干旱区生态环境知识资源中心(Arid): Eliminating the Surprise Question Leaves Home Care Providers With Few Options for Identifying Mortality Risk

Arid

DOI	10.1177/1049909119892830
	Eliminating the Surprise Question Leaves Home Care Providers With Few Options for Identifying Mortality Risk
	Sullivan, Suzanne S.1; Casucci, Sabrina 2; Li, Chin-Shang 1
通讯作者	Sullivan, Suzanne S.
来源期刊	AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE
ISSN	1049-9091
EISSN	1938-2715
出版年	2020
卷号	37 期号:7 页码:542-548
英文摘要	Background: Precision health initiatives for end-of-life planning require robust methods for identifying patient risk for decline and mortality. The Outcome and Assessment Information Set (OASIS) surprise question (SQ; M1034 Overall Status) is the primary tool for evaluating risks in homebound older adults. However, the OASIS-D, Released in 2019, eliminates this question. This study examines the prognostic ability of 12- and 24-month mortality risk reflected in the OASIS-SQ and develops an alternative approach for classifying mortality risk to support decision-making in the absence of the OASIS-SQ. Design: Retrospective secondary data analysis. Setting/Participants: A nationally representative sample of 69 097 OASIS-C assessments (2012) linked to the Master Beneficiary Summary file (2012 and 2013). Measurements: Survival analysis, k-means clustering, and Cohen kappa coefficient with Z test. Results: The OASIS-SQ predicts mortality (35% at 12 and 45% at 24 months; P < .001). Cluster analysis identified 2 risk groups: OASIS activity of daily living ADL total scores >15 = (lower risk) and <= 15 = (higher risk) for 24-month mortality. Model agreement is weak for both cluster 1 and cluster 2, the OASIS-SQ kappa = 0.20, 95% confidence interval (CI) = .19 to .21, and alive/not alive kappa = .17, 95% CI = .16 to .18. Conclusion: The OASIS-SQ and ADL total score are almost equally likely to predict 24-month mortality; therefore, it was reasonable to use the ADL total score as a substitute for the OASIS-SQ. Removal of the OASIS-SQ leaves home care providers with few clear options for risk screening resulting in missed opportunities to refer to palliative or hospice services.
英文关键词	terminal care prognostication care transitions nursing informatics home care services hospice and palliative care nursing electronic health record older adults
类型	Article
语种	英语
国家	USA
开放获取类型	Green Accepted
收录类别	SCI-E
WOS记录号	WOS:000501054200001
WOS关键词	AGREEMENT ; END
WOS类目	Health Care Sciences & Services
WOS研究方向	Health Care Sciences & Services
EI主题词	2019-12-06
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/311616
作者单位	1.Univ Buffalo State Univ New York, Sch Nursing, 3435 Main St,201A Wende Hall, Buffalo, NY 14214 USA; 2.Univ Buffalo State Univ New York, Dept Ind & Syst Engn, Buffalo, NY 14214 USA
推荐引用方式 GB/T 7714	Sullivan, Suzanne S.,Casucci, Sabrina,Li, Chin-Shang. Eliminating the Surprise Question Leaves Home Care Providers With Few Options for Identifying Mortality Risk[J],2020,37(7):542-548.
APA	Sullivan, Suzanne S.,Casucci, Sabrina,&Li, Chin-Shang.(2020).Eliminating the Surprise Question Leaves Home Care Providers With Few Options for Identifying Mortality Risk.AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE,37(7),542-548.
MLA	Sullivan, Suzanne S.,et al."Eliminating the Surprise Question Leaves Home Care Providers With Few Options for Identifying Mortality Risk".AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE 37.7(2020):542-548.