scholarly journals Co-morbidity and functional limitation in older patients underreported in medical records in Nordic Acute Care Hospitals when compared with the MDS-AC instrument

2006 ◽  
Vol 35 (4) ◽  
pp. 434-438 ◽  
Author(s):  
Pálmi V. Jónsson ◽  
Harriet Finne-Soveri ◽  
Anna B. Jensdóttir ◽  
Gunnar Ljunggren ◽  
Gösta Bucht ◽  
...  
Keyword(s):  
Acute Care ◽  
Medical Records ◽  
Older Patients ◽  
Functional Limitation ◽  
Acute Care Hospitals ◽  
Co Morbidity

scholarly journals An analysis of equity in treatment of hip fractures for older patients with dementia in acute care hospitals: observational study using nationwide hospital claims data in Japan

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shinichi Tomioka ◽  
Megumi Rosenberg ◽  
Kiyohide Fushimi ◽  
Shinya Matsuda
Keyword(s):  
Hip Fracture ◽  
Older People ◽  
Acute Care ◽  
Waiting Time ◽  
Older Patients ◽  
Acute Care Hospitals ◽  
Care Quality ◽  
Severe Dementia ◽  
People With Dementia ◽  
Acute Care Settings

Abstract Background Globally, and particularly in countries with rapidly ageing populations like Japan, there are growing concerns over the heavy burden of ill health borne by older people, and the capacity of the health system to ensure their access to quality care. Older people with dementia may face even greater barriers to appropriate care in acute care settings. Yet, studies about the care quality for older patients with dementia in acute care settings are still few. The objective of this study is to assess whether dementia status is associated with poorer treatment by examining the association of a patient’s dementia status with the probability of receiving surgery and the waiting time until surgery for a hip fracture in acute care hospitals in Japan. Methods All patients with closed hip fracture were extracted from the Diagnosis Procedure Combination (DPC) database between April 2014 and March 2018. After excluding complicated cases, we conducted regressions with multilevel models. We used two outcome measures: (i) whether the patient received a surgery or was treated by watchful waiting; and (ii) number of waiting days until surgery after admission. Results Two hundred fourteen thousand six hundred one patients discharged from 1328 hospitals were identified. Among them, 159,173 patients received surgery. Both 80–89 year-olds (OR 0.87; 95% CI, 0.84, 0.90) and those 90 years old and above (OR 0.67; 95% CI, 0.65, 0.70) had significantly lower odds ratios for receiving surgery compared to 65–79 year-olds. Those with severe dementia had a significantly greater likelihood of receiving surgery compared to those without dementia (OR 1.21; 95% CI, 1.16, 1.25). Patients aged 90 years old and above had shorter waiting time for surgery (Coef. -0.06; 95% CI, − 0.11, − 0.01). Mild dementia did not have a statistically significant impact on the number of waiting days until surgery (P = 0.34), whereas severe dementia was associated with shorter waiting days (Coef. -0.08; 95% CI, − 0.12, − 0.03). Conclusions These findings suggest physicians may be taking proactive measures to preserve physical function for those with severe dementia and to avoid prolonged hospitalization although there are no formal guidelines on prioritization for the aged and dementia patients.

scholarly journals Communication behavior of cognitively impaired older inpatients

2019 ◽  
Vol 52 (S4) ◽  
pp. 264-272
Author(s):  
Eva-Luisa Schnabel ◽  
Hans-Werner Wahl ◽  
Susanne Penger ◽  
Julia Haberstroh
Keyword(s):  
Cognitive Impairment ◽  
Psychometric Properties ◽  
Acute Care ◽  
Older Patients ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Acute Care Hospitals ◽  
Well Being ◽  
Communication Behavior ◽  
Care Hospital

Abstract Background and objective Acutely ill older patients with cognitive impairment represent a major subgroup in acute care hospitals. In this context, communication plays a crucial role for patients’ well-being, healthcare decisions, and medical outcomes. As validated measures are lacking, we tested the psychometric properties of an observational instrument to assess Communication Behavior in Dementia (CODEM) in the acute care hospital setting. As a novel feature, we were also able to incorporate linguistic and social-contextual measures. Material and methods Data were drawn from a cross-sectional mixed methods study that focused on the occurrence of elderspeak during care interactions in two German acute care hospitals. A total of 43 acutely ill older patients with severe cognitive impairment (CI group, Mage ± SD = 83.6 ± 5.7 years) and 50 without cognitive impairment (CU group, Mage ± SD = 82.1 ± 6.3 years) were observed by trained research assistants during a standardized interview situation and rated afterwards by use of CODEM. Results Factor analysis supported the expected two-factor solution for the CI group, i.e., a verbal content and a nonverbal relationship aspect. Findings of the current study indicated sound psychometric properties of the CODEM instrument including internal consistency, convergent, divergent, and criterion validity. Conclusion CODEM represents a reliable and valid tool to examine the communication behavior of older patients with CI in the acute care hospital setting. Thus, CODEM might serve as an important instrument for researcher and healthcare professionals to describe and improve communication patterns in this environment.

