deficits, and cognitive impairment. Little is known about how a particular NH is chosen once the decision to enter a NH has been made. This study identified VA staff perceptions of the key factors influencing the search and selection of NHs within the Veterans Health Administration (VHA)...
June 21, 2017: Gerontologist
https://www.readbyqxmd.com/read/28636200/functional-impairment-an-unmeasured-marker-of-medicare-costs-for-postacute-care-of-older-adults
#10
S Ryan Greysen, Irena Stijacic Cenzer, W John Boscardin, Kenneth E Covinsky
OBJECTIVES: To assess the effects of preadmission functional impairment on Medicare costs of postacute care up to 365 days after hospital discharge. DESIGN: Longitudinal cohort study. SETTING: Health and Retirement Study (HRS). PARTICIPANTS: Nationally representative sample of 16,673 Medicare hospitalizations of 8,559 community-dwelling older adults from 2000 to 2012. MEASUREMENTS: The main outcome was total Medicare costs in the year after hospital discharge, assessed according to Medicare claims data...
June 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28622186/a-90-day-bundled-payment-for-primary-single-level-lumbar-discectomy-decompression-what-does-big-data-say
#11
Nikhil Jain, Sohrab S Virk, Frank M Phillips, Elizabeth Yu, Safdar N Khan
Episode-based bundling may become the major form of reimbursement for many elective spine procedures. As the amount for a 90-day episode of care is not known for a lumbar discectomy, we analyzed the previous reimbursements from Commercial payers (2007-Q2 2015), Medicare Advantage (2007-Q2 2015), and Medicare (2005-2012) for a primary single-level lumbar discectomy/decompression. Distribution of payments among various service providers was studied and a 90-day bundle was simulated. Depending on the payer type, the average facility costs constituted 59...
June 15, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28614579/an-instrumental-variable-analysis-comparing-medicare-expenditures-for-laparoscopic-vs-open-colectomy
#12
Kyle H Sheetz, Edward C Norton, Scott E Regenbogen, Justin B Dimick
Importance: Numerous study findings suggest that the use of laparoscopy is associated with lower health care costs for many operations, including colectomy. The extent to which these differences are due to the laparoscopic approach itself or selection bias from healthier patients undergoing the less invasive procedure is unclear. Objective: To evaluate the differences in Medicare expenditures for laparoscopic and open colectomy. Design, Setting, and Participants: A population-based study was conducted of Medicare beneficiaries undergoing laparoscopic or open colectomy between January 1, 2010, and December 31, 2012...
June 14, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28598923/readmissions-to-different-hospitals-after-common-surgical-procedures-and-consequences-for-implementation-of-perioperative-surgical-home-programs
#13
Franklin Dexter, Richard H Epstein, Eric C Sun, David A Lubarsky, Elisabeth U Dexter
BACKGROUND: We consider whether there should be greater priority of information sharing about postacute surgical resources used: (1) at skilled nursing facilities or inpatient rehabilitation hospitals to which patients are transferred upon discharge (when applicable) versus (2) at different hospitals where readmissions occur. Obtaining and storing data electronically from these 2 sources for Perioperative Surgical Home initiatives are dissimilar; both can be challenging depending on the country and health system...
June 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28590894/hearing-characteristics-of-stroke-patients-prevalence-and-characteristics-of-hearing-impairment-and-auditory-processing-disorders-in-stroke-patients
#14
Nehzat Koohi, Deborah A Vickers, Rahul Lakshmanan, Hoskote Chandrashekar, David J Werring, Jason D Warren, Doris-Eva Bamiou
BACKGROUND: Stroke survivors may suffer from a range of hearing impairments that may restrict their participation in postacute rehabilitation programs. Hearing impairment may have a significant impact on listening, linguistic skills, and overall communication of the affected stroke patient. However, no studies sought to systematically characterize auditory function of stroke patients in detail, to establish the different types of hearing impairments in this cohort of patients. Such information would be clinically useful in understanding and addressing the hearing needs of stroke survivors...
June 2017: Journal of the American Academy of Audiology
https://www.readbyqxmd.com/read/28580725/effects-of-acute-postacute-continuity-on-community-discharge-and-30-day-rehospitalization-following-inpatient-rehabilitation
#15
James E Graham, Janet Prvu Bettger, Addie Middleton, Heidi Spratt, Gulshan Sharma, Kenneth J Ottenbacher
OBJECTIVE: To examine the effects of facility-level acute-postacute continuity on probability of community discharge and 30-day rehospitalization following inpatient rehabilitation. DATA SOURCES: We used national Medicare enrollment, claims, and assessment data to study 541,097 patients discharged from 1,156 inpatient rehabilitation facilities (IRFs) in 2010-2011. STUDY DESIGN: We calculated facility-level continuity as the percentages of an IRF's patients admitted from each contributing acute care hospital...
June 5, 2017: Health Services Research
https://www.readbyqxmd.com/read/28580644/relationships-between-acute-and-postacute-care-providers-measurement-and-estimation
#16
EDITORIAL
R Tamara Konetzka, Rachel M Werner
No abstract text is available yet for this article.
June 5, 2017: Health Services Research
https://www.readbyqxmd.com/read/28580588/response-to-relationships-between-acute-and-postacute-care-providers-measurement-and-estimation
#17
EDITORIAL
James E Graham
No abstract text is available yet for this article.
June 5, 2017: Health Services Research
https://www.readbyqxmd.com/read/28578883/hospital-at-home-integrated-care-program-for-older-patients-with-orthopedic-processes-an-efficient-alternative-to-usual-hospital-based-care
#18
Conxita Closa, Miquel À Mas, Sebastià J Santaeugènia, Marco Inzitari, Aida Ribera, Miquel Gallofré
OBJECTIVE: To compare outcomes and costs for patients with orthogeriatric conditions in a home-based integrated care program versus conventional hospital-based care. DESIGN: Quasi-experimental longitudinal study. SETTING: An acute care hospital, an intermediate care hospital, and the community of an urban area in the North of Barcelona, in Southern Europe. PARTICIPANTS: In a 2-year period, we recruited 367 older patients attended at an orthopedic/traumatology unit in an acute hospital for fractures and/or arthroplasty...
May 31, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28562474/responsiveness-of-the-functioning-and-disability-parts-of-the-international-classification-of-functioning-disability-and-health-core-sets-in-postacute-stroke-patients
#19
Shoji Kinoshita, Masahiro Abo, Takatsugu Okamoto, Wataru Kakuda, Kohei Miyamura, Ikuo Kimura
To study the responsiveness of the International Classification of Functioning, Disability, and Health (ICF) core set with respect to human functioning and disability in stroke patients. Postacute stroke patients who were admitted to the convalescent rehabilitation wards were included in this observational cohort study. The comprehensive ICF core set for neurological conditions for postacute care and the ICF rehabilitation set were evaluated at admission and discharge using five-grade qualifiers. Extension indexes were calculated for entire two ICF core sets...
May 30, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/28557478/assessment-of-emotion-processing-skills-in-acquired-brain-injury-using-an-ability-based-test-of-emotional-intelligence
#20
Sarah E Hall, Joanne M Wrench, Sarah J Wilson
Social and emotional problems are commonly reported after moderate to severe acquired brain injury (ABI) and pose a significant barrier to rehabilitation. However, progress in assessment of emotional skills has been limited by a lack of validated measurement approaches. This study represents the first formal psychometric evaluation of the use of the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) V2.0 as a tool for assessing skills in perceiving, using, understanding and managing emotions following ABI...
May 29, 2017: Psychological Assessment
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