scholarly journals Prevalence of Multiple Sclerosis in Tuscany (Central Italy): A Study Based on Validated Administrative Data

2015 ◽  
Vol 46 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Daiana Bezzini ◽  
Laura Policardo ◽  
Giuseppe Meucci ◽  
Monica Ulivelli ◽  
Sabina Bartalini ◽  
...  

Background: Multiple Sclerosis (MS) epidemiology in Italy is mainly based on population-based prevalence studies. Administrative data are an additional source of information, when available, in prevalence studies of chronic diseases such as MS. The aim of our study is to update the prevalence rate of MS in Tuscany (central Italy) as at 2011 using a validated case-finding algorithm based on administrative data. Methods: The prevalence was calculated using an algorithm based on the following administrative data: hospital discharge records, drug-dispensing records, disease-specific exemptions from copayment to health care, home and residential long-term care and inhabitant registry. To test algorithm sensitivity, we used a true-positive reference cohort of MS patients from the Tuscan MS register. To test algorithm specificity, we used another cohort of individuals who were presumably not affected by MS. Results: As at December 31, 2011, we identified 6,890 cases (4,738 females and 2,152 males) with a prevalence of 187.9 per 100,000. The sensitivity of algorithm was 98% and the specificity was 99.99%. Conclusions: We found a prevalence higher than the rates present in literature. Our algorithm, based on administrative data, can accurately identify MS patients; moreover, the resulting cohort is suitable to monitor disease care pathways.

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Mats L. Junek ◽  
Aaron Jones ◽  
George Heckman ◽  
Catherine Demers ◽  
Lauren E. Griffith ◽  
...  

Abstract Background Functional status is a patient-important, patient-centered measurement. The utility of functional status measures to inform post-discharge patient needs is unknown. We sought to examine the utility of routinely collected functional status measures gathered from older hospitalized patients to predict a panel of post-discharge outcomes. Methods In this population-based retrospective cohort study, Adults 65+ discharged from an acute hospitalization between 4 November 2008 and 18 March 2016 in Ontario, Canada and received an assessment of functional status at discharge using the Health Outcomes for Better Information and Care tool were included. Multivariable regression analysis was used to determine the relationship between functional status and emergency department (ED) re-presentation, hospital readmission, long term care facility (LTCF) admission or wait listing (‘LTCF readiness’), and death at 180 days from discharge. Results A total of 80 020 discharges were included. 38 928 (48.6%) re-presented to the ED, 24 222 (30.3%) were re-admitted, 5 037 (6.3%) were LTCF ready, and 9 047 (11.3%) died at 180 days. Beyond age, diminished functional status at discharge was the factor most associated with LTCF readiness (adjusted Odds Ratio [OR] 4.11 for those who are completely dependent for activities of daily living compared to those who are independent; 95% Confidence Interval [CI]: 3.70-4.57) and death (OR 3.99; 95% CI: 3.67-4.35). Functional status also had a graded relationship with each outcome and improved the discriminability of the models predicting death and LTCF readiness (p<0.01) but not ED re-presentation or hospital re-admission. Conclusion Routinely collected functional status at discharge meaningfully improves the prediction of long term care home readiness and death. The routine assessment of functional status can inform post-discharge care and planning for older adults.


Author(s):  
J. Jbilou ◽  
A. El Bouazaoui ◽  
B. Zhang ◽  
J.L. Henry ◽  
L McDonald ◽  
...  

Older adults living in long-term care facilities typically receive insufficient exercise and have long periods of the day when they are not doing anything other than sitting or lying down, watching television, or ruminating (Wilkinson et al., 2017). We developed an intervention called the Experiential Centivizer, which provides residents with opportunities to use a driving simulator, watch world travel videos, and engage in exercise. We assessed the impact of the intervention on residents of a long-term care home in Fredericton, NB, Canada. In this paper, we report on the results observed and highlight the lessons learned from implementing a technological intervention within a long-term care setting. Practical and research recommendations are also discussed to facilitate future intervention implementation in long-term care.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 755-755
Author(s):  
Gloria Gutman ◽  
Avantika Vashisht ◽  
Taranjot Kaur ◽  
Ryan Churchill ◽  
Amir Moztarzadeh ◽  
...  

