Predicting Nursing Home Length of Stay and Outcome with a Resource-Based Classification System

1996 ◽  
Vol 12 (1) ◽  
pp. 72-79 ◽  
Author(s):  
Gunnar Ljunggren ◽  
Lena Brandt
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
Length Of Stay ◽  
Activities Of Daily Living ◽  
Resource Utilization ◽  
Classification System ◽  
Daily Living ◽  
Prospective Payment System ◽  
Case Mix ◽  
Clinical Value

AbstractThe anticipated demographic changes with an increasing number of elderly force us to plan and use health care resources more efficiently. In this study we have used the components of a case-mix measure for nursing homes; the Resource Utilization Groups (RUG-II), to predict length of stay (LOS) and outcome in geriatric institutions. We have shown that the RUG categories and an activities of daily living (ADL) index differ significantly in both respects, but that other variables might be of more clinical value when establishing a prospective payment system, based on LOS in geriatric institutions.

Recording care time in nursing homes: development and validation of the “RUD-FOCA” (Resource Utilization in Dementia – Formal Care)

2010 ◽  
Vol 22 (8) ◽  
pp. 1291-1300 ◽  
Author(s):  
Katharina Luttenberger ◽  
Elmar Graessel
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Activities Of Daily Living ◽  
Resource Utilization ◽  
Daily Living ◽  
Direct Care ◽  
Formal Care ◽  
Retest Reliability ◽  
Dementia Patients ◽  
Home Recording

ABSTRACTBackground: Currently there is no standardized procedure for recording direct care time of dementia patients in a nursing home. Recording the direct care time, however, provides an important component of both cost estimates for time-dependent reimbursement of nursing activities and for recording the degree of dependency as an outcome measure for the efficiency of new treatment methods for dementia patients. The purpose of this study is thus to develop and validate the “RUD-FOCA” (Resource Utilization in Dementia – Formal Care), based on the RUD lite, as a standardized tool to measure the direct care time actually required in the nursing home.Methods: Based on four hypotheses, construct validity was tested within a randomized controlled trial in a sample of 148 residents in six German nursing homes. The RUD-FOCA records the care time in three areas: activities of daily living (ADL), instrumental activities of daily living (IADL) and supervision. For validation, the residents’ capabilities were examined using the Barthel Index, the Nurses’ Observation Scale on Geriatric Patients (NOSGER), the Alzheimer Disease Assessment Scale (ADAS), the Erlangen Test on Activities of Daily Living (E-ADL) and the Mini-mental State Examination (MMSE). The hypotheses assume relationships between the time required for care in the three areas and the limitations involved in these areas. The retest reliability was also determined.Results: ADL care accounts for two-thirds of total care time in the homes. The hypotheses which refer to total time, ADL and supervision are supported by differentiated correlation profiles. The IADL hypothesis is not supported owing to even, low correlations. The retest reliability was r = 0.76 for the entire care time.Conclusions: Overall time and the times for ADL care and supervision can be considered valid estimates. The validity is lowest for recording IADL times. Thus, the RUD-FOCA is suitable as an instrument to determine the direct care time in the nursing home. Recording IADL times should be improved by detailed operationalization.

scholarly journals Smart Care Using a DNN-Based Approach for Activities of Daily Living (ADL) Recognition

2020 ◽  
Vol 11 (1) ◽  
pp. 10
Author(s):  
Muchun Su ◽  
Diana Wahyu Hayati ◽  
Shaowu Tseng ◽  
Jiehhaur Chen ◽  
Hsihsien Wei
Keyword(s):  
Neural Network ◽  
Health Care ◽  
Activities Of Daily Living ◽  
Video Processing ◽  
Daily Living ◽  
Deep Neural Network ◽  
Recognition System ◽  
Automatic Recognition ◽  
Data Filtering ◽  
Accuracy Rate

Health care for independently living elders is more important than ever. Automatic recognition of their Activities of Daily Living (ADL) is the first step to solving the health care issues faced by seniors in an efficient way. The paper describes a Deep Neural Network (DNN)-based recognition system aimed at facilitating smart care, which combines ADL recognition, image/video processing, movement calculation, and DNN. An algorithm is developed for processing skeletal data, filtering noise, and pattern recognition for identification of the 10 most common ADL including standing, bending, squatting, sitting, eating, hand holding, hand raising, sitting plus drinking, standing plus drinking, and falling. The evaluation results show that this DNN-based system is suitable method for dealing with ADL recognition with an accuracy rate of over 95%. The findings support the feasibility of this system that is efficient enough for both practical and academic applications.

