We also evaluated the proportion of residents requiring assistance in their activities of daily living (ADLs) according to the KATZ scale. Within our cohort of residents ≥65 years old, the majority of residents with CHD needed assistance with 3-4 ADLs (p=0.18) (Figure 1). However, this was found this to not be statistically significant. Excluding the presence of CHD, persons within the CHD cohort were found to have a greater number of chronic conditions on average than those without CDH (CHD: 3.2 ± 1.7 non CHD 2.5 ± 1.4, p<0.0001) (Figure 2). Over the past 12 months, more residents with CHD had ER visits or overnight hospital stays after their arrival to the RCF than those without CHD (Figure 3). 42% of persons with CHD required Emergency Visits compared to 33% of persons without CHD (p<0.0001). Similarly, 31% of persons with CHD were hospitalized after arrival to the RCF compared to 22% of persons without CHD (p<0.0001). To better assess the odds of Overnight Hospitalization within our study cohort, we conducted multivariable logistic regression (Table 2). No sociodemographic variables, such as age, gender, or Medicaid coverage, were found to be significant and therefore are not included in Table 2. However, chronic conditions including high blood pressure (OR=1.17, CI: 1.04, 1.31), heart attack (OR=1.42, CI: 1.11-1.56), and CHF (OR=1.68 CI: 1.45, 196) were found to be positively associated with the overnight hospital stays. After adjusting for resident characteristics and health conditions (listed in Table 1), the adjusted odds of overnight hospitalization after arrival to the RCF was 1.29 times greater for patients with CHD than those without CHD (95% CI: 1.10, 1.51). The presence of chronic conditions, particular... ... middle of paper ... ... Meeting Preliminary Draft Working Paper Please Do Not Cite or Distribute without Permission Abstract Health Services Utilization of Residents in Assisted Living Com. 1–21 (2013). at 9. Moss, A. J. et al. Design and operation of the 2010 National Survey of Residential Care Facilities. Vital Health Stat. 1. 1–131 (2011). at 10. Balancing Incentive Program | Medicaid.gov. at 11. Shelkey, B. M. & Mason, V. Katz Index of Independence in Activities of Daily Living ( ADL ) Katz Index of Independence in Activities of Daily Living. 185, (2012).
Through a non-experimental design, the authors analyzed data to determine whether full, reduced, or restricted practice rights for NPs affected the health outcomes of medicare and medicaid patients in those states. The type of NP practice allowed was compared to state rankings for avoidable hospitalizations, readmission rates after inpatient rehabilitation, and hospitalizations of residents of long term care facilities, as well as state health outcome rankings provided by the United Health Foundation. The authors performed a quantitative statistical analysis of previous studies done pertaining to outcomes of medicare and medicaid patients. To be included in the analysis, previous studies had to have a national scope but also provide a state ranking system and an explanation of how the ranking was performed. The authors performed two-sampled t tests on all data to determine if there was a correlation between autonomous NP practice and patient outcomes. The results of comparing potentially avoidable hospitalizations, readmission rates of rehabilitation patients, annual hospitalizations of long term care patients and overall state health outcomes between states with full practice and those without, showed that full practice produces more desirable outcomes. Potentially avoidable hospitalizations per 1,000 person-years in
Scott,K., Webb,M,. Sorrentino,S., and Gorek, B. (2007). Long-term care assisting aged care and disability. Sydney, Australia.
There is no quick fix to reduce hospital readmission rate because of the complexity of the conditions for which patients are
The people that worked in assisting living facilities are dedicated, caring people that do a great service for the aged ones. As Annie, Care Manager says, “I love making my residents happy when they are feeling sad or down” (Sunrise). It is important for the resident to feel cared for. Staff nurses and trained specialists have a vast knowledge of working with seniors and anticipating their changes. The staff are committed to help residents stay independent, connecting with their families in a meaningful way and building friendships with residents who become part of the Sunrise
Many people confuse nursing homes with assisted living facilities, but there are several important differences between them. There is a very thin border, which separates the nursing homes from the assisted living facilities. The primary purpose of both of them is to provide medical care and assistance to the residents. However, there is a difference in the level of care provided in each of them, their eligibility criteria, privacy provided, their cost of living, amenities, social activities, and the coverage by the insurance.
