Geriatric conditions as predictors of increased number of hospital admissions and hospital bed days over one year: Findings of a nationwide cohort of older adults from Taiwan

2014 ◽  
Vol 59 (1) ◽  
pp. 169-174 ◽  
Author(s):  
Hui-Hsuan Wang ◽  
Ji-Tian Sheu ◽  
Yea-Ing Lotus Shyu ◽  
Hsing-Yi Chang ◽  
Chia-Lin Li
Keyword(s):  
Older Adults ◽  
Hospital Admissions ◽  
Geriatric Conditions ◽  
Hospital Bed ◽  
Bed Days ◽  
One Year

Clozapine in Community Practice: A 3-Year Follow-Up Study in the Australian Capital Territory

1999 ◽  
Vol 33 (5) ◽  
pp. 667-675 ◽  
Author(s):  
Leslie R. H. Drew ◽  
Donna M. Hodgson ◽  
Kathleen M. Griffiths
Keyword(s):  
Hospital Admissions ◽  
Community Practice ◽  
Australian Capital Territory ◽  
Financial Outcomes ◽  
Entire Cohort ◽  
Australian Capital ◽  
Hospital Bed ◽  
Significant Clinical Improvement ◽  
Bed Days ◽  
Official Records

Objective: This paper aims to present the first data on the long-term use of cloza-pine in an entire cohort of patients encountered in a community, the Australian Capital Territory. It examines the clinical and financial outcomes 3 years after the prescription of clozapine to a cohort of 37 patients. Method: Experience during the 2 years before clozapine was prescribed was compared with experience in the following 3 years on the basis of a retrospective review of official records. Data included hospital and hostel bed use and an estimate of treatment costs. In addition, changes in living circumstances and employment status were assessed and treating psychiatrists reported the presence of side effects and their impressions of clinical change since clozapine was prescribed. Results: Compared with the preclozapine period, there were significant reductions postclozapine in hospital admissions (year 3) and hospital bed-days (year 2) by the total cohort and in hospital bed-days and hospital expenditure for those patients (n = 25) who remained on clozapine (years 2 and 3). There was no significant increase or decrease postclozapine in the estimated combined cost of treatment attributable to bed use (hospital or hostel), clozapine tablets, blood monitoring, and the employment of a Clozapine Coordinator. Clinically, all patients who stayed on clozapine were reported to be moderately or markedly improved. Five of nine patients who were not taking clozapine at study's end were unimproved or deteriorated. Conclusions: The findings of significant clinical improvement without evidence of increased cost lend support for the selective use of clozapine in community practice.

scholarly journals Decreased Hospitalizations and Costs From Infection in Sixteen Nursing Homes in the SHIELD OC Regional Decolonization Initiative

2020 ◽  
Vol 41 (S1) ◽  
pp. s7-s8
Author(s):  
Gabrielle M. Gussin ◽  
James A. McKinnell ◽  
Raveena D. Singh ◽  
Ken Kleinman ◽  
Amherst Loren Miller ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Hospital Admissions ◽  
Orange County ◽  
Baseline Period ◽  
Primary Diagnosis ◽  
Healthcare Intervention ◽  
Contact Precautions ◽  
Hospitalization Rates ◽  
Hospital Bed ◽  
Bed Days