Abstract MindfulGarden (MG) is a digital device resembling a flat screen TV, with touchless sensors that react to voice and motion. In this study 13 long-term care home residents aged 74-100 exhibiting Behavioural and Psychological Symptoms of Dementia (BPSD) were randomized to treatment and control groups. On days 1-3 the treatment group received usual care plus exposure to MG during morning and evening care - events well documented to be problematic for residents and care staff; controls received usual care only. On day 4 both groups were exposed to MG with verbal cueing. A 26-item checklist was used to record frequency and types of disruptive BPSD exhibited; care duration was recorded in minutes. There was a trend toward reduction of BPSD and duration of care during morning care. Findings suggest that verbal cueing may be important for successful implementation of MG in calming residents with dementia during routine care.


2013 ◽  
Vol 14 (2) ◽  
pp. 343-375 ◽  
Author(s):  
Luigi Siciliani

Abstract Long-term care expenditure is expected to rise, driven by an ageing population. Given that public long-term care expenditure is high in many OECD countries, governments are increasingly concerned about its future growth. This study focuses on three relevant issues. First, we discuss factors that affect the growth of long-term expenditure and its projections. These include demographics, the balance in provision between informal and formal care, whether higher life expectancy translates into higher disability, the interrelation between health and long-term care, and whether long-term care suffers from Baumol’s disease. Second, given that a significant proportion of long-term care expenditure is nursing- and care-home expenditure, we discuss the role of government regulation aimed at ensuring that individuals receive appropriate quality of care in such institutions. We focus in particular on price regulation, competition, and the non-profit sector; these have been the subject of considerable empirical work (mainly in the United States). Third, we discuss the relative merits of public and private insurance. Countries differ greatly in their approach. Some countries have nearly exclusively public insurance but in others this is small. We consider the conditions under which public insurance can overcome the limitations of a private insurance market.


BMC Neurology ◽  
2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Ruth Ann Marrie ◽  
◽  
John D Fisk ◽  
Bo Nancy Yu ◽  
Stella Leung ◽  
...  

2010 ◽  
Vol 11 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Angela Colantonio ◽  
Dana Howse ◽  
Jigisha Patel

AbstractThe aim of this research was to identify the number and characteristics of adults under the age of 65 with a diagnosis of traumatic brain injury (TBI) living in long-term care homes (nursing homes, homes for the aged and charitable homes) in Ontario, Canada. Methods: The study used a cross-sectional design. Secondary data analysis of a comprehensive provincial database of long-term care homes was conducted. Results: Of the 399 residents coded as having a TBI, 154 were < 65 years of age. Virtually all residents were limited in personal care and required assistance for eating (94.2%), toileting (92.2%) and dressing (99.4%). A large percentage also required care for challenging behaviours, while care needs due to substance abuse was common among 12.3% of TBI residents. Conclusion: As similar research in Australia has found, young persons in long-term care homes in Ontario, Canada, have high level personal health needs, however the appropriateness of this environment is questionable.


2012 ◽  
Vol 37 (1) ◽  
pp. 100-105 ◽  
Author(s):  
Navita Viveky ◽  
Lynda Toffelmire ◽  
Lilian Thorpe ◽  
Jennifer Billinsky ◽  
Jane Alcorn ◽  
...  

Vitamin–mineral supplementation may offer older adults health and cognition-related benefits but overuse may contribute to polypharmacy. We examined the prevalence of supplement usage in long-term care facility (LTC) residents (≥65 years of age). As cognition may be affected by nutrition, we also examined use in those with diagnosis of dementia and those with no dementia diagnosis. The prevalence of supplement usage and overall “pill count” from pharmaceutical use was assessed in 189 LTC residents and a subsample of 56 older adults with dementia diagnosis, respectively. Participants were residing in an LTC facility of a mid-size metropolitan area during 2009. The average use of supplements was 1.0 per day for all residents, with 35% taking vitamin D supplements, 20% multivitamins, and 26% calcium. Supplement use was similar (p ≥ 0.05) for those with dementia diagnosis (53%, average 2.0 per day) and for those without such diagnosis (45%, average 2.2 per day). Usage ranged between 1–6 supplements per day. In both of these groups, ∼73% of users were taking vitamin D. The number of prescribed medications ranged from 4 to 24 (average 10.2) in a subsample of residents whose supplement intake was 0 to 6 (average 2). These findings suggest an overall low rate of supplement use, with no significant differences (p ≥ 0.05) in use between residents with and without dementia diagnosis. However, some residents were at risk for supplement overuse.


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