Wiener, J.M. (2003). An assessment of strategies for improving quality of care in nursing homes. The Gerontologist 43(Special Issue II), pp 19-27. Retrieved March 10, 2011 from http://www.geroservices.com/downloads/pdf/Assessment_of_Strategies.pdf
HCUP provides reliable comprehensive information for hospital, clinics and research organization (HCUP, 2015). These facilities can use the data that HCUP have collected to answer question they have about the use of healthcare, access, outcomes, and the cost that is related the hospital inpatient stay, emergency department visit and ambulatory surgery and services. They are several reports that HCUP produce to help aid the medical facilities. The HCUP statistical briefs reports is a short report that focuses on topics associated to hospital use and cost for specific conditions or populations (HCUP, 2015). For example it reports medical condition treated and procedures performed in the hospital, and quality of care. The projection report uses longitudinal HCUP data to project national and regional estimates on healthcare priorities (HCUP, 2015). “HCUP methods series reports address methodological issues regarding use of HCUP databases, software tools and supplemental files” (HCUP,
Three hospitals from different geographic locations were chosen for this study. At each hospital a care coordinator was chosen to be responsible for questionnaire review, communication with physicians, and further assessment and intervention when deemed necessary. Lists of patients 65 and older were generated from the caseloads of primary care physicians from the three hospital sites. The questionnaires were mailed out with physicians cover letters and consent forms in the summer of 1993. In the questionnaire patients were asked to assess their self-percieved notions of there medical and psychosocial needs, as well as the level of their functioning. Upon reciept of the completed questionnaires the care coordinators from each hospital assess the results of the survey. Those patients assessed as being high risk received follow up phone calls.
The patient-centered medical home (PCMH) is an important and vital concept in delivering quality and efficient care to patients outside the hospital setting. I once took care of a patient with a new onset congestive heart failure (CHF). CHF, as we all know, is a debilitating disease if not given sufficient medical attention and patient education. To prepare the patient with discharge, coordination of care with the help of the Home Health care (HHC) nurse, ensures continuity of care. The HHC nurse encourages the patient and family to take the necessary step to prevent exacerbation of the disease and promote healthier living through changes with their lifestyle that they can control. Also, access with the primary care provider (PCP) is an
Primary health problems at the time of enrolment into the TCM were 43% heart failure, 25% ischemic heart disease, 13% chronic obstructive pulmonary disease, 7% diabetes and 12% other conditions. To compare ordinal data, the Wilcoxon sum tests were used, and t-tests were used for interval or ratio data. Propensity modelling was used to ensure the control and experimental groups were equally represented in demographics, socio-economic status and geographical characteristics. Study findings confirm earlier results regarding the effectiveness of the TCM in enhancing health outcomes and satisfaction with care among chronically ill older
Eight years later it was observed that 257 of the participants had developed CHD. 70% of these had originally been classed as Type A.
National Hospital Discharge Survey, United States, 2005. Morbidity and Mortality Weekly Report July 20, 2007; 56(28):713
... patients with heart failure: Impact on patients. American Journal of Critical Care, 20(6), 431-442.
What should the government do to make better lifestyle and better treatments the residents of nursing homes deserve? So far, there has been a problem of trying to regulate safety and ensure nursing homes prioritizing care and responsibility on those residents. There has been staffs lacking responsibility for providing treatment, giving their medication, and especially keeping their facilities a clean environment. Overall, what caused is a massive concern of how the residents aren’t treated properly when they deserve to be. Many residents’ health and how they live in nursing homes are at risk and must be improved of how they should live their lives in a nursing home. Therefore, what and how the government should do to make better living environments
The results of this project were derived from a series of interviews and surveys that were distributed among selected local health care institutions such as Assisted Livings, Nursing homes as well as group homes. Reports were also gathered from online sources such as the Substance Abuse and Mental Health Services Administration site. As America's population ages, the need for mental and behavioral health services continues to increase. Public Health professionals are playing a critical role in addressing this situation and part of this is to determine any correlation with lifestyle or socio-economic background.17 Psychologists are studying and treating the mental and behavioral problems associated with growing old, such as loss of spouse, loss