scholarly journals Home care service utilisation by people with dementia—A retrospective cohort study of community nursing data in Australia

2018 ◽  
Vol 27 (3) ◽  
pp. 665-675 ◽  
Author(s):  
Joel M. van Weel ◽  
Emma Renehan ◽  
Kaye E. Ervin ◽  
Joanne Enticott
Keyword(s):  
Cohort Study ◽  
Home Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Care Service ◽  
Home Care Service ◽  
Service Utilisation ◽  
Community Nursing ◽  
People With Dementia ◽  
Nursing Data

scholarly journals How effective and cost-effective is water fluoridation for adults? Protocol for a 10-year retrospective cohort study

BDJ Open ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Deborah Moore ◽  
Thomas Allen ◽  
Stephen Birch ◽  
Martin Tickle ◽  
Tanya Walsh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cost Effectiveness ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Dental Treatment ◽  
Age Groups ◽  
Cost Effective ◽  
Tooth Decay ◽  
Service Utilisation ◽  
Water Fluoridation

Abstract Background Tooth decay can cause pain, sleepless nights and loss of productive workdays. Fluoridation of drinking water was identified in the 1940s as a cost-effective method of prevention. In the mid-1970s, fluoride toothpastes became widely available. Since then, in high-income countries the prevalence of tooth decay in children has reduced whilst natural tooth retention in older age groups has increased. Most water fluoridation research was carried out before these dramatic changes in fluoride availability and oral health. Furthermore, there is a paucity of evidence in adults. The aim of this study is to assess the clinical and cost-effectiveness of water fluoridation in preventing invasive dental treatment in adults and adolescents aged over 12. Methods/design Retrospective cohort study using 10 years of routinely available dental treatment data. Individuals exposed to water fluoridation will be identified by sampled water fluoride concentration linked to place of residence. Outcomes will be based on the number of invasive dental treatments received per participant (fillings, extractions, root canal treatments). A generalised linear model with clustering by local authority area will be used for analysis. The model will include area level propensity scores and individual-level covariates. The economic evaluation will focus on (1) cost-effectiveness as assessed by the water fluoridation mean cost per invasive treatment avoided and (2) a return on investment from the public sector perspective, capturing the change in cost of dental service utilisation resulting from investment in water fluoridation. Discussions There is a well-recognised need for contemporary evidence regarding the effectiveness and cost-effectiveness of water fluoridation, particularly for adults. The absence of such evidence for all age groups may lead to an underestimation of the potential benefits of a population-wide, rather than targeted, fluoride delivery programme. This study will utilise a pragmatic design to address the information needs of policy makers in a timely manner.

scholarly journals External validation of the detection of indicators and vulnerabilities for emergency room trips (DIVERT) scale: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fabrice I. Mowbray ◽  
Aaron Jones ◽  
Connie Schumacher ◽  
John Hirdes ◽  
Andrew P. Costa
Keyword(s):  
Cohort Study ◽  
Home Care ◽  
Emergency Room ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Reporting System ◽  
Predictive Accuracy ◽  
External Validation ◽  
Discriminative Ability ◽  
Geographical Regions

Abstract Background The Detection of Indicators and Vulnerabilities of Emergency Room Trips (DIVERT) scale was developed to classify and estimate the risk of emergency department (ED) use among home care clients. The objective of this study was to externally validate the DIVERT scale in a secondary population of home care clients. Methods We conducted a retrospective cohort study, linking data from the Home Care Reporting System and the National Ambulatory Care Reporting System. Data were collected on older long-stay home care clients who received a RAI Home Care (RAI-HC) assessment. Data were collected for home care clients in the Canadian provinces of Ontario and Alberta, as well as in the cities of Winnipeg, Manitoba and Whitehorse, Yukon Territories between April 1, 2011 and September 30, 2014. The DIVERT scale was originally derived from the items of the RAI-HC through the use of recursive partitioning informed by a multinational clinical panel. This scale is currently implemented alongside the RAI-HC in provinces across Canada. The primary outcome of this study was ED visitation within 6 months of a RAI-HC assessment. Results The cohort contained 1,001,133 home care clients. The vast majority of cases received services in Ontario (88%), followed by Alberta (8%), Winnipeg (4%), and Whitehorse (< 1%). Across the four cohorts, the DIVERT scale demonstrated similar discriminative ability to the original validation work for all outcomes during the six-month follow-up: ED visitation (AUC = 0.617–0.647), two or more ED visits (AUC = 0.628–0.634) and hospital admission (AUC = 0.617–0.664). Conclusions The findings of this study support the external validity of the DIVERT scale. More specifically, the predictive accuracy of the DIVERT scale from the original work was similar to the accuracy demonstrated within a new cohort, created from different geographical regions and time periods.

