Matches in SemOpenAlex for { <https://semopenalex.org/work/W3136229143> ?p ?o ?g. }
Showing items 1 to 77 of
77
with 100 items per page.
- W3136229143 endingPage "S132" @default.
- W3136229143 startingPage "S132" @default.
- W3136229143 abstract "Introduction In 2018, 1.6 million fee-for-service (FFS) Medicare beneficiaries used skilled nursing facilities (SNFs) at least once. Older adult SNF patients with mental illness (MI) and Alzheimer's disease and related dementias (ADRD) comprise groups that are at risk of nursing home long-term care. We examined how the presence of MI and ADRD were associated with discharge from SNF admissions to the community and home time (the number of days alive that were not in a hospital, inpatient rehabilitation facility, or SNF). We hypothesized that older adults with MI and ADRD were less likely to have been discharged to the community and had less home time. We anticipated that these associations would be attenuated, however, after accounting for the behavioral and psychological manifestations of MI and ADRD such as daily functioning, depressive symptoms, and aggressive behaviors. Methods Our study examined 46,342 New York State FFS Medicare beneficiaries aged 65 years and older with an index SNF admission in 2014 following a hospitalization of three or more days. Our first outcome was whether an SNF patient was discharged to the community within 100 days of SNF admission (binary: yes/no). Included in the “no” category were older adults who were discharged from the SNF to a hospital or a different SNF, remained in the SNF longer than 100 days, or died. For those discharged to the community, our second outcome was home time (continuous) in the 90 days following SNF discharge. The key independent variable was the presence of a MI or ADRD diagnosis, which we organized into three groupings: 1) MI present and ADRD absent, 2) ADRD present (with and without MI), and 3) both MI and ADRD absent (serving as reference group). We extracted data from the Minimum Data Set, Medicare claims, and other administrative databases. We conducted logistic and zero-inflated negative binomial regressions to analyze the associations between MI/ADRD grouping with our outcomes. Results Among SNF post-acute care admissions, 23.0% had MI only, 22.7% had ADRD, and 58.9% were discharged to the community. In analyses adjusting for socio-demographic and clinical characteristics, MI and ADRD were associated with decreased odds of community discharge (MI: odds ratio, OR=0.90, 95% confidence interval, CI: 0.86-0.95; ADRD: OR=0.51, 95% CI: 0.49-0.54). When the manifestations of MI and ADRD were added to the regression models, however, MI was no longer associated with community discharge and ADRD's association was attenuated (MI: OR=0.97, 95% CI: 0.92-1.02; ADRD: OR=0.71, 95% CI: 0.67-0.75). Among those discharged to the community, after adjusting for socio-demographic and clinical characteristics, MI and ADRD were associated with 1.26 and 1.41 fewer days in the community (MI: -1.26 days, 95% CI: -1.95, -0.57; ADRD: -1.41 days, 95% CI: -2.21, -0.60). When the manifestations of MI and ADRD were added to the regression models, MI's association with home time persisted, but ADRD was no longer associated (MI: -0.73 days, 95% CI: -1.41, -0.05; ADRD: 0.45 days, 95% CI: -0.27, 1.17). Conclusions Among NYS FFS Medicare beneficiaries who received post-acute care SNF services, older adults with MI and ADRD had worse SNF discharge outcomes. These worse outcomes appear to have been at least partially driven by impaired daily functioning, depressive symptoms, and aggressive behaviors that can be consequences of MI or ADRD. Accordingly, psychogeriatric care to optimally manage the symptoms and behaviors associated with MI and ADRD may be necessary to improve community discharge and home time. Funding Dr. Simning was supported by the Empire Clinical Research Investigator Program, sponsored by the New York State Department of Health, as well as the National Institute on Aging (grant number K23AG058757). The content is solely the responsibility of the authors and does not necessarily reflect the official views of the National Institutes