Preadmission Functional Decline Predicts Functional Improvement Among Older Patients Admitted to Acute Care Hospital

Abstract Background and objective Acutely ill older patients with cognitive impairment represent a major subgroup in acute care hospitals. In this context, communication plays a crucial role for patients’ well-being, healthcare decisions, and medical outcomes. As validated measures are lacking, we tested the psychometric properties of an observational instrument to assess Communication Behavior in Dementia (CODEM) in the acute care hospital setting. As a novel feature, we were also able to incorporate linguistic and social-contextual measures. Material and methods Data were drawn from a cross-sectional mixed methods study that focused on the occurrence of elderspeak during care interactions in two German acute care hospitals. A total of 43 acutely ill older patients with severe cognitive impairment (CI group, Mage ± SD = 83.6 ± 5.7 years) and 50 without cognitive impairment (CU group, Mage ± SD = 82.1 ± 6.3 years) were observed by trained research assistants during a standardized interview situation and rated afterwards by use of CODEM. Results Factor analysis supported the expected two-factor solution for the CI group, i.e., a verbal content and a nonverbal relationship aspect. Findings of the current study indicated sound psychometric properties of the CODEM instrument including internal consistency, convergent, divergent, and criterion validity. Conclusion CODEM represents a reliable and valid tool to examine the communication behavior of older patients with CI in the acute care hospital setting. Thus, CODEM might serve as an important instrument for researcher and healthcare professionals to describe and improve communication patterns in this environment.

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Characteristics of institutionalized older patients with delirium newly admitted to an acute care hospital

Clinical Effectiveness in Nursing ◽

10.1016/j.cein.2005.08.001 ◽

2005 ◽

Vol 9 (1-2) ◽

pp. 13-25 ◽

Cited By ~ 2

Author(s):

Philippe Voyer ◽

Martin G. Cole ◽

Jane McCusker ◽

Éric Belzile

Keyword(s):

Acute Care ◽

Older Patients ◽

Acute Care Hospital ◽

Care Hospital

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Factors Associated with Functional Decline in Older Adults After Discharge from an Acute-Care Hospital

Asian Nursing Research ◽

10.1016/j.anr.2019.05.001 ◽

2019 ◽

Vol 13 (3) ◽

pp. 192-199

Author(s):

Hai-Won Yoo ◽

Myo-Gyeong Kim ◽

Doo-Nam Oh ◽

Jeong-Hae Hwang ◽

Kun-Sei Lee

Keyword(s):

Older Adults ◽

Acute Care ◽

Functional Decline ◽

Acute Care Hospital ◽

Care Hospital ◽

Factors Associated

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Effect of discharge conference on rehospitalization among older patients: An analysis of administrative claims data in Japan

10.21203/rs.3.rs-32155/v1 ◽

2020 ◽

Author(s):

Boyoung Jeon ◽

Nanako Tamiya ◽

Xueying Jin ◽

Satoru Yoshie ◽

Katsuya Iijima ◽

...

Keyword(s):

Acute Care ◽

Older Patients ◽

Claims Data ◽

Acute Care Hospital ◽

Control Group ◽

Administrative Claims ◽

Care Hospital ◽

Matching Method ◽

Term Care ◽

The Impact

Abstract Background The policy of discharge conference has function of guiding patients to stay at community. This study aims to investigate the effect of a discharge conference on a probability of hospital readmission and readmission costs among older patients in Japan. Methods We included 8,096 individuals admitted to acute care hospitals, using health and long-term care insurance claims data on older patients (age ≥ 75 years) in a suburban city in Japan, from April 2012 to September 2013. To balance the two groups according to whether a patient received a service of discharge conference or not, we used propensity score matching method. We identified readmission within 360 days from discharges and estimated the impact of a discharge conference on the probability of readmission and readmission costs using multiple logistic and linear regression model. Results Among patients who discharged from an acute care hospital, 367 (4.5%) received a discharge conference. Using the matching method, 304 participants in a control group was matched to 304 participants in a discharge conference group. Readmission rate was 21.1% in patients with a discharge conference and 23.0% in those without a discharge conference. Although there was no significant effect of discharge conference on probability of readmission, but it showed significant effect on lower cost per day. Conclusions These results imply a discharge conference has effect on mitigating cost per day of readmission after adjusting for confounding. This study suggests that there are potential possibilities in the policy of discharge conference on reducing the readmission costs per day amongst older patients.

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