A Hospice-Hospital Partnership: Reducing Hospitalization Costs and 30-Day Readmissions among Seriously Ill Adults

2014 ◽  
Vol 17 (9) ◽  
pp. 1005-1010 ◽  
Author(s):  
John C. Tangeman ◽  
Carole B. Rudra ◽  
Christopher W. Kerr ◽  
Pei C. Grant
2019 ◽  
Vol 58 (4) ◽  
pp. 567-577.e1 ◽  
Author(s):  
Matthew E. Modes ◽  
Ruth A. Engelberg ◽  
Lois Downey ◽  
Elizabeth L. Nielsen ◽  
Robert Y. Lee ◽  
...  

2020 ◽  
Vol 4 (s1) ◽  
pp. 104-104
Author(s):  
Komal Murali ◽  
Gary Yu ◽  
John D. Merriman ◽  
Abraham A. Brody

OBJECTIVES/GOALS: The purpose of this secondary data analysis was to identify latent subgroups of seriously ill adults based on multiple chronic conditions and mortality risk using the CCI. This study was conducted by performing a secondary analysis of data from a randomized controlled trial of seriously ill patients receiving palliative care. METHODS/STUDY POPULATION: A cross-sectional analysis of baseline CCI data was conducted. 381 seriously ill adults receiving palliative care were in the original study. Latent subgroups were identified based on the CCI by conducting a latent class analysis in MPlus. The LCA was modeled on each of the 19 disease items as binary latent predictor variables, an additional binary variable representing presence of any disease not accounted for by the CCI, and a final categorical variable representing the total CCI score divided based on clinically significant cutoffs including zero, low (> = 1-<2), moderate (> = 2-<5), and high CCI (> = 5). RESULTS/ANTICIPATED RESULTS: Three distinct latent subgroups were identified based on the CCI. Latent subgroup 1 included those with a low-moderate CCI consisting of MCC and non-Metastatic Cancers (n = 178), with 45% of this group having chronic obstructive pulmonary disease. The second two subgroups included individuals with a high CCI or a score greater than or equal to 5. Latent subgroup 2 (n = 64) was comprised of individuals with MCC and non-metastatic cancer. Latent subgroup 3 (n = 139) included individuals with metastatic cancer. DISCUSSION/SIGNIFICANCE OF IMPACT: In a sample of seriously ill adults with MCC, latent subgroups were identified consisting of individuals with low, moderate, or high CCI. The low to moderate CCI group consists of individuals with chronic conditions including COPD, congestive heart failure, myocardial infarction, cardiovascular disease. There were two subgroups with high CCI scores and the differentiating factor between the two subgroups was the presence of metastatic cancer in latent subgroup 3. The identification of latent subgroups sets the groundwork for further analyses to compare differences in symptom burden, quality of life, and functional status between groups. The findings have the potential to inform future studies seeking to better characterize seriously adults with MCC based on their disease burden and mortality risk.


1999 ◽  
Vol 43 (5) ◽  
pp. 1277-1280 ◽  
Author(s):  
Douglas N. Fish ◽  
Edward Abraham

ABSTRACT The pharmacokinetics of clarithromycin and its 14-(R)-hydroxylated metabolite were studied on two separate occasions after nasogastric administration of 500 mg of a clarithromycin suspension to 16 seriously ill adults in an intensive care unit. The clarithromycin suspension appeared to be adequately absorbed, and the pharmacokinetics of neither clarithromycin nor 14-(R)-hydroxyclarithromycin differed significantly between the two dosing periods. No substantial differences in pharmacokinetics were observed compared to previously published studies of other adult populations. Minimal intrapatient variability of pharmacokinetic parameters was observed in these seriously ill patients.


2021 ◽  
pp. 019394592110411
Author(s):  
Komal P. Murali ◽  
Gary Yu ◽  
John D. Merriman ◽  
Allison Vorderstrasse ◽  
Amy S. Kelley ◽  
...  

The objective of this study was to characterize multiple chronic conditions (MCCs) among seriously ill adults receiving palliative care at the end of life. A latent class analysis was conducted to identify latent subgroups of seriously ill older adults based on a baseline Charlson comorbidity index (CCI) measurement, a measure of comorbidity burden, and mortality risk. The three latent subgroups were: (1) low to moderate CCI with MCC, (2) high CCI with MCC, and (3) high CCI and metastatic cancer. The “low to moderate CCI and MCC” subgroup included older adults with chronic obstructive pulmonary disease (COPD), cardiovascular disease, congestive heart failure, myocardial infarction, dementia, diabetes, and lymphoma. A “high CCI and MCC” subgroup included individuals with severe illness including liver or renal disease among other MCCs. A “high CCI and metastatic cancer” included all participants with metastatic cancer. This study sheds light on the MCC profile of seriously ill adults receiving palliative care.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Komal P. Murali ◽  
Gary Yu ◽  
John D. Merriman ◽  
Allison Vorderstrasse ◽  
Amy S. Kelley ◽  
...  

2018 ◽  
Vol 75 ◽  
pp. 67-73 ◽  
Author(s):  
Tom H. Boyles ◽  
Rulan Griesel ◽  
Annemie Stewart ◽  
Marc Mendelson ◽  
Gary Maartens

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