scholarly journals National Trends in Potentially Preventable Hospitalizations of Older Adults with Dementia

2020 ◽  
Vol 68 (10) ◽  
pp. 2240-2248
Author(s):  
Timothy S. Anderson ◽  
Edward R. Marcantonio ◽  
Ellen P. McCarthy ◽  
Shoshana J. Herzig
Keyword(s):  
Older Adults ◽  
Preventable Hospitalizations ◽  
Potentially Preventable Hospitalizations ◽  
National Trends

scholarly journals Trends in Diabetes-Related Potentially Preventable Hospitalizations in Adult Population in Spain, 1997–2015: A Nation-Wide Population-Based Study

2019 ◽  
Vol 8 (4) ◽  
pp. 492 ◽  
Author(s):  
Ricardo Gómez-Huelgas ◽  
Carmen M. Lara-Rojas ◽  
María D. López-Carmona ◽  
Sergio Jansen-Chaparro ◽  
Raquel Barba ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Adult Population ◽  
Population Based ◽  
Short Term ◽  
Population Based Study ◽  
Preventable Hospitalizations ◽  
Uncontrolled Diabetes ◽  
Potentially Preventable Hospitalizations ◽  
National Trends

We aimed to assess national trends in the rates of diabetes-related potentially preventable hospitalizations (overall and by preventable condition) in the total adult population of Spain. We performed a population-based study of all adult patients with diabetes who were hospitalized from 1997 to 2015. Overall potentially preventable hospitalizations and hospitalizations by diabetes-related preventable conditions (short-term complications, long-term complications, uncontrolled diabetes, and lower-extremity amputations) were examined. Annual rates adjusted for age and sex were analyzed and trends were calculated. Over 19-years-period, 424,874 diabetes-related potentially preventable hospitalizations were recorded. Overall diabetes-related potentially preventable hospitalizations decreased significantly, with an average annual percentage change of 5.1 (95%CI: −5.6—(−4.7%); ptrend < 0.001). Among preventable conditions, the greatest decrease was observed in uncontrolled diabetes (−5.6%; 95%CI: −6.7—(−4.7%); ptrend < 0.001), followed by short-term complications (−5.4%; 95%CI: −6.1—(−4.9%); ptrend < 0.001), long-term complications (−4.6%; 95%CI: −5.1—(−3.9%); ptrend < 0.001), and lower-extremity amputations (−1.9%; 95%CI: −3.0—(−1.3%); ptrend < 0.001). These reductions were observed in all age strata for overall DM-related PPH and by preventable condition but lower-extremity amputations for those <65 years old. There was a greater reduction in overall DM-related PPH, uncontrolled DM, long-term-complications, and lower extremity amputations in females than in males (all p < 0.01). No significant difference was shown for short-term complications (p = 0.101). Our study shows a significant reduction in national trends for diabetes-related potentially preventable hospitalizations in Spain. These findings could suggest a sustained improvement in diabetes care in Spain, despite the burden of these diabetes-related complications and the increase in the diabetes mellitus prevalence.

scholarly journals Potentially Preventable Hospitalizations Among Older Adults: 2010-2014

2020 ◽  
Vol 18 (6) ◽  
pp. 511-519
Author(s):  
Elham Mahmoudi ◽  
Neil Kamdar ◽  
Allison Furgal ◽  
Ananda Sen ◽  
Phillip Zazove ◽  
...  
Keyword(s):  
Older Adults ◽  
Preventable Hospitalizations ◽  
Potentially Preventable Hospitalizations

Post-Hospital Syndrome (PHS) and Potentially Preventable Hospitalizations(PPH) in Adults. MonashWatch adult cohort patient telehealth journeys (Preprint)

2018 ◽  
Author(s):  
Associate Professor Martin ◽  
Narelle Hinckley ◽  
Keith Stockman ◽  
Donadl Campbell
Keyword(s):  
Adverse Outcomes ◽  
Phone Call ◽  
Post Discharge ◽  
Patient Journey ◽  
Preventable Hospitalizations ◽  
Acute Admission ◽  
Avoidable Hospitalizations ◽  
Self Rated Health ◽  
Phone Calls ◽  
Potentially Preventable Hospitalizations

