scholarly journals The Clinical Frailty Scale and Health Services Use for Older Adults in the Emergency Department

2020 ◽  
Author(s):  
Peter Serina ◽  
Alexander X. Lo ◽  
Masha Kocherginsky ◽  
Elizabeth Gray ◽  
Lee A. Lindquist ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Health Services ◽  
Health Services Use ◽  
Clinical Frailty Scale ◽  
Services Use

scholarly journals Associations of insomnia symptoms with subsequent health services use among community-dwelling U.S. older adults

SLEEP ◽  
2020 ◽  
Author(s):  
Marian Tzuang ◽  
Jocelynn T Owusu ◽  
Jin Huang ◽  
Orla C Sheehan ◽  
George W Rebok ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Health Services ◽  
Home Health Care ◽  
Home Health ◽  
Community Dwelling ◽  
Health Services Use ◽  
Ed Visits ◽  
Insomnia Symptoms ◽  
Services Use

Abstract Study Objectives Determine the association of insomnia symptoms with subsequent health services use, in a representative sample of U.S. older adults. Methods Participants were 4,289 community-dwelling Medicare beneficiaries who had continuous fee-for-service Medicare coverage 30 days before, and 1 year after the National Health and Aging Trends Study (NHATS) Round 1 interview. Participants reported past-month insomnia symptoms (i.e. sleep onset latency >30 min, difficulty returning to sleep) which we categorized as 0, 1, or 2 symptoms. Outcomes were health services use within 1 year of interviews from linked Medicare claims: emergency department (ED) visits, hospitalizations, 30-day readmissions, home health care (all measured as yes/no), and number of hospitalizations and ED visits. Results Overall, 18.5% of participants were hospitalized, 28.7% visited the ED, 2.5% had a 30-day readmission, and 11.3% used home health care. After adjustment for demographics, depressive and anxiety symptoms, medical comorbidities, and BMI, compared to participants with no insomnia symptoms, those with two insomnia symptoms had a higher odds of ED visits (odds ratio [OR) = 1.60, 95% confidence interval [CI] = 1.24–2.07, p < 0.001), hospitalizations (OR = 1.29, 95% CI = 1.01–1.65, p < 0.05), and 30-day readmissions (OR = 1.88, 95% CI = 1.88–3.29, p < 0.05). Reporting 2 insomnia symptoms, versus no insomnia symptoms, was associated with a greater number of ED visits and hospitalizations (incidence rate ratio (IRR) = 1.52, 95% CI = 1.23–1.87, p < 0.001; IRR = 1.21, 95% CI = 1.02–1.44, p < 0.05, respectively) after adjusting for demographic and health characteristics. Conclusions Among older adults, insomnia symptoms are associated with greater health services use, including emergency department use, hospitalization, and 30-day readmission. Targeting insomnia may lower health services use.

scholarly journals 0844 Links of Napping With Subsequent All-Cause Hospitalizations and Emergency Department Visits in Older Adults

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A321-A322
Author(s):  
M Tzuang ◽  
J T Owusu ◽  
J Huang ◽  
O C Sheehan ◽  
G W Rebok ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Health Services ◽  
National Health ◽  
Community Dwelling ◽  
Objective Measures ◽  
Health Services Use ◽  
Medicare Claims ◽  
Ed Visits ◽  
Services Use

Abstract Introduction Few studies have examined whether napping is associated with objective measures of health services use. We investigated links of napping characteristics with all-cause hospitalizations and emergency department (ED) visits in Medicare claims from a nationally representative sample of older adults. Methods Participants were 869 community-dwelling Medicare beneficiaries aged ≥65 years from Round 3 (2013) and Round 4 (2014) of the National Health and Aging Trends Study (NHATS) who had continuous fee-for-service coverage 1 year before and after the NHATS interview. Participants reported past-month napping frequency (re-categorized as non-nappers, infrequent nappers, frequent nappers), napping type (intentional, unintentional), and nap duration. Outcomes were from linked Medicare claims measured after napping assessment: all-cause ED visits and hospitalizations (yes vs. no), and number of hospitalizations and ED visits. Results Overall, 45.4% of participants were nappers, and 55.2% of the nappers reported taking unintentional naps. After adjustment for demographics, depressive/anxiety symptoms, medical comorbidities and BMI, compared with non-nappers, infrequent and frequent nappers had a higher odds of hospitalization (odds ratio (OR)=1.65 and 1.73, respectively, both p<0.05), as did unintentional nappers (OR=1.85, p<0.05). We found no significant adjusted associations of napping frequency with ED visits. However, compared with non-nappers, unintentional nappers had a higher odds of visiting the ED (OR=1.94, p<0.01). Additionally, compared to nappers taking short naps (≤30 minutes), those with naps >60 minutes had a greater number of ED visits (Incidence Rate Ratio=1.99, p<0.05). Conclusion Among older adults, napping—and particularly unintentional napping—may be a modifiable risk factor for health services use. More studies that consider multiple napping characteristics (e.g., duration, frequency), and using objective measures (e.g., actigraphy), are needed to advance understanding of how napping might influence health services use. Support National Institute on Aging: R01AG050507 & R01AG050507-02S (PI: Spira); F31-AG058389; U01AG032947 (PI: Kasper) for the National Health and Aging Trends Study. Johns Hopkins Center on Aging and Health Data Use Agreement (PI: Roth, Co-I: Sheehan) with Centers for Medicare & Medicaid Services titled, “Potentially modifiable factors influencing outcomes in NHATS.”

scholarly journals Comorbidity Burden and Health Services Use in Community-Living Older Adults with Diabetes Mellitus: A Retrospective Cohort Study

2016 ◽  
Vol 40 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Andrea Gruneir ◽  
Maureen Markle-Reid ◽  
Kathryn Fisher ◽  
Holly Reimer ◽  
Xiaomu Ma ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Older Adults ◽  
Cohort Study ◽  
Health Services ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Community Living ◽  
Health Services Use ◽  
Comorbidity Burden ◽  
Services Use

Mortality, Health Services Use, and Health Behavior in a Cohort of Well Older Adults

1999 ◽  
Vol 47 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Judith A. Malmgren ◽  
Thomas D. Koepsell ◽  
Diane P. Martin ◽  
Paula Diehr ◽  
Andrea Z. LaCroix
Keyword(s):  
Older Adults ◽  
Health Services ◽  
Health Behavior ◽  
Health Services Use ◽  
Services Use

Health services use by older adults in an urban public health system

2005 ◽  
Vol 23 (2) ◽  
pp. 233-234 ◽  
Author(s):  
Kevin M. Terrell ◽  
Carey D. Chisholm ◽  
Roland B. McGrath ◽  
Anthony J. Perkins ◽  
Amna B. Buttar ◽  
...  
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Health Services ◽  
Health System ◽  
Public Health System ◽  
Health Services Use ◽  
Services Use

Accuracy of Self-Reported Health Services Use and Patterns of Care Among Urban Older Adults

Medical Care ◽  
1999 ◽  
Vol 37 (7) ◽  
pp. 662-670 ◽  
Author(s):  
Daniel B. Wallihan ◽  
Timothy E. Stump ◽  
Christopher M. Callahan
Keyword(s):  
Older Adults ◽  
Health Services ◽  
Patterns Of Care ◽  
Health Services Use ◽  
Reported Health ◽  
Services Use
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