scholarly journals Psychological Distress After Covid-19 Recovery: Reciprocal Effects With Temperament and Emotional Dysregulation. An Exploratory Study of Patients Over 60 Years of Age Assessed in a Post-acute Care Service

2020 ◽  
Vol 11 ◽  
Author(s):  
Delfina Janiri ◽  
Georgios D. Kotzalidis ◽  
Giulia Giuseppin ◽  
Marzia Molinaro ◽  
Marco Modica ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Acute Care ◽  
Exploratory Study ◽  
Care Service ◽  
Emotional Dysregulation ◽  
Reciprocal Effects ◽  
Acute Care Service ◽  
Post Acute Care

scholarly journals Post-Acute Care Service use in Lung Cancer Patients

2021 ◽  
Author(s):  
Mitra McLarney ◽  
Frances S. Shofer ◽  
Jasmine Zheng
Keyword(s):  
Lung Cancer ◽  
Length Of Stay ◽  
Cancer Patients ◽  
Acute Care ◽  
Service Use ◽  
Care Service ◽  
Rehabilitation Service ◽  
Lung Cancer Patients ◽  
Acute Care Service ◽  
Post Acute Care

Abstract Purpose: Lung cancer patients experience functional deconditioning secondary to their underlying cancer and treatment yet rehabilitation service use remains low. The goal of this study is to compare post-acute care service use in lung cancer patients admitted to a metropolitan academic medical center. Methods: Adult lung cancer patients admitted from January 1, 2017 to August 31, 2018 with a diagnosis of lung cancer based on International Classification of Diseases 10, C34.0-C34.9, were included in this study. Patient characteristics including age, gender, race, marital status, functional status on admission, length of stay, and number of comorbidities were compared based on discharge setting. Results: 1,139 lung cancer patients were included in our study. The majority of patients discharged home with home care (51%) followed by home without services (35%), skilled nursing facilities (SNF) (10%) and acute inpatient rehabilitation facilities (IRF) (4%). 44% (498) of patients were primarily admitted for their lung cancer diagnosis. In unadjusted analyses, patients who discharged to SNF compared to home were more likely to be older, black, unmarried, live alone and have died during the study period. Patients who discharged to IRF had longer acute care hospitalization length of stays. In adjusted analyses, age, number of concurrent comorbidities and length of stay significantly correlated with discharge location. Conclusion: Lung cancer patients are unlikely to be discharged to a post-acute care facility after an acute hospitalization. Rehabilitation service use differs by sociodemographic factors, concurrent medical history and functional status. Future study is needed to better understand why these differences in discharge setting persists.

Impact of Anterior vs Posterior Approach for Total Hip Arthroplasty on Post-Acute Care Service Utilization

2016 ◽  
Vol 31 (9) ◽  
pp. 73-77 ◽  
Author(s):  
Coles E. L'Hommedieu ◽  
James J. Gera ◽  
Gerald Rupp ◽  
Jeffery W. Salin ◽  
John S. Cox ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Acute Care ◽  
Service Utilization ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Care Service ◽  
Total Hip ◽  
Acute Care Service ◽  
Post Acute Care

scholarly journals 196OUTCOMES FROM AN OFFSITE POST-ACUTE CARE SERVICE GOVERNED BY AN ACUTE TEACHING HOSPITAL

2016 ◽  
Vol 45 (suppl 2) ◽  
pp. ii13.80-ii56
Author(s):  
Ciara Dowling ◽  
Ronan O'Toole ◽  
Laura Fennelly ◽  
Amanda Casey ◽  
Dermot Power
Keyword(s):  
Acute Care ◽  
Teaching Hospital ◽  
Care Service ◽  
Acute Care Service ◽  
Post Acute Care

scholarly journals Post-acute care use patterns among Hospital Service Areas by older adults in the United States: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julianna M. Dean ◽  
Kimberly Hreha ◽  
Ickpyo Hong ◽  
Chih-Ying Li ◽  
Daniel Jupiter ◽  
...  
Keyword(s):  
Acute Care ◽  
Care Service ◽  
Inpatient Rehabilitation ◽  
The United States ◽  
Service Area ◽  
Hospital Service ◽  
Medicare Beneficiaries ◽  
Skilled Nursing ◽  
Service Areas ◽  
Post Acute Care

