Risk of Continued Institutionalization After Hospitalization in Older Adults

Goodwin, James S.; Howrey, Bret; Zhang, Dong D.; Kuo, Yong Fang

doi:10.1093/gerona/glr171

Cited by 84 publications

(97 citation statements)

References 31 publications

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“…Increasing age, living alone, cognitive impairment particularly dementia, psychiatric diagnoses, and limited functional performance (activities of daily living and instrumental activities of daily living) have all been shown to strongly predict the need for skilled care in the United States and Europe. [11][12][13][14][15]36,37 These findings uniquely inform clinical decision making as they are derived from the largest non-proprietary longitudinal data set concerning individuals with TBI that is representative of patients receiving inpatient rehabilitation for TBI in the United States. 22,23 While age and pre-injury living status are important to consider when establishing a plan of care on admission to IR, skills for independence improve with recovery, making prediction of outcome for any individual challenging and the discharge planning process dynamic.…”

Section: Discussionmentioning

confidence: 99%

Predicting Institutionalization after Traumatic Brain Injury Inpatient Rehabilitation

Eum

Seel

Goldstein

et al. 2015

Journal of Neurotrauma

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Risk factors contributing to institutionalization after inpatient rehabilitation for people with traumatic brain injury (TBI) have not been well studied and need to be better understood to guide clinicians during rehabilitation. We aimed to develop a prognostic model that could be used at admission to inpatient rehabilitation facilities to predict discharge disposition. The model could be used to provide the interdisciplinary team with information regarding aspects of patients' functioning and/or their living situation that need particular attention during inpatient rehabilitation if institutionalization is to be avoided. The study population included 7219 patients with moderate-severe TBI in the Traumatic Brain Injury Model Systems (TBIMS) National Database enrolled from 2002-2012 who had not been institutionalized prior to injury. Based on institutionalization predictors in other populations, we hypothesized that among people who had lived at a private residence prior to injury, greater dependence in locomotion, bed-chair-wheelchair transfers, bladder and bowel continence, feeding, and comprehension at admission to inpatient rehabilitation programs would predict institutionalization at discharge. Logistic regression was used, with adjustment for demographic factors, proxy measures for TBI severity, and acute-care length-of-stay. Cstatistic and predictiveness curves validated a five-variable model. Higher levels of independence in bladder management (adjusted odds ratio [OR], 0.88; 95% CI 0.83, 0.93), bed-chair-wheelchair transfers (OR, 0.81 [95% CI,, and comprehension (OR, 0.78 [95% CI, 0.68, 0.89]) at admission were associated with lower risks of institutionalization on discharge. For every 10-year increment in age was associated with a 1.38 times higher risk for institutionalization (95% CI, 1.29, 1.48) and living alone was associated with a 2.34 times higher risk (95% CI, 1.86, 2.94). The c-statistic was 0.780. We conclude that this simple model can predict risk of institutionalization after inpatient rehabilitation for patients with TBI.

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Section: Discussionmentioning

confidence: 99%

Predicting Institutionalization after Traumatic Brain Injury Inpatient Rehabilitation

Eum

Seel

Goldstein

et al. 2015

Journal of Neurotrauma

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“…These predictors were usually derived from cohort studies that assessed participants' baseline characteristics and chronic conditions but did not account for more proximal, acute events that often precipitate nursing home placement. Goodwin et al, 4 for example, observed in a large dataset from the United States, that 75% of all nursing home placements were preceded by a previous hospitalization. Some studies analyzed predictors of institutionalization in patients with specific diseases like dementia, hip fracture, or heart failure.…”

mentioning

confidence: 99%

Risk of Nursing Home Admission After Femoral Fracture Compared With Stroke, Myocardial Infarction, and Pneumonia

Rapp

Rothenbacher

Magaziner

et al. 2015

Journal of the American Medical Directors Association

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“…At the same time, older people are Anxious to live independently, regardless of chronic complex Conditions such as weakness, dementia and fall hazards. However, independent lifestyles may lead to delays and health assessments due to lack of monitoring, which is Associated with long-term poor health problems [3]. Late Health assessment is a risk factor that is stressed as normal this happens because of the fear of institutionalization Lack of medical evaluation [4].…”

Section: Introductionmentioning

confidence: 99%

The Similarity Quantification of Multidimensional Time Series Data Sets in Surveillance Applications for Health Monitoring System

Hasan¹

2017

ijarcs

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Abstract:In the last decade, Data mining techniques have been applied for sensor data in a wide range of applications. Like health care monitoring systems, manufacturing process. Intruder detection, database management and other. A lot of data mining engineering is based on the calculation of the similarity between two models of sensor data. A number of representations and Equality measures for multi -assign time series was suggested in the literature. In this paper, we describe a new way of calculating whether two similarities in the series of multiple series are based on the temporal version of Smith-Waterman (SW), a known information algorithm. Next, we apply our method to detect data on the demand for care of the elderly to early detection of the disease. Our procedure absorber is difficulties linked to the data uncertainty and aggregation that often occurs during treatment sensor data. The trials will take place one aging-in-place installation, Tiger Place placed in Columbia, MO. To validate our method we used data on nine no-portable a sensor for one-p located in TigerPlace apartments, combined with information of one Electronic Health Record (EHR).We deliver a set of experiments studying the temporal version of SW properties, with experiences on TigerPlace dataset.

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Risk of Continued Institutionalization After Hospitalization in Older Adults

Abstract: Most placements in nursing homes are preceded by a hospitalization followed by discharge to a SNF. Discharge to a SNF is associated with a high risk of subsequent long-term care.

Cited by 84 publications

References 31 publications

Predicting Institutionalization after Traumatic Brain Injury Inpatient Rehabilitation

Predicting Institutionalization after Traumatic Brain Injury Inpatient Rehabilitation

Risk of Nursing Home Admission After Femoral Fracture Compared With Stroke, Myocardial Infarction, and Pneumonia

The Similarity Quantification of Multidimensional Time Series Data Sets in Surveillance Applications for Health Monitoring System

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