August 6, 2019

Effects of Care Coordination on Hospitalization, Quality of Care, and Health Care Expenditures Among Medicare Beneficiaries: 15 Randomized Trials

Peikes D, Chen A, Schore J, Brown R. Effects of Care Coordination on Hospitalization, Quality of Care, and Health Care Expenditures Among Medicare Beneficiaries. JAMA. 2009;301(6). Http://jama.jamanetwork.com/article.aspx?articleid=183370 Accessed 7/9/14. Medicare expenditures of patients with chronic illnesses might be reduced through improvements in care, patient adherence, and communication.
Peikes D, Chen A, Schore J, Brown R. Effects of Care Coordination on Hospitalization, Quality of Care, and Health Care Expenditures Among Medicare Beneficiaries. JAMA. 2009;301(6). Http://jama.jamanetwork.com/article.aspx?articleid=183370 Accessed 7/9/14. Medicare expenditures of patients with chronic illnesses might be reduced through improvements in care, patient adherence, and communication.
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http://jama.jamanetwork.com/article.aspx?articleid=183370

August 7, 2019

Reducing Emergency Visits in Older Adults With Chronic Illness

Coleman E, Eilertsen T, Kramer A. Reducing Emergency Visits in Older Adults With Chronic Illness. Eff Clin Pract. 2001;(4) 49-57. http://www.caretransitions.org/documents/Reducing%20ER%20-%20ECP.pdf Accessed August 1, 2014. On average, patients in the intervention group attended 10.6 group visits during the 2-year study period. These patients averaged fewer emergency department visits (0.65 vs. […]
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Coleman E, Eilertsen T, Kramer A. Reducing Emergency Visits in Older Adults With Chronic Illness. Eff Clin Pract. 2001;(4) 49-57. http://www.caretransitions.org/documents/Reducing%20ER%20-%20ECP.pdf Accessed August 1, 2014. On average, patients in the intervention group attended 10.6 group visits during the 2-year study period. These patients averaged fewer emergency department visits (0.65 vs. 1.08 visits; P=0.005) and were less likely to have any emergency department visits (34.9% vs. 52.4%; P =0.003) than controls. These differences remained statistically significant after controlling for demographic factors, comorbid conditions, functional status, and prior utilization. Adjusted mean difference in visits was –0.42 visits (95% CI, –0.13 to –0.72), and adjusted RR for any emergency department visit was 0.64 (CI, 0.44 to 0.86).
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http://www.caretransitions.org/documents/Reducing%20ER%20-%20ECP.pdf

August 7, 2019

Hospitalization Rates in Nursing Home Residents with Dementia: A Pilot Study of the Impact of a Special Care Unit. Journal of the American Geriatrics Society. 1990;38(2):108-12

Coleman E, Barbaccia J, Croughan-Minihane M.Hospitalization Rates in Nursing Home Residents with Dementia: A Pilot Study of the Impact of a Special Care Unit. Journal of the American Geriatrics Society. 1990;38(2):108-12. http://www.caretransitions.org/documents/Hosp%20Rates%20-%20JAGS%20Abstract.pdf . Accessed July 31, 2014. Although Special Care Units (SCUs) have recently gained attention as appropriate places for […]
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Coleman E, Barbaccia J, Croughan-Minihane M.Hospitalization Rates in Nursing Home Residents with Dementia: A Pilot Study of the Impact of a Special Care Unit. Journal of the American Geriatrics Society. 1990;38(2):108-12. http://www.caretransitions.org/documents/Hosp%20Rates%20-%20JAGS%20Abstract.pdf . Accessed July 31, 2014. Although Special Care Units (SCUs) have recently gained attention as appropriate places for caring for institutionalized patients with dementia, few studies have evaluated their effectiveness. This pilot study focused primarily on one aspect of patient care, the possible prevention of acute hospitalization. Because transfer from nursing home to the acute hospital can be a traumatic experience for patients with dementia, important services that SCUs might provide include those preventive strategies aimed at reducing the need for transfer to the acute hospital. Medical record abstraction revealed that over one year, the rate of acute hospitalization was 21% among 47 patients with dementia in SCUs, compared with 14% among 36 patients with dementia and 14% among 22 patients with no listed diagnosis of dementia residing in non-SCU settings within the same facility. Thus, no statistically significant difference in hospitalization rates was found, although the trend was for increased hospitalization for SCU patients. There was a trend toward deterioration in functional status among SCU patients following first hospitalization (P less than .10). Since the majority of these patients were hospitalized for hip fractures, this finding was not unexpected. There was a trend toward cognitive decline after hospitalization among patients with dementia who were not residing in an SCU (P less than .10). In order to investigate whether acute hospitalizations among SCU patients were preventable, an expert panel was convened to review each episode of illness leading to acute hospitalization. Of the 15 hospitalizations, none were judged "preventable," four were believed to be "possibly preventable," and 11 were considered to have been "not preventable."
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http://www.caretransitions.org/documents/Hosp%20Rates%20-%20JAGS%20Abstract.pdf