Hospitalization of Elderly Medicaid Long‐Term Care Users Who Transition from Nursing Homes

Wysocki, Andrea; Kane, Robert L; Dowd, Bryan E; Golberstein, Ezra; Lum, Terry Yat Sang; Shippee, Tetyana

doi:10.1111/jgs.12614

Cited by 27 publications

(35 citation statements)

References 33 publications

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“…Eleven of these 13 studies accounted for need (Amador et al, ; Bardsley et al, ; Blackburn, Locher, & Kilgore, ; Carter, ; Chappell, Dlitt, Hollander, Miller, & McWilliam, ; Deraas, ; Gruneir et al, ; Hollander & Chappell, ; Hutt et al, ; Sloane et al, ; Wysocki et al, ) and a further two did so in a subset of the reported analyses (Reeves & Baker, ; Victor, Healy, Thomas, & Seargeant, ).…”

Section: Resultsmentioning

confidence: 99%

“…Across included studies, social care utilisation was operationalised as: the amount of social care used (six studies, Table ) (Amador et al, ; Carter, ; Deraas, ; Gruneir et al, ; Hutt et al, ; Reeves & Baker, ); the type of social care used (four studies, Table ) (Bardsley et al, ; Chappell et al, ; Hollander & Chappell, ; Sloane et al, ) and, whether or not social care was used (three studies, Table ) (Blackburn et al, ; Victor et al, ; Wysocki et al, ). The synthesis reports evidence according to these three sub‐groups.…”

Section: Resultsmentioning

confidence: 99%

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Does older adults’ use of social care influence their healthcare utilisation? A systematic review of international evidence

Spiers

Matthews

Moffatt

et al. 2019

Health Soc Care Community

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Improving our understanding of the complex relationship between health and social care utilisation is vital as populations age. This systematic review aimed to synthesise evidence on the relationship between older adults’ use of social care and their healthcare utilisation. Ten databases were searched for international literature on social care (exposure), healthcare use (outcome) and older adults (population). Searches were carried out in October 2016, and updated May 2018. Studies were eligible if they were published after 2000 in a high income country, examined the relationship between use of social care and healthcare utilisation by older adults (aged ≥60 years), and controlled for an indicator of need. Study quality and bias were rated using the National Institute of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross‐Sectional Studies. Study data were extracted and a narrative synthesis was conducted. Data were not suitable for quantitative synthesis. Thirteen studies were identified from 12,065 citations. Overall, the quality and volume of evidence was low. There was limited evidence to suggest that longer lengths of stay in care homes were associated with a lower risk of inpatient admissions. Residents of care homes with onsite nursing had fewer than expected admissions to hospital, compared to people in care homes without nursing, and adjusting for need. Evidence for other healthcare use outcomes was even more limited and heterogeneous, with notable gaps in primary care. We conclude that older adults’ use of care homes may moderate inpatient admissions. In particular, the presence of registered nurses in care homes may reduce the need to transfer residents to hospital. However, further evidence is needed to add weight to this conclusion. Future research should build on this evidence and address gaps regarding the influence of community based social care on older adults’ healthcare use. A greater focus on primary care outcomes is imperative.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Does older adults’ use of social care influence their healthcare utilisation? A systematic review of international evidence

Spiers

Matthews

Moffatt

et al. 2019

Health Soc Care Community

View full text Add to dashboard Cite

show abstract

“…The research literature although diverse is insufficiently robust to answer the most pressing research questions . A primary focus of prior research has been the effectiveness of the program in keeping individuals in the community after nursing home discharge, and in examining outcomes such as hospitalization, readmission, and mortality . Less attention has been given to the question further upstream that influences the interpretation of postdischarge outcomes.…”

Section: Introductionmentioning

confidence: 99%

Assessing the impact of Minnesota's return to community initiative for newly admitted nursing home residents

Hass

Woodhouse

Grabowski

2019

Health Services Research

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Objective To evaluate Minnesota's Return to Community Initiative's (RTCI) impact on community discharges from nursing homes. Data Sources Secondary data were from the Minimum Data Set and RTCI staff (April 2014 – December 2016). The sample consisted of 18 444 non‐Medicaid nursing home admissions in Minnesota remaining for at least 45 days, with high predicted probability of community discharge. Study Design The RTCI facilitates community discharge for non‐Medicaid nursing home residents by assisting with discharge planning, transitioning to the community, and postdischarge follow‐up. A key evaluation question is how many of those transitions were directly attributable to the program. Return to Community Initiative was implemented statewide without a control group. Program impact was measured using regression discontinuity, a quasi‐experimental design approach that leverages the programs targeting model. Principal Findings Return to Community Initiative increased community discharge rates by an estimated 11 percent (P < 0.05) for the targeted population. The program effect was robust to time and increased with level of facility participation in RTCI. Conclusions The RTCI had a modest yet significant impact on the community discharge rates for its targeted population. Findings have been applied in strengthening the RTCI's targeting approach and transitioning process.

