干旱区生态环境知识资源中心(Arid): Functional outcome in home health: Do racial and ethnic minority patients with dementia fare worse?

Arid

DOI	10.1371/journal.pone.0233650
	Functional outcome in home health: Do racial and ethnic minority patients with dementia fare worse?
	Wang, Jinjiao 1; Yu, Fang 2; Cai, Xueya 3; Caprio, Thomas V.4,5,6; Li, Yue 7
通讯作者	Wang, Jinjiao
来源期刊	PLOS ONE
ISSN	1932-6203
出版年	2020
卷号	15 期号:5
英文摘要	Objectives Evaluate the independent and interactive effects of dementia and racial/ethnic minority status on functional outcomes during a home health (HH) admission among Medicare beneficiaries. Methods Secondary analysis of data from the Outcome and Assessment Information Set [OASIS] and billing records in a non-profit HH agency in New York. Participants were adults. 65 years old who received HH in CY 2017 with OASIS records at HH admission and HH discharge. Dementia was identified by diagnosis (ICD-10 codes) and cognitive impairment (OASIS: M1700, M1710, M1740). We used OASIS records to assess race/ethnicity (M0140) and functional status (M1800-M1870 on activities of daily living [ADL]). Functional outcome was measured as change in the composite ADL score from HH admission to HH discharge, where a negative score means improvement and a positive score means decline. Results The sample included 4,783 patients, among whom 93.9% improved in ADLs at HH discharge. In multivariable linear regression that adjusted for HH service use and covariates (R-2 = 0.23), being African American (beta = 0.21, 95% confidence interval [CI]: 0.06, 0.35, p = 0.005) and having dementia (beta = 0.51, 95% CI: 0.41, 0.62, p<0.001) were independently related to less ADL improvement at HH discharge, with significant interaction related to further decrease in ADL improvement. Relative to white patients without dementia, African American patients with dementia (beta = 1.08, 95% CI: 0.81, 1.35, p<0.001), Hispanics with dementia (beta = 0.92, 95% CI: 0.38, 1.47, p = 0.001) and Asian Americans with dementia (beta = 1.47, 95% CI: 0.81, 2.13, p<0.001) showed the least ADL improvement at HH discharge. Conclusion Racial/ethnic minority status and dementia were associated with less ADL improvement in HH with independent and interactive effects. Policies should ensure that these patients have equitable access to appropriate, adequate community-based services to meet their needs in ADLs and disease management for improved outcomes.
类型	Article
语种	英语
国家	USA
开放获取类型	Green Published, gold
收录类别	SCI-E ; SSCI
WOS记录号	WOS:000537529500040
WOS关键词	INFORMATION SET OASIS ; POST-ACUTE CARE ; OLDER-ADULTS ; MEDICARE BENEFICIARIES ; COGNITIVE IMPAIRMENT ; ALZHEIMERS-DISEASE ; HOSPITAL DISCHARGE ; SERVICE USE ; VALIDITY ; DISPARITIES
WOS类目	Multidisciplinary Sciences
WOS研究方向	Science & Technology - Other Topics
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/318679
作者单位	1.Univ Rochester, Sch Nursing, Rochester, NY USA; 2.Univ Minnesota, Sch Nursing, Minneapolis, MN USA; 3.Univ Rochester, Dept Biostat & Computat Biol, Rochester, NY USA; 4.Univ Rochester, Med Ctr, Dept Med, Rochester, NY 14642 USA; 5.Univ Rochester, Med Home Care, Rochester, NY USA; 6.Finger Lakes Geriatr Educ Ctr, Rochester, NY USA; 7.Univ Rochester, Dept Publ Hlth Sci, Rochester, NY USA
推荐引用方式 GB/T 7714	Wang, Jinjiao,Yu, Fang,Cai, Xueya,et al. Functional outcome in home health: Do racial and ethnic minority patients with dementia fare worse?[J],2020,15(5).
APA	Wang, Jinjiao,Yu, Fang,Cai, Xueya,Caprio, Thomas V.,&Li, Yue.(2020).Functional outcome in home health: Do racial and ethnic minority patients with dementia fare worse?.PLOS ONE,15(5).
MLA	Wang, Jinjiao,et al."Functional outcome in home health: Do racial and ethnic minority patients with dementia fare worse?".PLOS ONE 15.5(2020).