Issues Regarding Aggregation of Data in Nursing Systems Research

1994 ◽  
Vol 2 (1) ◽  
pp. 79-101 ◽  
Author(s):  
Linda C. Hughes ◽  
Ruth A. Anderson
Keyword(s):  
Patient Outcomes ◽  
Outcomes Research ◽  
Organizational Context ◽  
Nursing Intervention ◽  
Group Level ◽  
Skilled Nursing ◽  
Aggregated Data ◽  
Nursing Unit ◽  
Systems Research ◽  
Using Data

The unit of analysis at which variables are conceptualized and measured is an important consideration when conducting patient outcomes research. Outcomes research ranges from study of individual responses to nursing intervention to investigation of group level outcomes associated with the contexts and processes through which nursing care is delivered. Because many variables salient to the investigation of group level patient outcomes are not amenable to direct measurement, aggregation procedures are used to generate proxy measurement of organizational context or process variables. In this article, key conceptual and methodologic issues encountered when using data aggregation procedures are reviewed. Following this, estimation of aggregated data reliability is illustrated using data from a study conducted to investigate skilled nursing unit structures.

Rehabilitation Intensity and Patient Outcomes in Skilled Nursing Facilities in the United States: A Systematic Review

2021 ◽  
Author(s):  
Rachel A Prusynski ◽  
Allison M Gustavson ◽  
Siddhi R Shrivastav ◽  
Tracy M Mroz
Keyword(s):  
United States ◽  
Systematic Review ◽  
Patient Outcomes ◽  
Hospital Readmissions ◽  
The United States ◽  
Skilled Nursing Facilities ◽  
Functional Improvement ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
The Relationship

Abstract Objective Exponential increases in rehabilitation intensity in skilled nursing facilities (SNFs) motivated recent changes in Medicare reimbursement policies, which remove financial incentives for providing more minutes of physical therapy, occupational therapy, and speech therapy. Yet there is concern that SNFs will reduce therapy provision and patients will experience worse outcomes. The purpose of this systematic review was to synthesize current evidence on the relationship between therapy intensity and patient outcomes in SNFs. Methods PubMed, Medline, Scopus, Embase, CINAHL, PEDro, and COCHRANE databases were searched. English-language studies published in the United States between 1998 and February 14, 2020, examining the relationship between therapy intensity and community discharge, hospital readmission, length of stay (LOS), and functional improvement for short-stay SNF patients were considered. Data extraction and risk of bias were performed using the American Academy of Neurology (AAN) Classification of Evidence scale for causation questions. AAN criteria were used to assess confidence in the evidence for each outcome. Results Eight observational studies met inclusion criteria. There was moderate evidence that higher intensity therapy was associated with higher rates of community discharge and shorter LOS. One study provided very low-level evidence of associations between higher intensity therapy and lower hospital readmissions after total hip and knee replacement. There was low-level evidence indicating higher intensity therapy is associated with improvements in function. Conclusions This systematic review concludes, with moderate confidence, that higher intensity therapy in SNFs leads to higher community discharge rates and shorter LOS. Future research should improve quality of evidence on functional improvement and hospital readmissions. Impact This systematic review demonstrates that patients in SNFs may benefit from higher intensity therapy. Because new policies no longer incentivize intensive therapy, patient outcomes should be closely monitored to ensure patients in SNFs receive high-quality care.

A Preliminary Test of the Impact of De-Globalization on MNC Performance

2021 ◽  
Vol 17 (2) ◽  
pp. 412-428
Author(s):  
Hilla Peretz ◽  
Michael J. Morley
Keyword(s):  
Organizational Context ◽  
Preliminary Test ◽  
Organizational Level ◽  
Institutional Fit ◽  
Preliminary Examination ◽  
Negative Effect ◽  
Key Dimensions ◽  
Using Data ◽  
The Impact ◽  
The Relationship

ABSTRACTWe offer a preliminary examination of whether national and organizational level contexts amplify or reduce the effects of de-globalization on the performance of MNCs. Theoretically, we borrow ideas from both event system theory and institutional fit to propose a model explicating key dimensions of the relationship between de-globalization, national and organizational context, and MNC performance. We then test our ideas using data assembled from 283 MNCs in 20 countries. We find that while de-globalization has a negative effect on MNC performance, national and organizational level contextual endowments do moderate this relationship. We discuss some implications of our findings and highlight attendant limitations.