Abstract Background Despite the success of stroke rehabilitation services, differences in service utilization exist. Some patients with stroke may travel across regions to receive necessary care prescribed by their physician. It is unknown how availability and combinations of post-acute care facilities in local healthcare markets influence use patterns. We present the distribution of skilled nursing, inpatient rehabilitation, and long-term care hospital services across Hospital Service Areas among a national stroke cohort, and we describe drivers of post-acute care service use. Methods We extracted data from 2013 to 2014 of a national stroke cohort using Medicare beneficiaries (174,498 total records across 3232 Hospital Service Areas). Patients’ ZIP code of residence was linked to the facility ZIP code where care was received. If the patient did not live in the Hospital Service Area where they received care, they were considered a “traveler”. We performed multivariable logistic regression to regress traveling status on the care combinations available where the patient lived. Results Although 73.4% of all Hospital Service Areas were skilled nursing-only, only 23.5% of all patients received care in skilled nursing-only Hospital Service Areas; 40.8% of all patients received care in Hospital Service Areas with only inpatient rehabilitation and skilled nursing, which represented only 18.2% of all Hospital Service Areas. Thirty-five percent of patients traveled to a different Hospital Service Area from where they lived. Regarding “travelers,” for those living in a skilled nursing-only Hospital Service Area, 49.9% traveled for care to Hospital Service Areas with only inpatient rehabilitation and skilled nursing. Patients living in skilled nursing-only Hospital Service Areas had more than five times higher odds of traveling compared to those living in Hospital Service Areas with all three facilities. Conclusions Geographically, the vast majority of Hospital Service Areas in the United States that provided rehabilitation services for stroke survivors were skilled nursing-only. However, only about one-third lived in skilled nursing-only Hospital Service Areas; over 35% traveled to receive care. Geographic variation exists in post-acute care; this study provides a foundation to better quantify its drivers. This study presents previously undescribed drivers of variation in post-acute care service utilization among Medicare beneficiaries—the “traveler effect”.

scholarly journals Single session work: Implementing brief intervention as routine practice in an acute care mental health assessment service.

2018 ◽  
Vol 27 (1) ◽  
pp. 21-24
Author(s):  
Jillian Le Gros ◽  
Marianne Wyder ◽  
Vanessa Brunelli
Keyword(s):  
Clinical Practice ◽  
Acute Care ◽  
Brief Intervention ◽  
Care Service ◽  
Health Assessment ◽  
Research Process ◽  
Routine Practice ◽  
Single Session ◽  
Mental Health Assessment ◽  
Acute Care Service

Objectives: The study describes the implementation and adaptation of a brief intervention model as routine clinical practice in an acute care service. Methods: An action research process informed the evaluation and design of the intervention. Results: The model’s theoretical framework enhanced clinical practice and benefited consumers, though it was too rigid to be implemented in an acute care setting, so was adapted to suit this environment. Conclusions: This paper highlights the value in realigning practice with fundamental engagement principles to improve practice outcomes.

scholarly journals An Integrated Mobile Acute Care Service Enhances Value

2020 ◽  
Author(s):  
Andrew W. Artenstein ◽  
Nathan Stanaway ◽  
Amy Roy ◽  
Lauren Westafer ◽  
Peter K. Lindenauer ◽  
...  
Keyword(s):  
Acute Care ◽  
Care Service ◽  
Acute Care Service

scholarly journals Effect of socio-demographic factors on the association between multimorbidity and acute care service use: a population-based retrospective cohort study

2020 ◽  
Author(s):  
Kathryn Ann Fisher ◽  
Lauren Griffith ◽  
Andrea Gruneir ◽  
Richard Perez ◽  
Lindsay Favotto ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Administrative Data ◽  
Service Use ◽  
Care Service ◽  
Demographic Factors ◽  
Emergency Department Visits ◽  
Socio Demographic Factors ◽  
The Relationship ◽  
Acute Care Service

