干旱区生态环境知识资源中心(Arid): Dementia Severity Associated With Increased Risk of Potentially Preventable Readmissions During Home Health Care

Arid

DOI	10.1016/j.jamda.2019.09.012
	Dementia Severity Associated With Increased Risk of Potentially Preventable Readmissions During Home Health Care
	Knox, Sara 1; Downer, Brian 2; Haas, Allen 3; Middleton, Addie 4; Ottenbacher, Kenneth J.2
通讯作者	Knox, Sara
来源期刊	JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
ISSN	1525-8610
EISSN	1538-9375
出版年	2020
卷号	21 期号:4 页码:519-+
英文摘要	Objectives: Approximately 14% of Medicare beneficiaries are readmitted to a hospital within 30 days of home health care admission. Individuals with dementia account for 30% of all home health care admissions and are at high risk for readmission. Our primary objective was to determine the association between dementia severity at admission to home health care and 30-day potentially preventable readmissions (PPR) during home health care. A secondary objective was to develop a dementia severity scale from Outcome and Assessment Information Set (OASIS) items based on the Functional Assessment Staging Tool (FAST). Design: Retrospective cohort study. Setting and participants: Home health care; 126,292 Medicare beneficiaries receiving home health care (July 1, 2013-June 1, 2015) diagnosed with dementia (ICD-9 codes). Measures: 30-day PPR during home health care. Dementia severity categorized into 6 levels (non-affected to severe). Results: The overall rate of 30-day PPR was 7.6% [95% confidence interval (CI) 7.4, 7.7] but varied by patient and health care utilization characteristics. After adjusting for sociodemographic and clinical characteristics, the odds ratio (OR) for dementia severity category 6 was 1.37 (95% CI 1.29, 1.46) and the OR for category 7 was 1.94 (95% CI 1.64, 2.31) as compared to dementia severity category 1/2. Conclusions and implications: Dementia severity in the later stages is associated with increased risk for potentially preventable readmissions. Our findings suggest that individuals admitted to home health during the later stages of Alzheimer's disease and related dementias may require greater supports and specialized care to minimize negative outcomes such as readmissions. Development of a dementia severity scale based on OASIS items and the FAST is feasible. Future research is needed to determine effective strategies for decreasing potentially preventable readmissions of individuals with severe dementia who receive home health care. Future research is also needed to validate the proposed dementia severity categories used in this study. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
英文关键词	Potentially preventable readmissions dementia home health care
类型	Article
语种	英语
国家	USA
开放获取类型	Green Accepted
收录类别	SCI-E ; SSCI
WOS记录号	WOS:000522627000014
WOS关键词	ALZHEIMERS-DISEASE ; OLDER-ADULTS ; OF-LIFE ; TRANSITIONS ; HOSPITALIZATION ; DELIRIUM ; OUTCOMES ; REHOSPITALIZATION ; POPULATION
WOS类目	Geriatrics & Gerontology
WOS研究方向	Geriatrics & Gerontology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/315092
作者单位	1.MGH Inst Hlth Profess, Dept Phys Therapy, 36,1st Ave, Charlestown, MA 02129 USA; 2.Univ Texas Med Branch, Div Rehabil Sci, Galveston, TX 77555 USA; 3.Univ Texas Med, Dept Preventat Med & Community Hlth, Galveston, TX USA; 4.Med Univ South Carolina, Div Phys Therapy, Charleston, SC 29425 USA
推荐引用方式 GB/T 7714	Knox, Sara,Downer, Brian,Haas, Allen,et al. Dementia Severity Associated With Increased Risk of Potentially Preventable Readmissions During Home Health Care[J],2020,21(4):519-+.
APA	Knox, Sara,Downer, Brian,Haas, Allen,Middleton, Addie,&Ottenbacher, Kenneth J..(2020).Dementia Severity Associated With Increased Risk of Potentially Preventable Readmissions During Home Health Care.JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION,21(4),519-+.
MLA	Knox, Sara,et al."Dementia Severity Associated With Increased Risk of Potentially Preventable Readmissions During Home Health Care".JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION 21.4(2020):519-+.