Hospital Diagnosis of Malnutrition: A Call for Action

2009 ◽  
Vol 70 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Mary Ann Bocock ◽  
Heather H. Keller
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Information ◽  
Hospital Admissions ◽  
Care Facility ◽  
International Classification Of Diseases ◽  
Health Condition ◽  
Care Utilization ◽  
Discharge Abstract Database ◽  
Term Care

The Canadian Institute for Health Information (CIHI) provides accurate health information needed to establish sound health care policies. The CIHI mandate is to develop and coordinate a uniform approach to health care information in Canada. The institute uses the International Classification of Diseases (ICD) system to record the most responsible diagnosis for each hospital admission. This investigation was conducted to determine if six ICD protein-calorie malnutrition (PCM) codes could be used for health care utilization analyses. Aggregate data (1996 to 2000) from the CIHI discharge abstract database were used. The data analyzed were the most responsible diagnoses data for the six PCM codes and a single summary statistic for all other “non-malnutrition” diagnoses for all long-term care facility residents aged 65 or older who were transferred to an acute care facility. In this population, fewer than five hospital admissions per year were assigned a PCM code. There were too few PCM cases to do trend analyses for morbidity or mortality. This study suggests a lack of recognition and documentation of PCM as a specific health condition in older adults. Lack of tracking of this diagnosis prevents documentation that could lead to policy changes to support older adults’ nutrition.

scholarly journals Predicting health care utilization using CIHI's Population Grouping Methodology

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Yvonne Rosehart
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Utilization ◽  
Healthcare Utilization ◽  
Capacity Planning ◽  
Disease Surveillance ◽  
Health Condition ◽  
Care Utilization ◽  
Term Care ◽  
Planning Processes

IntroductionCIHI’s Population Grouping Methodology uses data from multiple sectors to create clinical profiles and to predict the entire population’s current and future morbidity burden and healthcare utilization. Outputs from the grouper can be applied to healthcare decision making and planning processes. Objectives and ApproachThe population grouping methodology starts with everyone who is eligible for healthcare, including those who haven’t interacted with the healthcare system, providing a true picture of the entire population. The grouper uses diagnosis information over a 2-year period to create health profiles and predict individuals’ future morbidity and expected use of primary care, emergency department and long-term care services. Predictive models were developed using age, sex, health conditions and the most influential health condition interactions as the predictors. These models produce predictive indicators for the concurrent period as well as one year into the future. ResultsThe power of the model lies in the user’s ability to aggregate the data by population segments and compare healthcare resource utilization by different geographic regions, health sectors and health status. The presentation will focus on how CIHI’s population grouping methodology helps client’s monitor population health and conduct disease surveillance. It assists clients with population segmentation, health profiling, predicting health care utilization patterns and explaining variation in health care resource use. It can be used for risk adjustment of populations for inter-jurisdictional analysis, for capacity planning and it can also be used as a component in funding models. Conclusion/ImplicationsCIHI’s population grouping methodology is a useful tool for profiling and predicting healthcare utilization, with key applications for health policy makers, planners and funders. The presentation will focus on how stakeholders can apply the outputs to aid in their decision-making and planning processes.

Social Support, Health Literacy, and Health Care Utilization Among Older Adults

2019 ◽  
Vol 31 (4) ◽  
pp. 359-366 ◽  
Author(s):  
Yong-Bing Liu ◽  
Ping Hou ◽  
Hui-Ping Xue ◽  
Xin-E Mao ◽  
Yong-Nan Li
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Health Care ◽  
Health Literacy ◽  
Nursing Homes ◽  
Health Care Utilization ◽  
Hospital Admissions ◽  
Effective Means ◽  
Care Utilization ◽  
Cross Sectional Survey

The purpose of this study was to explore the relationship between social support, health literacy, and health care utilization in older Chinese adults. A cross-sectional survey design was employed. Data were collected from 32 nursing homes from Urumqi in Xinjiang of China. A total of 1486 respondents completed a pack of questionnaires. The average health literacy level of older adults in nursing homes was relatively low, only 73.68 ± 29.42 points; the average social support level was also relatively low, only 31.42 ± 7.12 points (lower than domestic norm of Chinese residents, P < .001). Both values were below the midpoint for the overall population, indicating a sample with below-average levels of healthy literacy and social support. Low social support levels are associated with poor health literacy and greater likelihood of hospital admission ( P < .05). Social support was significantly associated with health literacy. Improving the quantity and quality of social support may be an effective means to obtain better health literacy and lower hospital admissions.