of Health. In 2018, 1.6 million fee-for-service (FFS) Medicare beneficiaries used skilled nursing facilities (SNFs) at least once. Older adult SNF patients with mental illness (MI) and Alzheimer's disease and related dementias (ADRD) comprise groups that are at risk of nursing home long-term care. We examined how the presence of MI and ADRD were associated with discharge from SNF admissions to the community and home time (the number of days alive that were not in a hospital, inpatient rehabilitation facility, or SNF). We hypothesized that older adults with MI and ADRD were less likely to have been discharged to the community and had less home time. We anticipated that these associations would be attenuated, however, after accounting for the behavioral and psychological manifestations of MI and ADRD such as daily functioning, depressive symptoms, and aggressive behaviors. Our study examined 46,342 New York State FFS Medicare beneficiaries aged 65 years and older with an index SNF admission in 2014 following a hospitalization of three or more days. Our first outcome was whether an SNF patient was discharged to the community within 100 days of SNF admission (binary: yes/no). Included in the “no” category were older adults who were discharged from the SNF to a hospital or a different SNF, remained in the SNF longer than 100 days, or died. For those discharged to the community, our second outcome was home time (continuous) in the 90 days following SNF discharge. The key independent variable was the presence of a MI or ADRD diagnosis, which we organized into three groupings: 1) MI present and ADRD absent, 2) ADRD present (with and without MI), and 3) both MI and ADRD absent (serving as reference group). We extracted data from the Minimum Data Set, Medicare claims, and other administrative databases. We conducted logistic and zero-inflated negative binomial regressions to analyze the associations between MI/ADRD grouping with our outcomes. Among SNF post-acute care admissions, 23.0% had MI only, 22.7% had ADRD, and 58.9% were discharged to the community. In analyses adjusting for socio-demographic and clinical characteristics, MI and ADRD were associated with decreased odds of community discharge (MI: odds ratio, OR=0.90, 95% confidence interval, CI: 0.86-0.95; ADRD: OR=0.51, 95% CI: 0.49-0.54). When the manifestations of MI and ADRD were added to the regression models, however, MI was no longer associated with community discharge and ADRD's association was attenuated (MI: OR=0.97, 95% CI: 0.92-1.02; ADRD: OR=0.71, 95% CI: 0.67-0.75). Among those discharged to the community, after adjusting for socio-demographic and clinical characteristics, MI and ADRD were associated with 1.26 and 1.41 fewer days in the community (MI: -1.26 days, 95% CI: -1.95, -0.57; ADRD: -1.41 days, 95% CI: -2.21, -0.60). When the manifestations of MI and ADRD were added to the regression models, MI's association with home time persisted, but ADRD was no longer associated (MI: -0.73 days, 95% CI: -1.41, -0.05; ADRD: 0.45 days, 95% CI: -0.27, 1.17). Among NYS FFS Medicare beneficiaries who received post-acute care SNF services, older adults with MI and ADRD had worse SNF discharge outcomes. These worse outcomes appear to have been at least partially driven by impaired daily functioning, depressive symptoms, and aggressive behaviors that can be consequences of MI or ADRD. Accordingly, psychogeriatric care to optimally manage the symptoms and behaviors associated with MI and ADRD may be necessary to improve community discharge and home time." @default.
- W3136229143 created "2021-03-29" @default.
- W3136229143 creator A5017981970 @default.
- W3136229143 creator A5019665800 @default.
- W3136229143 creator A5025018265 @default.
- W3136229143 creator A5044367029 @default.
- W3136229143 creator A5059161431 @default.
- W3136229143 creator A5070462421 @default.
- W3136229143 date "2021-04-01" @default.
- W3136229143 modified "2023-09-27" @default.
- W3136229143 title "Older Adults with Mental Illness or Dementia Struggle with the Skilled Nursing Facility-to-Home Transition" @default.
- W3136229143 doi "https://doi.org/10.1016/j.jagp.2021.01.127" @default.
