دورية أكاديمية
Comparing Post-Acute Populations and Care in Veterans Affairs and Community Nursing Homes.
| العنوان: | Comparing Post-Acute Populations and Care in Veterans Affairs and Community Nursing Homes. |
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| المؤلفون: | Intrator O; Geriatrics & Extended Care Data Analyses Center (GECDAC), Canandaigua VA Medical Center, Canandaigua, NY, USA; Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA. Electronic address: Orna_Intrator@URMC.Rochester.edu., O'Hanlon CE; Health Services Research & Development Center for the Study of Healthcare Innovation, Implementation & Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; RAND Corporation, Santa Monica, CA, USA., Makineni R; Geriatrics & Extended Care Data Analyses Center (GECDAC), Canandaigua VA Medical Center, Canandaigua, NY, USA; Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA., Scott WJ; Geriatrics & Extended Care Data Analysis Center (GECDAC), Health Economics Resource Center, VA Palo Alto Health Care System, Palo Alto, CA, USA., Saliba D; Health Services Research & Development Center for the Study of Healthcare Innovation, Implementation & Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; RAND Corporation, Santa Monica, CA, USA; Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Borun Center for Gerontological Research, University of California at Los Angeles and Los Angeles Jewish Home, Los Angeles, CA, USA. |
| المصدر: | Journal of the American Medical Directors Association [J Am Med Dir Assoc] 2021 Dec; Vol. 22 (12), pp. 2425-2431.e7. Date of Electronic Publication: 2021 Nov 02. |
| نوع المنشور: | Journal Article; Observational Study; Research Support, U.S. Gov't, Non-P.H.S. |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 100893243 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1538-9375 (Electronic) Linking ISSN: 15258610 NLM ISO Abbreviation: J Am Med Dir Assoc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2005- : [New York?] : Elsevier Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins, c2000- |
| مواضيع طبية MeSH: | Veterans*, Cross-Sectional Studies ; Humans ; Male ; Nursing Homes ; Subacute Care ; United States ; United States Department of Veterans Affairs |
| مستخلص: | Objective: The quality of care provided by the US Department of Veterans Affairs (VA) is increasingly being compared to community providers. The objective of this study was to compare the VA Community Living Centers (CLCs) to nursing homes in the community (NHs) in terms of characteristics of their post-acute populations and performance on 3 claims-based ("short-stay") quality measures. Design: Observational, cross-sectional. Setting and Participants: CLC and NH residents admitted from hospitals during July 2015-June 2016. Methods: CLC residents were compared with 3 NH populations: males, Veterans, and all NH residents. CLC and NH performance was compared on risk-adjusted claims-based measures: unplanned rehospitalizations and emergency department visits within 30 days of CLC or NH admission and successful discharge to the community within 100 days of NH admission. Results: Veterans admitted from hospitals to CLCs (n = 23,839 Veterans/135 CLCs) were less physically impaired, less likely to have anxiety, congestive heart failure, hypertension, and dementia than Veterans (n = 241,177/14,818 NHs), males (n = 661,872/15,280 NHs), and all residents (n = 1,674,578/15,395 NHs) admitted to NHs from hospitals. Emergency department and successful discharge risk-adjusted rates of CLCs were statistically significantly better than those of NHs [mean (standard deviation): 8.3% (4.6%) and 67.7% (11.5%) in CLCs vs 11.9% (5.3%) and 57.0% (10.5%) in NHs, respectively]. CLCs had slightly worse rehospitalization rates [22.5% (6.2%) in CLCs vs 21.1% (5.9%) in NHs], but lower combined emergency department and rehospitalization rates [30.8% (0.8%) in CLCs vs 33.0% (0.7%) in NHs]. Conclusions and Implications: CLCs and NHs serve different post-acute care populations. Using the same risk-adjusted NH quality metrics, CLCs provided better post-acute care than community NHs. (Published by Elsevier Inc.) |
| فهرسة مساهمة: | Keywords: Centers for Medicare & Medicaid Services (CMS); Rehospitalization; emergency department; risk adjustment; successful discharge |
| تواريخ الأحداث: | Date Created: 20211106 Date Completed: 20220107 Latest Revision: 20220107 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1016/j.jamda.2021.10.007 |
| PMID: | 34740562 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1538-9375 |
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| DOI: | 10.1016/j.jamda.2021.10.007 |