Abstract Background: This study explores how a broad-range of socio-demographic factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) among older adults in Ontario, Canada. Methods: We linked multiple cycles (2005-2006, 2007-2008, 2009-2010, 2011-2012) of the Canadian Community Health Survey (CCHS) to health administrative data to create a cohort of adults aged 65 and older in Ontario. Twelve chronic conditions identified from the administrative data were used to estimate multimorbidity (number of chronic conditions). We identified acute care service use over one year from the administrative data. We examined the relationship between multimorbidity and service use stratified by a comprehensive range of socio-demographic variables available from the CCHS. Logistic and Poisson multivariable regressions were used to explore the association between multimorbidity and service use and the role of socio-demographic factors in shaping this relationship. Results: Of the 28,361 members of the study sample, 60% were between the ages of 65 and 74 years, 57% were female, 72% were non-immigrant, and over 75% lived in an urban area. Emergency department visits and hospitalizations consistently increased with the level of multimorbidity. Stratified analyses revealed further patterns, with many being similar for both services – e.g., the odds ratios for both services were higher at all levels of multimorbidity for men, older age groups, and those with lower annual household income. Rurality and immigrant status appeared to impact emergency department use (higher in rural residents and non-immigrants) but not hospitalizations. Multimorbidity and most socio-demographic variables remained significant predictors of acute care service use in the multivariable regressions. Conclusions: Strong evidence links multimorbidity with increased acute care service use. This study showed that socio-demographic factors did not modify the relationship between multimorbidity and acute care service use, they were independently associated with acute care service use. Acute care service use was associated with perceived physical and mental health status as well as psychosocial factors, suggesting that optimizing service use requires attention to self-reported health status and social determinants, with programs that are multifaceted and integrated across the health and social service sectors.

scholarly journals Effect of socio-demographic and health factors on the association between multimorbidity and acute care service use: population-based survey linked to health administrative data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathryn A. Fisher ◽  
Lauren E. Griffith ◽  
Andrea Gruneir ◽  
Ross Upshur ◽  
Richard Perez ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Administrative Data ◽  
Service Use ◽  
Care Service ◽  
Emergency Department Visits ◽  
Socio Demographic Factors ◽  
One Year ◽  
The Relationship ◽  
Acute Care Service

Abstract Background This study explores how socio-demographic and health factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) in older adults in Ontario, Canada. Methods We linked multiple cycles (2005–2006, 2007–2008, 2009–2010, 2011–2012) of the Canadian Community Health Survey (CCHS) to health administrative data to create a cohort of adults aged 65 and older. Administrative data were used to estimate one-year service use and to identify 12 chronic conditions used to measure multimorbidity. We examined the relationship between multimorbidity and service use stratified by a range of socio-demographic and health variables available from the CCHS. Logistic and Poisson regressions were used to explore the association between multimorbidity and service use and the role of socio-demographic factors in this relationship. Results Of the 28,361 members of the study sample, 60% were between the ages of 65 and 74 years, 57% were female, 72% were non-immigrant, and over 75% lived in an urban area. Emergency department visits and hospitalizations consistently increased with the level of multimorbidity. This study did not find strong evidence of moderator or interaction effects across a range of socio-demographic factors. Stratified analyses revealed further patterns, with many being similar for both services – e.g., the odds ratios were higher at all levels of multimorbidity for men, older age groups, and those with lower household income. Rurality and immigrant status influenced emergency department use (higher in rural residents and non-immigrants) but not hospitalizations. Multimorbidity and the range of socio-demographic variables remained significant predictors of service use in the regressions. Conclusions Strong evidence links multimorbidity with increased acute care service use. This study showed that a range of factors did not modify this relationship. Nevertheless, the factors were independently associated with acute care service use, pointing to modifiable risk factors that can be the focus of resource allocation and intervention design to reduce service use in those with multimorbidity. The study’s results suggest that optimizing acute care service use in older adults requires attention to both multimorbidity and social determinants, with programs that are multifactorial and integrated across the health and social service sectors.

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