Postacute Care: A Guide for People With Dementia and Their Caregiver

Downer, Brian; Knox, Sara; Wong, Diana; Faieta, Julie; Krishnan, Shilpa

doi:10.1016/j.apmr.2021.01.065

Cited by 2 publications

(3 citation statements)

References 10 publications

(10 reference statements)

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“…PAC provides continuing skilled services for Medicare beneficiaries after an acute hospitalization. 1 The utilization of PAC services among Medicare beneficiaries has rapidly increased in the past few decades, with over 40% now utilizing these services after acute hospitalizations. 2,3 Skilled nursing facilities (SNFs) and home health agencies (HHAs) are the two most common settings and account for the majority (90%) of PAC services.…”

Section: Introductionmentioning

confidence: 99%

“…The COVID‐19 pandemic has profoundly impacted various sectors of the U.S. healthcare system, including post‐acute care (PAC). PAC provides continuing skilled services for Medicare beneficiaries after an acute hospitalization 1 . The utilization of PAC services among Medicare beneficiaries has rapidly increased in the past few decades, with over 40% now utilizing these services after acute hospitalizations 2,3 .…”

Section: Introductionmentioning

confidence: 99%

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Post‐acute care transitions during COVID‐19: Racial, ethnic, and socioeconomic differences in older adults with Alzheimer's disease and related dementia

Yang,

Temkin‐Greener,

Veazie

et al. 2024

J American Geriatrics Society

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BackgroundDifferences in the post‐acute care (PAC) destinations among racial, ethnic, and socioeconomic groups have been documented before the COVID‐19 pandemic. Yet, the pandemic's impact on these differences remains unknown. We examined the impact of the COVID‐19 pandemic on PAC destinations and its variation by individual race, ethnicity, and socioeconomic status among community‐dwelling older adults with Alzheimer's disease and related dementia (ADRD).MethodsWe linked 2019–2021 national data (Medicare claims, Minimum Data Set, Master Beneficiary Summary File) and several publicly available datasets, including Provider of Services File, Area Deprivation Index, Area Health Resource File, and COVID‐19 infection data. PAC discharge destinations included skilled nursing facilities (SNFs), home health agencies (HHA), and homes without services. Key variables of interest included individual race, ethnicity, and Medicare‐Medicaid dual status. The analytic cohort included 830,656 community‐dwelling Medicare fee‐for‐service beneficiaries with ADRD who were hospitalized between 2019 and 2021. Regression models with hospital random effects and state‐fixed effects were estimated, stratified by the time periods, and adjusted for the individual, hospital, and county‐level covariates.ResultsSNF discharges decreased while home and HHA discharges increased during the pandemic. The trend was more prominent among racial and ethnic minoritized groups and even more so among dual‐eligible beneficiaries. For instance, the reduction in the probabilities of SNF admissions between the pre‐pandemic period and the 2nd year of COVID was 4.6 (White non‐duals), 18.5 (White duals), 8.7 (Black non‐duals), and 20.1 (Black duals) percentage‐point, respectively. We also found that non‐duals were more likely to replace SNF with HHA services, while duals were more likely to be discharged home without HHA.ConclusionsThe COVID‐19 pandemic significantly impacted PAC destinations for individuals with ADRD, especially among socioeconomically disadvantaged and racial and ethnic minoritized populations. Future research is needed to understand if and how these transitions may have affected health outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Post‐acute care transitions during COVID‐19: Racial, ethnic, and socioeconomic differences in older adults with Alzheimer's disease and related dementia

Yang,

Temkin‐Greener,

Veazie

et al. 2024

J American Geriatrics Society

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“…Since then, there has been a need to know about the demographic profile, nature of the conditions managed, and the functional outcome of the admitted patients in this tertiary academic hospital rehabilitation facility. There were recommendations for more research on the role of the post-acute care indoor setting and its attributes in determining health outcomes ( 13 ). The goal of the present study was to conduct an analysis of indoor rehabilitation programs in a developing country based on the demographics and medical conditions of admitted patients.…”

Section: Introductionmentioning

confidence: 99%

Relations between indoor rehabilitation and basic health services in a developing country

Uddin

Ahmed

Shoma

2023

Front. Rehabil. Sci.

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Backgroundand Introduction: Physical rehabilitation is vital for patients to regain maximum function. Approximately 80% of people with a disability live in developing countries, where they face multiple challenges in rehabilitation. The goal of the study was to conduct an analysis of indoor rehabilitation programs based on the demographics and medical conditions of the admitted patients and to relate to the available basic health and rehabilitation facilities.MethodsThis was a mixed method study conducted in an inpatient rehabilitation ward of a tertiary level academic university hospital in a developing country. All admitted patients who stayed for a period of minimum two weeks were included in the study. Demographic and clinical data were obtained by means of a retrospective medical record review utilizing a standardized data extraction form. The study was further strengthened by an online literature search for the available documents for analysis, relation, and discussion.ResultsAmong the 1,309 admitted patients was male- female ratio was 10:7, with the majority (31.4%) cases falling between the ages of 46 and 60yrs. Rehabilitation outpatient department was the principal mode of admission (78%), and musculoskeletal and neurological conditions represented the maximum number (79.8%). Majority of patients (60.8%) were discharged home on completion of the rehabilitation program with a large number of patients who were absconded. Poor health budget allocation and lack of prioritization of the rehabilitation sector face multiple challenges, including the rehabilitation team functioning resources, space crisis for expansion which was further impacted by the COVID-19 pandemic.ConclusionsThe country's current health-related rehabilitation process and socio-demographic variables have a negative relationship. There was a large number of missing data in the medical records and many patients were lost prematurely from the indoor rehabilitation program. Musculoskeletal disorders were common, and the majority of patients were discharged home once the program was completed.

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Postacute Care: A Guide for People With Dementia and Their Caregiver

Cited by 2 publications

References 10 publications

Post‐acute care transitions during COVID‐19: Racial, ethnic, and socioeconomic differences in older adults with Alzheimer's disease and related dementia

Post‐acute care transitions during COVID‐19: Racial, ethnic, and socioeconomic differences in older adults with Alzheimer's disease and related dementia

Relations between indoor rehabilitation and basic health services in a developing country

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