Migrant care workers and rehospitalization among older patients discharged from acute care hospitals

2014 ◽  
Vol 15 (2) ◽  
pp. 196-203 ◽  
Author(s):  
Sergio Fusco ◽  
Andrea Corsonello ◽  
Carlos Chiatti ◽  
Paolo Fabbietti ◽  
Giovanni Salerno ◽  
...  
Keyword(s):  
Acute Care ◽  
Older Patients ◽  
Acute Care Hospitals ◽  
Care Workers

scholarly journals 2053. Information Gaps Among Patients Prescribed Antibiotics on Discharge to Nursing Homes

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S692-S692
Author(s):  
Jon P Furuno ◽  
Brie N Noble ◽  
Bo Weber ◽  
Vicki Nordby ◽  
Jessina C McGregor ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Hospital Discharge ◽  
Acute Care ◽  
Medical Records ◽  
Acute Care Hospitals ◽  
Antibiotic Prescribing ◽  
Oral Antibiotic ◽  
Discharge Summaries ◽  
Information Gaps

Abstract Background Antibiotic use in nursing homes (NHs) is frequently initiated in acute care hospitals. Comprehensive antibiotic administration instructions are critical to inform antimicrobial stewardship efforts in NHs. However; little is known about the quality of discharge communication for residents transitioning from hospitals to NHs with an antibiotic prescription. Methods We reviewed hospital discharge summaries from a 10% random sample of hospital-initiated antibiotic prescriptions among residents of 17 for-profit NHs in Oregon, California, and Nevada admitted between January 1 and December 31, 2017. Data elements of interest were documentation of antibiotic choice, indication, instructions, and pending microbiology tests. Results Among 217 hospital-initiated antibiotic prescriptions, mean (standard deviation) age was 64 (29) years and 57% were female. The most frequently prescribed hospital-initiated antibiotics were cephalosporins (36%), fluoroquinolones (16%), and penicillins (14%). Hospital discharge summaries were missing from 19% (42/217) of the resident medical records. Core antibiotic prescribing information was missing from 38% (67/175) of the medical records with a discharge summary: 11% (20/175) were missing all core elements, 23% (41/175) were missing the antibiotic indication, 27% (48/175) were missing antibiotic dose, 27% (48/175) were missing antibiotic frequency, and 32% (56/175) were missing antibiotic duration. Parental antibiotics were more frequently missing information compared with oral antibiotic prescriptions (45% vs. 37%, P = 0.32). Conclusion Information gaps around antibiotic prescriptions are prevalent in transfer documentation for NH residents admitted from acute care hospitals. Interventions are needed to improve the quality of information transferred from acute care hospitals to NHs. Disclosures All authors: No reported disclosures.

scholarly journals Prognostic Significance of the Short Physical Performance Battery in Older Patients Discharged from Acute Care Hospitals

2012 ◽  
Vol 15 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Andrea Corsonello ◽  
Fabrizia Lattanzio ◽  
Claudio Pedone ◽  
Sabrina Garasto ◽  
Irma Laino ◽  
...  
Keyword(s):  
Acute Care ◽  
Physical Performance ◽  
Older Patients ◽  
Prognostic Significance ◽  
Acute Care Hospitals ◽  
Short Physical Performance Battery

Does Concealed Chronic Kidney Disease Predict Survival of Older Patients Discharged from Acute Care Hospitals?

2010 ◽  
Vol 13 (5) ◽  
pp. 539-545 ◽  
Author(s):  
Andrea Corsonello ◽  
Claudio Pedone ◽  
Fabrizia Lattanzio ◽  
Sabrina Garasto ◽  
Francesco Corica ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Acute Care ◽  
Older Patients ◽  
Acute Care Hospitals

scholarly journals Proton Pump Inhibitors and Risk of 1-Year Mortality and Rehospitalization in Older Patients Discharged From Acute Care Hospitals

2013 ◽  
Vol 173 (7) ◽  
pp. 518 ◽  
Author(s):  
Marcello Maggio ◽  
Andrea Corsonello ◽  
Gian Paolo Ceda ◽  
Chiara Cattabiani ◽  
Fulvio Lauretani ◽  
...  
Keyword(s):  
Acute Care ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Older Patients ◽  
Acute Care Hospitals

Usefulness of subacute care for older patients discharged from acute care hospitals: a prospective observational study in Crema

2013 ◽  
Vol 11 (2) ◽  
pp. 78-81 ◽  
Author(s):  
Gianfrancesco Fiorini ◽  
Luigi Ablondi ◽  
Roberto Sfogliarini ◽  
Sergio Inzoli ◽  
Stefania Pandini ◽  
...  
Keyword(s):  
Observational Study ◽  
Acute Care ◽  
Older Patients ◽  
Prospective Observational Study ◽  
Acute Care Hospitals ◽  
Subacute Care
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