Impact of Physical and Functional Limitations on Health Care Utilization in Older Cancer Survivors: A Medicare Current Beneficiary Survey

2019 ◽  
Vol 32 (9) ◽  
pp. 987-997 ◽  
Author(s):  
Prachi P. Chavan ◽  
Satish K. Kedia ◽  
Xinhua Yu
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Activities Of Daily Living ◽  
Cancer Survivors ◽  
Daily Living ◽  
Functional Limitations ◽  
Emergency Department Visits ◽  
Care Utilization ◽  
Care Needs ◽  
Medicare Current Beneficiary Survey

Objective: This study examines effects of physical and functional limitations on health care utilization among older cancer survivors, compared with those without cancer and without physical and functional limitations. Method: Medicare Current Beneficiary Survey data from 2008 to 2011 were used. Physical limitations (PL), activities of daily living (ADL), and instrumental activities of daily living (IADL) were measured on a 5-point scale. Propensity score weighting was developed using logistic regressions. Results: Older cancer survivors with physical and functional limitations had higher rate of emergency department visits than those without limitations (PL: 21.8% vs.17%, adjusted odds ratio [aOR]:1.72, 95% confidence interval [CI]: [1.26, 2.35], p < .05; ADL: 25.8% vs.17.4%, aOR: 2.68, 95% CI: [1.86, 3.86], p < .001), and higher cost of hospitalization (IADL: M = US$24,916, SD: 3,877.1). Conclusion: Older cancer survivors with physical and functional limitations had higher health care utilization compared with those without cancer. Addressing complex and unique health care needs in this population will help reduce excess burden on the health care system.

Predictors of the Level of Care assigned to New Nursing Home Residents

1985 ◽  
Vol 4 (1) ◽  
pp. 38-46 ◽  
Author(s):  
Peter R. Grant
Keyword(s):  
Nursing Home ◽  
Activities Of Daily Living ◽  
Behavioral Problems ◽  
Daily Living ◽  
Stressful Life Event ◽  
Nursing Home Residents ◽  
Level Of Care ◽  
Admission Data ◽  
Major Predictor ◽  
High Level

ABSTRACTAdmission data from 159 residents of four Saskatchewan nursing homes were analysed in order to identify predictors of level of care. Multiple regression analyses showed that a high level of care was assigned to those who were unable to perform various activities of daily living, those who had behavioral problems, and those who had recently experienced a stressful life event; with these variables and a nursing home variable explaining 47.2% of the variance. Appropriately, the most important predictor is activities of daily living. The other major predictor is behavioral problems which, the results suggest, are caused by either an organic psychotic disorder or a high level of stress. It is recommended that, following admission, new residents with behavioral problems caused by stress should be the recipients of programs designed to help them cope with this stress and mitigate their behavioral problems. Then, they should be reassessed and, where appropriate, reassigned to a lower level of care.

scholarly journals Prevalence of epilepsy/seizures as a comorbidity of neurologic disorders in nursing homes

Neurology ◽  
2017 ◽  
Vol 88 (8) ◽  
pp. 750-757 ◽  
Author(s):  
Angela K. Birnbaum ◽  
Ilo E. Leppik ◽  
Kenneth Svensden ◽  
Lynn E. Eberly
Keyword(s):  
Nursing Home ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Clinical Characteristics ◽  
The United States ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Data Set ◽  
Neurologic Disorders ◽  
Comorbidity Burden

Objective:To determine the prevalence of epilepsy/seizure (epi/sz) comorbid with other neurologic disorders in elderly nursing home residents and to examine demographic and regional variability and associations with clinical characteristics.Methods:We studied 5 cross-sectional cohorts of all residents in any Medicare/Medicaid–certified nursing home in the United States on July 15 of each year from 2003 to 2007. Epi/sz was identified by ICD-9 codes (345.xx or 780.39) or check box (Minimum Data Set). Epi/sz prevalence was stable across all years, so only 2007 data were examined further. Logistic regression with generalized estimating equations was used to model cross-sectional prevalence of epi/sz as a function of demographics and neurologic comorbidities of interest, with adjustment for clinical characteristics, including cognitive status, comorbidity burden, medication burden, and activities of daily living.Results:Point prevalence of epi/sz in 2007 was 7.7% (n = 91,372 of N = 1,186,579) differing by geographical region, race/ethnicity, age group, and sex. Neurologic conditions having the highest association with epi/sz were brain tumor (epi/sz prevalence 23.4%–35.2%), head injury (17.9%), hemiplegia (17.7%), and stroke (13.7%). Epi/sz comorbid with stroke or dementia had a strong decreasing association with age (65–74 years had ≈3.8-times higher odds of epi/sz than 85+ years). Activities of daily living, comorbidity burden, and cognition scores were worse in persons with than without epi/sz.Conclusions:The prevalence of epi/sz in the elderly nursing home population is >7-fold higher compared to community-dwelling elderly and is 7 to 30 times higher among those with certain comorbid neurologic conditions. Demographics and clinical characteristics had weaker associations with epi/sz prevalence.

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