scholarly journals Trends in diagnosis and treatment for people with dementia in the UK from 2005 to 2015: a longitudinal retrospective cohort study

2017 ◽  
Vol 2 (3) ◽  
pp. e149-e156 ◽  
Author(s):  
Katherine Donegan ◽  
Nick Fox ◽  
Nick Black ◽  
Gill Livingston ◽  
Sube Banerjee ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Diagnosis And Treatment ◽  
People With Dementia ◽  
The Uk

scholarly journals External Validation of the Detection of Indicators and Vulnerabilities for Emergency Room Trips (DIVERT) Scale: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Fabrice Immanuel Mowbray ◽  
Aaron Jones ◽  
Connie Schumacher ◽  
John Hirdes ◽  
Andrew Paul Costa
Keyword(s):  
Cohort Study ◽  
Home Care ◽  
Emergency Room ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Reporting System ◽  
Predictive Accuracy ◽  
External Validation ◽  
Discriminative Ability ◽  
Geographical Regions

Abstract Background: The Detection of Indicators and Vulnerabilities of Emergency Room Trips (DIVERT) scale was developed to classify and estimate the risk of emergency department (ED) use in home care clients. The objective of this study was to externally validate the DIVERT scale in a secondary population of home care clients.Methods: We conducted a retrospective cohort study, linking data from the Home Care Reporting System and the National Ambulatory Care Reporting System. Data were collected on older long-stay home care clients who received a RAI Home Care (RAI-HC) assessment. Data were collected for home care clients in the Canadian provinces of Ontario and Alberta, as well as in the cities of Winnipeg, Manitoba and Whitehorse, Yukon Territories, between April 1, 2011 and September 30, 2014. The DIVERT Scale was originally derived from the items of the RAI-HC through the use of recursive partitioning informed by a multinational clinical panel. This scale is currently implemented alongside the RAI-HC in provinces across Canada. The primary outcome of this study was an ED visit within six months of a RAI-HC assessment.Results: The cohort contained 1,001,133 home care clients. The vast majority of cases received services in Ontario (88%), followed by Alberta (8%), Winnipeg (4%), and Whitehorse (<1%). Across the four cohorts, the DIVERT scale demonstrated similar discriminative ability to the original validation work for all outcomes during the six-month follow-up: ED visitation (AUC =0.617-0.647), two or more ED visits (AUC = 0.628-0.634), and hospital admission (AUC = 0.617-0.664).Conclusions: The findings of this study support the external validity of the DIVERT scale. More specifically, the predictive accuracy of the DIVERT scale from the original work was similar to the accuracy demonstrated within a new cohort, created from different geographical regions and time periods.

scholarly journals Inequity in palliative care service full utilisation among patients with advanced cancer: a retrospective Cohort study

2020 ◽  
Vol 59 (6) ◽  
pp. 620-627
Author(s):  
Daniela D’Angelo ◽  
Marco Di Nitto ◽  
Diana Giannarelli ◽  
Ileana Croci ◽  
Roberto Latina ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cohort Study ◽  
Advanced Cancer ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Care Service ◽  
Palliative Care Service

Palliative home care and emergency department visits in the last 30 and 90 days of life: a retrospective cohort study of patients with cancer

2021 ◽  
pp. bmjspcare-2021-002889
Author(s):  
Jennifer Mracek ◽  
Madalene Earp ◽  
Aynharan Sinnarajah
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Home Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Emergency Department Visits ◽  
Palliative Home Care ◽  
Patients With Cancer ◽  
Diagnosis Of Cancer ◽  
Ed Visits

ObjectivesEvaluate the association of specialist palliative home care (HC) on emergency department (ED) visits in the 30 and 90 days prior to death.MethodsThis retrospective cohort study using administrative data identified 6976 adults deceased from cancer between 2008 and 2015, living ≥180 days after diagnosis of cancer, and residing in the urban Calgary Zone of Alberta Health Services. All palliative HC and generalist HC services were examined. Regression analyses examined the relationships of HC type to ED visits in the last 30 or 90 days of life.ResultsIn the last 30 days of life, compared with patients receiving palliative HC, patients receiving only generalist HC, or no HC, were more likely to visit the ED (OR)generalist-HC 1.19; 95% CI 1.06 to 1.34; ORno-HC 1.54; 95% CI 1.31 to 1.82). In the last 90 days of life, compared with patients receiving palliative HC, those receiving generalist HC (OR 1.48; 95% CI 1.32 to 1.67) and no HC (OR 1.66; 95% CI 1.39 to 1.99) had increased odds of visiting the ED.ConclusionsReceiving generalist HC and no HC was associated with increased odds of visiting the ED in the last 30 and 90 days of life, when compared with patients receiving palliative HC. Improving access to palliative HC for patients at high risk of visiting the ED may reduce ED visits and acute care costs and improve quality of life in the last 90 days of life.

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