Distinguished OralBackground: Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, California (SHIELD OC) was a CDC-funded regional decolonization intervention from April 2017 through July 2019 involving 38 hospitals, nursing homes (NHs), and long-term acute-care hospitals (LTACHs) to reduce MDROs. Decolonization in NH and LTACHs consisted of universal antiseptic bathing with chlorhexidine (CHG) for routine bathing and showering plus nasal iodophor decolonization (Monday through Friday, twice daily every other week). Hospitals used universal CHG in ICUs and provided daily CHG and nasal iodophor to patients in contact precautions. We sought to evaluate whether decolonization reduced hospitalization and associated healthcare costs due to infections among residents of NHs participating in SHIELD compared to nonparticipating NHs. Methods: Medicaid insurer data covering NH residents in Orange County were used to calculate hospitalization rates due to a primary diagnosis of infection (counts per member quarter), hospital bed days/member-quarter, and expenditures/member quarter from the fourth quarter of 2015 to the second quarter of 2019. We used a time-series design and a segmented regression analysis to evaluate changes attributable to the SHIELD OC intervention among participating and nonparticipating NHs. Results: Across the SHIELD OC intervention period, intervention NHs experienced a 44% decrease in hospitalization rates, a 43% decrease in hospital bed days, and a 53% decrease in Medicaid expenditures when comparing the last quarter of the intervention to the baseline period (Fig. 1). These data translated to a significant downward slope, with a reduction of 4% per quarter in hospital admissions due to infection (P < .001), a reduction of 7% per quarter in hospitalization days due to infection (P < .001), and a reduction of 9% per quarter in Medicaid expenditures (P = .019) per NH resident. Conclusions: The universal CHG bathing and nasal decolonization intervention adopted by NHs in the SHIELD OC collaborative resulted in large, meaningful reductions in hospitalization events, hospitalization days, and healthcare expenditures among Medicaid-insured NH residents. The findings led CalOptima, the Medicaid provider in Orange County, California, to launch an NH incentive program that provides dedicated training and covers the cost of CHG and nasal iodophor for OC NHs that enroll.Funding: NoneDisclosures: Gabrielle M. Gussin, University of California, Irvine, Stryker (Sage Products): Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes.

Evaluation of myCOPD, a digital self-management technology, in a remote and rural population. (Preprint)

2021 ◽  
Author(s):  
Beth Sage ◽  
Rowena Cooper ◽  
Adam Giangreco ◽  
Michelle Duffy ◽  
Elaine Finlayson ◽  
...  
Keyword(s):  
Rural Communities ◽  
Hospital Admissions ◽  
Self Management ◽  
Service Needs ◽  
Management Technology ◽  
Lower Health ◽  
Bed Days ◽  
One Year ◽  
Very High ◽  
Improve Health

UNSTRUCTURED Digital self-management technologies are increasingly common given their potential to improve health outcomes and mitigate demands on clinical services. This study evaluated myCOPD in 113 participants from predominantly remote and rural communities for up to one year. Although popular, myCOPD was not associated with reduced hospital admissions, inpatient bed days or lower health service needs. Further subgroup analysis did however suggest that very high myCOPD usage may benefit some individuals.

Cumulative number of hospital bed days among older adults in the last year of life: A retrospective cohort study

2016 ◽  
Vol 17 (5) ◽  
pp. 737-743 ◽  
Author(s):  
Tatsuro Ishizaki ◽  
Masaya Shimmei ◽  
Haruhisa Fukuda ◽  
Eun-Hwan Oh ◽  
Chiho Shimada ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cumulative Number ◽  
Hospital Bed ◽  
Bed Days

scholarly journals GERI-VET: A PROGRAM FOR OLDER VETERANS SEEN IN THE EMERGENCY ROOM

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S146-S146
Author(s):  
Denise M Kresevic ◽  
Albert Lee ◽  
Mustafa Ascha ◽  
Todd Smith
Keyword(s):  
Older Adults ◽  
Emergency Room ◽  
Hospital Admissions ◽  
Social Issues ◽  
Functional Decline ◽  
Care Staff ◽  
Caregiver Support ◽  
Avoidable Hospitalizations ◽  
One Year ◽  
Family Caregiver Burden

Abstract Older adults made over 21 million Emergency Room (ER) visits accounting for nearly 46% of all ER hospital admissions in 2015. The ER setting provides not only a unique opportunity to assess patients’ health, functional status and social issues, but also provide recommendations to help coordinate care. Geriatric ER assessments have been associated with reduced avoidable hospitalizations, functional decline, and institutionalization. However, few ER clinicians including physicians, nurses and technicians have received adequate training to perform geriatric screenings and implement timely referrals. In 2014 American College of Emergency physicians and American Geriatric Society published guidelines for care. Based on these guidelines A” Geri-Vet Bootcamp” Program was developed and piloted at the Northeast Ohio VAMC. This program included: simulation emphasizing standardized screenings, and the use of decision support aides for management and referrals for older adults seen in the ER. Following this multi-modal education program, 91% clinicians reported greater ability to apply knowledge learned, 82% clinicians were able to more accurately identify geriatric syndromes, and 86% were able to identify additional resources. Of the patients screened over one year, 73% of patients were identified as being at high risk for falls, 32% had high family caregiver burden, 15% had moderate to severe dementia, and 14% had positive delirium screens. Those veterans screened by Geri Vet trained Staff received significantly more referrals than usual care staff, home care 28.7% vs.15.6%, geriatric clinic 20.5% vs. 11.7% and caregiver support 5.0% vs. 1.3%. Data show hospital admissions have decreased 5-7%. Education and dissemination continues