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“…Her family noted, "We had little information about where she was at with her dementia and, with the added diagnosis of lung cancer, we felt overwhelmed when thinking about what her likely prognosis and journey would be given both of these conditions" (Sheila's story). Although health status is commonly linked to heightened frailty and increased vulnerability to poor transitions, there is limited research on the specific ways that comorbidity interacts with other contextual factors to influence trajectories and quality of life (Chen, Chan, Kiely, Morris, & Mitchell, 2007;Kellett, Moyle, McAllister, King, & Gallagher, 2010;Moorhouse & Mallery, 2012;Sivananthan, 2015;Wysocki et al, 2014).…”

Section: Health and Care Trajectories And Service Contextsmentioning

confidence: 99%

“…Additionally, research has focused more on singular care transitions (Wysocki et al, 2014) and their predictors (Callahan et al, 2012;Luppa et al, 2010) rather than examining the overall patterns of service use for LTC clients over time (Coleman, Min, Chomiak, & Kramer, 2004;Murtaugh & Litke, 2002). This gap in knowledge, coupled with the increasing prevalence of dementia among older persons, provides an important rationale for this work (Alzheimer Society of Canada, 2010;WHO, 2015).…”

Section: Introductionmentioning

confidence: 99%

Janus at the Crossroads: Perspectives on Long-term Care Trajectories for Older Women With Dementia in a Canadian Context

Cloutier¹,

Penning

2016

GERONT

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Purpose of the Study: Janus, the two-faced, Roman god of beginnings and transitions, is used as a metaphor to explore our personal narratives and our quantitative research on the experiences of older women with dementia in long-term care (LTC). Two research questions are addressed: (a) How do our quantitative data map onto our mothers' experiences? (b) What lessons do our mothers' experiences offer for the care of older women with dementia? Design and Methods: Informed by a life-course perspective, we triangulate administrative data on 3,717 women with dementia receiving LTC in British Columbia, Canada, with personal narratives-the stories of our mothers who made the transition from home care into residential (nursing home) care. Results: Our quantitative data reveal that the home care to residential care transition is the most common LTC trajectory for women with dementia who are most likely to be widowed and living alone in suburban areas. On entry into residential care, they exhibit greater frailty in terms of activities of daily living, cognition, aggression, and incontinence. Our personal narrative data on our mothers reveals that the relatively straightforward pathways through LTC for women with dementia, are often considerably more complex in a real-world context. Attention is drawn to the public and private services, hospitalization patterns, and substantial communication gaps experienced by our moms and families. Implications: A life-course perspective, and qualitative and quantitative data facilitate understanding the care journeyshealth and service trajectories of older women with dementia. Writing over a decade ago about their mother's experience of nursing home care after a serious stroke, Kane and West (2005) argued that society appears uninterested in making the necessary commitment to care for frail older adults in creative, compassionate, and appropriate ways aligned with goals of quality of care and quality of life. In this special issue called, Aging-It's Personal, we explore this concern by triangulating data from our funded research program with our personal narratives describing our mothers' experiences as clients of the long-term care (LTC) system.As social gerontologists, we have spent much of our careers studying health service provision for vulnerable older adults. As adult children, we have recent personal and family-centered experience related to our mothers' care journeys as women who began their service trajectory in home care and continued on to become clients of residential (nursing home) care until their deaths. In thisThe Gerontologist cite as : Gerontologist, 2017, Vol. 57, No. 1, 68-81 doi:10.1093 Advance Access publication November 16, 2016 article, we employ the metaphor of Janus, the two-faced Roman god of beginnings and transitions, to explore how our personal and professional worlds have intertwined, affecting us indelibly as family members, sparking our research questions, and giving us a greater appreciation for the ways that care is navigated. We consider ...

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Hospitalization of Elderly Medicaid Long‐Term Care Users Who Transition from Nursing Homes

Cited by 27 publications

References 33 publications

Does older adults’ use of social care influence their healthcare utilisation? A systematic review of international evidence

Does older adults’ use of social care influence their healthcare utilisation? A systematic review of international evidence

Assessing the impact of Minnesota's return to community initiative for newly admitted nursing home residents

Janus at the Crossroads: Perspectives on Long-term Care Trajectories for Older Women With Dementia in a Canadian Context

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