scholarly journals Health Care Utilization in Patients Undergoing Repeat Stereotactic Radiosurgery for Vestibular Schwannoma with 5-Year Follow-up: A National Database Analysis

2020 ◽  
Author(s):  
Nicholas Dietz ◽  
Mayur Sharma ◽  
Beatrice Ugiliweneza ◽  
Dengzhi Wang ◽  
Maxwell Boakye ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Stereotactic Radiosurgery ◽  
Vestibular Schwannoma ◽  
Hospital Admissions ◽  
International Classification Of Diseases ◽  
National Database ◽  
Care Utilization ◽  
Outpatient Services

Abstract Background Stereotactic radiosurgery (SRS) has been used as an alternative to microsurgery in patients with small vestibular schwannoma (VS). We compare health care utilization metrics in patients undergoing repeat-SRS (re-SRS) and no repeat SRS (nr-SRS) at long-term follow-up. Materials and Methods We queried the MarketScan database using International Classification of Diseases, Ninth Revision and Current Procedural Terminology 4, from 2000 to 2016. We included adult patients who had diagnosis of VS and treatment with SRS with at least 5 years of continuous enrollment after the procedure. Outcomes were hospital admissions, outpatient services, and medication refills. Results Of 1,047 patients, 5.1% (n = 53) had repeat SRS. Majority of re-SRS (74%, n = 39) were done within 2 years of index procedure and 51% were within 1-year of initial procedure. Patients who required re-SRS incurred higher hospital readmission rate, outpatient services, and had higher payments compared with those who did not require re-SRS at 6 months, 1 year, and 2 years following the initial procedures. Re-SRS received 3.0- and 3.1-times higher payments at 1 and 2 years compared with nr-SRS cohort. At 5 years following SRS, median combined payments for re-SRS cohort was $105286 (interquartile range [IQR] $70999, $156569) compared with $44172 (IQR $22956, $84840) for nr-SRS cohort. Conclusion More than half of the re-SRS procedures were noted within first year of initial SRS for VS. Overall payments at 5 years for repeat SRS was more than double that for nr-SRS. Repeat SRS was also associated with more re-admissions and outpatient services at annual follow-up time points.

scholarly journals Older Adults’ Health Care Utilization a Year After Experiencing Fear or Distress from Hurricane Sandy

2018 ◽  
Vol 12 (5) ◽  
pp. 578-581
Author(s):  
Laura P. Sands ◽  
Yimeng Xie ◽  
Rachel Pruchno ◽  
Allison Heid ◽  
Yili Hong
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Psychological Distress ◽  
New Jersey ◽  
Health Care Utilization ◽  
Hospital Admissions ◽  
Hurricane Sandy ◽  
Care Utilization ◽  
Health Care Needs ◽  
Care Needs

AbstractObjectiveTo determine whether self-reports of disaster-related psychological distress predict older adults’ health care utilization during the year after Hurricane Sandy, which hit New Jersey on October 29, 2012.MethodsRespondents were from the ORANJ BOWL Study, a random-digit dialed sample from New Jersey recruited from 2006 to 2008. Medicare hospital, emergency department (ED) and outpatient claims data from 2012 and 2013 were matched to 1607 people age 65 and older in 2012 who responded to follow-up surveys conducted from July 2013 to July 2015 to determine their hurricane-related experiences.ResultsIn total, 7% (107) of respondents reported they experienced a lot versus 93% (1493) respondents reported they experienced little or no fear and distress from Hurricane Sandy. Those who experienced a lot versus little or no fear and distress had higher probability of all-cause hospital admissions and more ED visits through 3 months (hazard ratio [HR]: 2.19, 95% CI: 1.03-4.63; incidence ratio [IR]: 2.57, 95% CI: 1.21-5.35), and ED and outpatient visits (IR: 2.20, 95% CI: 1.44-3.37; IR: 1.37, 95% CI: 1.02-1.87) through the year after the hurricane.ConclusionsA self-reported assessment of disaster-related psychological distress is a strong predictor of older adults’ health care needs the year after the disaster. The results indicate that disaster preparedness should extend beyond acute health care needs to address longer-term health consequences of disasters. (Disaster Med Public Health Preparedness. 2018;12:578–581)