- W3136229143 hasPublicationYear "2021" @default.
- W3136229143 type Work @default.
- W3136229143 sameAs 3136229143 @default.
- W3136229143 citedByCount "1" @default.
- W3136229143 countsByYear W31362291432022 @default.
- W3136229143 crossrefType "journal-article" @default.
- W3136229143 hasAuthorship W3136229143A5017981970 @default.
- W3136229143 hasAuthorship W3136229143A5019665800 @default.
- W3136229143 hasAuthorship W3136229143A5025018265 @default.
- W3136229143 hasAuthorship W3136229143A5044367029 @default.
- W3136229143 hasAuthorship W3136229143A5059161431 @default.
- W3136229143 hasAuthorship W3136229143A5070462421 @default.
- W3136229143 hasConcept C104317684 @default.
- W3136229143 hasConcept C118552586 @default.
- W3136229143 hasConcept C134362201 @default.
- W3136229143 hasConcept C142724271 @default.
- W3136229143 hasConcept C15744967 @default.
- W3136229143 hasConcept C159110408 @default.
- W3136229143 hasConcept C185592680 @default.
- W3136229143 hasConcept C194232998 @default.
- W3136229143 hasConcept C2776674806 @default.
- W3136229143 hasConcept C2779134260 @default.
- W3136229143 hasConcept C2779483572 @default.
- W3136229143 hasConcept C2908916198 @default.
- W3136229143 hasConcept C3019398978 @default.
- W3136229143 hasConcept C55493867 @default.
- W3136229143 hasConcept C71924100 @default.
- W3136229143 hasConcept C74909509 @default.
- W3136229143 hasConceptScore W3136229143C104317684 @default.
- W3136229143 hasConceptScore W3136229143C118552586 @default.
- W3136229143 hasConceptScore W3136229143C134362201 @default.
- W3136229143 hasConceptScore W3136229143C142724271 @default.
- W3136229143 hasConceptScore W3136229143C15744967 @default.
- W3136229143 hasConceptScore W3136229143C159110408 @default.
- W3136229143 hasConceptScore W3136229143C185592680 @default.
- W3136229143 hasConceptScore W3136229143C194232998 @default.
- W3136229143 hasConceptScore W3136229143C2776674806 @default.
- W3136229143 hasConceptScore W3136229143C2779134260 @default.
- W3136229143 hasConceptScore W3136229143C2779483572 @default.
- W3136229143 hasConceptScore W3136229143C2908916198 @default.
- W3136229143 hasConceptScore W3136229143C3019398978 @default.
- W3136229143 hasConceptScore W3136229143C55493867 @default.
- W3136229143 hasConceptScore W3136229143C71924100 @default.
- W3136229143 hasConceptScore W3136229143C74909509 @default.
- W3136229143 hasIssue "4" @default.
- W3136229143 hasLocation W31362291431 @default.
- W3136229143 hasOpenAccess W3136229143 @default.
- W3136229143 hasPrimaryLocation W31362291431 @default.
- W3136229143 hasRelatedWork W1966213055 @default.
- W3136229143 hasRelatedWork W2031263872 @default.
- W3136229143 hasRelatedWork W2169522272 @default.
- W3136229143 hasRelatedWork W2369871521 @default.
- W3136229143 hasRelatedWork W2409008804 @default.
- W3136229143 hasRelatedWork W2743628933 @default.
- W3136229143 hasRelatedWork W2975467408 @default.
- W3136229143 hasRelatedWork W3102067457 @default.
- W3136229143 hasRelatedWork W3132601482 @default.
- W3136229143 hasRelatedWork W4247054811 @default.
- W3136229143 hasVolume "29" @default.
- W3136229143 isParatext "false" @default.
- W3136229143 isRetracted "false" @default.
- W3136229143 magId "3136229143" @default.
- W3136229143 workType "article" @default.