BACKGROUND Monash Watch (MW) aims to reduce avoidable hospitalizations in a cohort above a risk ‘threshold’ identified by HealthLinks Chronic Care (HLCC) algorithms using personal, diagnostic, and service data, excluding surgical and psychiatric admissions. MW conducted regular patient monitoring through outbound phone calls using the Patient Journey Record System (PaJR). PaJR alerts are intended to act as a self-reported barometer of health perceptions with more alerts per call indicating greater risk of Potentially Preventable Hospitalizations (PPH) and Post Hospital Syndrome (PHS). Most knowledge of PPH and PHS occurs at a macro-level with little understanding of fine-grained dynamics. OBJECTIVE To describe patterns of self-reported concerns and self-rated health 10 days before and after acute hospital admission in the telehealth intervention cohort of MonashWatch in the context of addressing PPH and PHS. METHODS Participants: 173 who had an acute admission of the of the 232 HLCC cohort with predicted 3+ admissions/year, in MW service arm for >40 days. Measures: Self-reported health and health care status in 764 MW phone call records which were classified into Total Alerts (all concerns - self-reported) and Red Alerts (concerns judged to be higher risk of adverse outcomes/admissions -acute medical and illness symptoms). Acute (non-surgical) admissions from Victorian Admitted Episode database. Analysis: Descriptive Timeseries homogeneity metrics using XLSTAT. RESULTS Self-reported problems (Total Alerts) statistically shifted to a higher level 3 days before an acute admission and stayed at a high level for the 10 days post discharge; reported acute medical and illness symptoms (Red Alerts) increased 1 day prior to admission and but remained at a higher level than before admission. Symptoms of concern did not change before admission or after discharge. Self-rated health and feeling depressed were reported to worsen 5 days post discharge. Patients reported more medication changes up to 2 days before acute admission. CONCLUSIONS These descriptive findings in a cohort of high risk individuals suggest a prehospital phase of what is termed PHS, which persisted on discharge and possibly worsened 5 days after discharge with worse self-rated health and depressive symptoms. Further research is needed. The role and place of community and hospital in such a cohort needs further investigation and research into PPH and PHS.

scholarly journals Potentially preventable hospitalizations for acute and chronic conditions in Alaska, 2010–2012

2016 ◽  
Vol 4 ◽  
pp. 614-621 ◽  
Author(s):  
Prabhu P. Gounder ◽  
Sara M. Seeman ◽  
Robert C. Holman ◽  
Alice Rarig ◽  
Mary K. McEwen ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Preventable Hospitalizations ◽  
Potentially Preventable Hospitalizations

scholarly journals Disparities in Potentially Preventable Hospitalizations: Near-National Estimates for Hispanics

2017 ◽  
Vol 53 (3) ◽  
pp. 1349-1372 ◽  
Author(s):  
Chen Feng ◽  
Michael K. Paasche-Orlow ◽  
Nancy R. Kressin ◽  
Jennifer E. Rosen ◽  
Lenny López ◽  
...  
Keyword(s):  
Preventable Hospitalizations ◽  
National Estimates ◽  
Potentially Preventable Hospitalizations

scholarly journals Coprescribing of Benzodiazepines and Opioids in Older Adults: Rates, Correlates, and National Trends

2018 ◽  
Vol 74 (12) ◽  
pp. 1910-1915 ◽  
Author(s):  
Taeho Greg Rhee
Keyword(s):  
Older Adults ◽  
Future Research ◽  
Physician Visits ◽  
Prescribing Trends ◽  
Clinical Diagnoses ◽  
Nationally Representative ◽  
Using Data ◽  
National Trends ◽  
Ambulatory Medical Care ◽  
Over Time