Neuropsychological Effects of Cybercycling for Older Adults: One-Year Follow-Up

2010 ◽  
Author(s):  
Cay Anderson-Hanley ◽  
Paul Arciero ◽  
Joseph Nimon ◽  
Vadim Yerkohin ◽  
Veronica Hopkins ◽  
...  
Keyword(s):  
Older Adults ◽  
Neuropsychological Effects ◽  
One Year

Functional Decline in Emergency Department Patients with Dyspnea; a Register-Based Cohort

2021 ◽  
Author(s):  
Karoline Stentoft Rybjerg Larsen ◽  
Marianne Lisby ◽  
Hans Kirkegaard ◽  
Annemette Krintel Petersen
Keyword(s):  
Emergency Department ◽  
Electronic Patient Record ◽  
Hospital Admissions ◽  
Functional Decline ◽  
Patient Characteristics ◽  
Risk Of Death ◽  
Record Data ◽  
Emergency Department Patients ◽  
One Year ◽  
Historic Cohort

Abstract Background Functional decline is associated with frequent hospital admissions and elevated risk of death. Presumably patients acutely admitted to hospital with dyspnea have a high risk of functional decline. The aim of this study was to describe patient characteristics, hospital trajectory, and use of physiotherapy services of dyspneic patients in an emergency department. Furthermore, to compare readmission and death among patients with and without a functional decline, and to identify predictors of functional decline. Methods Historic cohort study of patients admitted to a Danish Emergency Department using prospectively collected electronic patient record data from a Business Intelligence Registry of the Central Denmark Region. The study included adult patients that due to dyspnea in 2015 were treated at the emergency department (ED). The main outcome measures were readmission, death, and functional decline. Results In total 2,048 dyspneic emergency treatments were registered. Within 30 days after discharge 20% was readmitted and 3.9% had died. Patients with functional decline had a higher rate of 30-day readmission (31.2% vs. 19.1%, p&lt;0.001) and mortality (9.3% vs. 3.6%, p=0.009) as well as mortality within one year (36.1% vs. 13.4%, p&lt;0.001). Predictors of functional decline were age ≥60 years and hospital stay ≥6 days. Conclusion Patients suffering from acute dyspnea are seen at the ED at all hours. In total one in five patients were readmitted and 3.9% died within 30 days. Patients with a functional decline at discharge seems to be particularly vulnerable.

scholarly journals One Year of the COVID-19 Pandemic in Galicia: A Global View of Age-Group Statistics during Three Waves

2021 ◽  
Vol 18 (10) ◽  
pp. 5104
Author(s):  
Iván Area ◽  
Henrique Lorenzo ◽  
Pedro J. Marcos ◽  
Juan J. Nieto
Keyword(s):  
Intensive Care Unit ◽  
Hospital Admissions ◽  
Age Groups ◽  
Age Group ◽  
Nw Spain ◽  
The Past ◽  
Global View ◽  
Time Period ◽  
Key Variables ◽  
One Year

In this work we look at the past in order to analyze four key variables after one year of the COVID-19 pandemic in Galicia (NW Spain): new infected, hospital admissions, intensive care unit admissions and deceased. The analysis is presented by age group, comparing at each stage the percentage of the corresponding group with its representation in the society. The time period analyzed covers 1 March 2020 to 1 April 2021, and includes the influence of the B.1.1.7 lineage of COVID-19 which in April 2021 was behind 90% of new cases in Galicia. It is numerically shown how the pandemic affects the age groups 80+, 70+ and 60+, and therefore we give information about how the vaccination process could be scheduled and hints at why the pandemic had different effects in different territories.

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