scholarly journals Descriptive Epidemiology and Prior Healthcare Utilization of Patients in the Spine Patient Outcomes Research Trial’s (SPORT) Three Observational Cohorts

Spine ◽  
2006 ◽  
Vol 31 (7) ◽  
pp. 806-814 ◽  
Author(s):  
Justin Cummins ◽  
Jon D. Lurie ◽  
Tor D. Tosteson ◽  
Brett Hanscom ◽  
William A. Abdu ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Patient Outcomes ◽  
Outcomes Research ◽  
Descriptive Epidemiology

The effects of telehealth use for post-acute rehabilitation patient outcomes

2016 ◽  
Vol 24 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Stephanie A Hicks ◽  
Verena R Cimarolli
Keyword(s):  
Cognitive Functioning ◽  
Patient Outcomes ◽  
Skilled Nursing Facility ◽  
Functional Independence ◽  
Emergency Department Visits ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Rehabilitation Care ◽  
Acute Rehabilitation ◽  
The Impact

Introduction Previous research has shown that home telehealth services can reduce hospitalisations and emergency department visits and improve clinical outcomes among older adults with chronic conditions. However, there is a lack of research on the impact of telehealth (TH) use on patient outcomes in post-acute rehabilitation settings. The current study examined the effects of TH for post-acute rehabilitation patient outcomes (i.e. discharge setting and change in functional independence) when controlling for other factors (e.g. cognitive functioning). Methods For this retrospective study, electronic medical records (EMRs) of 294 patients who were discharged from a post-acute rehabilitation unit at a skilled nursing facility were reviewed. Only patients with an admitting condition of a circulatory disease based on ICD-9 classification were included. Main EMR data extracted included use of TH, cognitive functioning, admission and discharge functional independence, and discharge setting (returning home vs. returning to acute care/re-hospitalisation). Results Results from a regression analysis showed that although TH use was unrelated to post-acute rehabilitation care transition, it was significantly related to change in functional independence. Patients who used TH during their stay had significantly more improvement in functional independence from admission to discharge when compared to those who did not use TH. Discussion Findings indicate that TH use during post-acute rehabilitation has the potential to improve patient physical functioning.

scholarly journals The Economic Impact of Inflammatory Bowel Disease in Canada

2004 ◽  
Vol 18 (4) ◽  
pp. 255-257
Author(s):  
Robert Hilsden
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Labour Force ◽  
Incidence Rates ◽  
Age Group ◽  
Group Level ◽  
The Past ◽  
Inflammatory Bowel ◽  
Using Data ◽  
Very High

Longobardi and colleagues examined the effect of inflammatory bowel disease (IBD) on employment, using data from 10,891 respondents aged 20 to 64 years from the 1998 cycle of the Canadian National Population Health Survey (NPHS) (1). This sample included 187 (1.7%) subjects who self-reported IBD or a similar bowel disorder. A significantly greater proportion of IBD than non-IBD respondents reported that they were not in the labour force (28.9% versus 18.5%). Even after adjusting for other factors (age group, level of pain, etc), subjects with IBD had a 2.9% higher nonparticipation rate (21.4%). For example, among people not hospitalized within the past year and with no limitation of activities due to pain, IBD subjects were 1.2 times more likely to be unemployed than those without IBD. Subjects who reported high levels of pain had a very high probability of being out of the labour force. Based on Canadian annual compensation data for all employed persons in Canada, and age- and sex-specific prevalence, and incidence rates for IBD, the authors estimated that there are 119,980 IBD patients between the ages of 20 and 64 years in Canada and that this group includes 3479 people who are not in the labour force. This translates into lost wages of $104.2 million, or $868 per IBD patient

scholarly journals Patient Outcomes Research Teams: Contribution to Outcomes and Effectiveness Research

1999 ◽  
Vol 20 (1) ◽  
pp. 337-359 ◽  
Author(s):  
Deborah Freund ◽  
Judith Lave ◽  
Carolyn Clancy ◽  
Gillian Hawker ◽  
Victor Hasselblad ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Outcomes Research ◽  
Effectiveness Research ◽  
Research Teams
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