Abstract Background To estimate prescribing trends of and correlates independently associated with coprescribing of benzodiazepines and opioids among adults aged 65 years or older in office-based outpatient visits. Methods I examined a nationally representative sample of office-based physician visits by older adults between 2006 and 2015 (n = 109,149 unweighted) using data from the National Ambulatory Medical Care Surveys (NAMCS). National rates and prescribing trends were estimated. Then, I used multivariable logistic regression analyses to identify demographic and clinical factors associated with coprescriptions of benzodiazepines and opioids. Results From 2006 to 2015, 15,954 (14.6%) out of 109,149 visits, representative of 39.3 million visits nationally, listed benzodiazepine, opioid, or both medications prescribed. The rate of prescription benzodiazepines only increased monotonically from 4.8% in 2006–2007 to 6.2% in 2014–2015 (p < .001), and the rate of prescription opioids only increased monotonically from 5.9% in 2006–2007 to 10.0% in 2014–2015 (p < .001). The coprescribing rate of benzodiazepines and opioids increased over time from 1.1% in 2006–2007 to 2.7% in 2014–2015 (p < .001). Correlates independently associated with a higher likelihood of both benzodiazepine and opioid prescriptions included: female sex, a visit for chronic care, receipt of six or more concomitantly prescribed medications, and clinical diagnoses of anxiety and pain (p < .01 for all). Conclusion The coprescribing rate of benzodiazepines and opioids increased monotonically over time in outpatient care settings. Because couse of benzodiazepines and opioids is associated with medication burdens and potential harms, future research is needed to address medication safety in these vulnerable populations.

scholarly journals Potentially Preventable Hospitalizations and the Burden of Healthcare-Associated Infections

2017 ◽  
Vol 4 ◽  
pp. 233339281772110 ◽  
Author(s):  
Andrea L. Lorden ◽  
Luohua Jiang ◽  
Tiffany A. Radcliff ◽  
Kathleen A. Kelly ◽  
Robert L. Ohsfeldt
Keyword(s):  
Clostridium Difficile ◽  
Lower Extremity ◽  
Clostridium Difficile Infection ◽  
Lower Extremity Amputation ◽  
Diabetic Patients ◽  
Healthcare Associated Infections ◽  
Preventable Hospitalizations ◽  
Potentially Preventable Hospitalizations ◽  
Healthcare Associated ◽  
Extremity Amputation

Background: An estimated 4% of hospital admissions acquired healthcare-associated infections (HAIs) and accounted for $9.8 (USD) billion in direct cost during 2011. In 2010, nearly 140 000 of the 3.5 million potentially preventable hospitalizations (PPHs) may have acquired an HAI. There is a knowledge gap regarding the co-occurrence of these events. Aims: To estimate the period occurrences and likelihood of acquiring an HAI for the PPH population. Methods: Retrospective, cross-sectional study using logistic regression analysis of 2011 Texas Inpatient Discharge Public Use Data File including 2.6 million admissions from 576 acute care hospitals. Agency for Healthcare Research and Quality Prevention Quality Indicator software identified PPH, and existing administrative data identification methodologies were refined for Clostridium difficile infection, central line–associated bloodstream infection, catheter-associated urinary tract infection, and ventilator-associated pneumonia. Odds of acquiring HAIs when admitted with PPH were adjusted for demographic, health status, hospital, and community characteristics. Findings: We identified 272 923 PPH, 14 219 HAI, and 986 admissions with PPH and HAI. Odds of acquiring an HAI for diabetic patients admitted for lower extremity amputation demonstrated significantly increased odds ratio of 2.9 (95% confidence interval: 2.16-3.91) for Clostridium difficile infection. Other PPH patients had lower odds of acquiring HAI compared to non-PPH patients, and results were frequently significant. Conclusions: Clinical implications include increased risk of HAI among diabetic patients admitted for lower extremity amputation. Methodological implications include identification of rare events for inpatient subpopulations and the need for improved codification of HAIs to improve cost and policy analyses regarding allocation of resources toward clinical improvements.

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