A Web-Based Interactive Map to Promote Health-Care Facility Flood Preparedness

2021 ◽  
pp. 1-4
Author(s):  
Elena Grossman ◽  
Michelle Hathaway ◽  
Amber Khan ◽  
Apostolis Sambanis ◽  
Samuel Dorevitch
Keyword(s):  
Health Care ◽  
Emergency Preparedness ◽  
Online Survey ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Term Care ◽  
Web Based ◽  
Care Facilities ◽  
Interactive Map

Abstract Objectives: Little is known about how flood risk of health-care facilities (HCFs) is evaluated by emergency preparedness professionals and HCFs administrators. This study assessed knowledge of emergency preparedness and HCF management professionals regarding locations of floodplains in relation to HCFs. A Web-based interactive map of floodplains and HCF was developed and users of the map were asked to evaluate it. Methods: An online survey was completed by administrators of HCFs and public health emergency preparedness professionals in Illinois, before and after an interactive online map of floodplains and HCFs was provided. Results: Forty Illinois HCFs located in floodplains were identified, including 12 long-term care facilities. Preparedness professionals have limited knowledge of whether local HCFs were in floodplains, and few reported availability of geographic information system (GIS) resources at baseline. Respondents intended to use the interactive map for planning and stakeholder communications. Conclusions: Given that HCFs are located in floodplains, this first assessment of using interactive maps of floodplains and HCFs may promote a shift to reliable data sources of floodplain locations in relation to HCFs. Similar approaches may be useful in other settings.

scholarly journals Person-Centered Health Care: An Approach That Integrates Acute and Long-Term Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 704-704
Author(s):  
Yuchi Young ◽  
Barbara Resnick
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Systems ◽  
Long Term Care ◽  
The United States ◽  
World Population ◽  
Term Care ◽  
The Usa ◽  
Aged Society

Abstract The world population is aging. The proportion of the population over 60 will nearly double from 12% in 2015 to 22% in 2050. Global life expectancy has more than doubled from 31 years in 1900 to 72.6 years in 2019. The need for long-term care (LTC) services is expanding with the same rapidity. A comprehensive response is needed to address the needs of older adults. Learning from health systems in other countries enables health systems to incorporate best long-term care practices to fit each country and its culture. This symposium aims to compare long-term care policies and services in Taiwan, Singapore, and the USA where significant growth in aging populations is evidenced. In 2025, the aging population will be 20% in Taiwan, 20% in Singapore and 18 % in the USA. In the case of Taiwan, it has moved from aging society status to aged society, and to super-aged society in 27 years. Such accelerated rate of aging in Taiwan is unparalleled when compared to European countries and the United States. In response to this dramatic change, Taiwan has passed long-term care legislation that expands services to care for older adults, and developed person-centered health care that integrates acute and long-term care services. Some preliminary results related to access, care and patterns of utilization will be shared in the symposium. International Comparisons of Healthy Aging Interest Group Sponsored Symposium.

Evaluation of Ceiling Lifts in Health Care Settings

AAOHN Journal ◽  
2009 ◽  
Vol 57 (9) ◽  
pp. 374-380 ◽  
Author(s):  
Hasanat Alamgir ◽  
Olivia Wei Li ◽  
Erin Gorman ◽  
Catherine Fast ◽  
Shicheng Yu ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Pressure Ulcer ◽  
Care Facility ◽  
Care Quality ◽  
Patient Perceptions ◽  
Term Care ◽  
Health Care Settings ◽  
The Relationship

Ceiling lifts have been introduced into health care settings to reduce manual patient lifting and thus occupational injuries. Although growing evidence supports the effectiveness of ceiling lifts, a paucity of research links indicators, such as quality of patient care or patient perceptions, to the use of these transfer devices. This study explored the relationship between ceiling lift coverage rates and measures of patient care quality (e.g., incidence of facility-acquired pressure ulcers, falls, urinary infections, urinary incontinence, and assaults [patient to staff] in acute and long-term care facilities), as well as patient perceptions of satisfaction with care received while using ceiling lifts in a complex care facility. Qualitative semi-structured interviews were used to generate data. A significant inverse relationship was found between pressure ulcer rates and ceiling lift coverage; however, this effect was attenuated by year. No significant relationships existed between ceiling lift coverage and patient outcome indicators after adding the “year” variable to the model. Patients generally approved of the use of ceiling lifts and recognized many of the benefits. Ceiling lifts are not detrimental to the quality of care received by patients, and patients prefer being transferred by ceiling lifts. The relationship between ceiling lift coverage and pressure ulcer rates warrants further investigation.

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