Effects of Home-Based Primary Care on Hospital Use for High-Need Medicare Patients: an Observational Study.

Background: High-need, high-cost Medicare patients can have difficulties accessing office-based primary care. Home-based primary care (HBPC) can reduce access barriers and allow a clinician to obtain valuable information not obtained during office visit, possibly leading to reductions in hospital use.

Objective: To determine whether HBPC for high-need, high-cost patients reduces hospitalizations and Medicare inpatient expenditures.

The Adverse Effects of the COVID-19 Pandemic on Nursing Home Resident Well-Being.

Objective: Quantify the effects of the COVID-19 pandemic on nursing home resident well-being.

Design: Quantitative analysis of resident-level assessment data.

Setting And Participants: Long-stay residents living in Connecticut nursing homes.

Using Qualitative Methods to Create a Home Health Web Application User Interface for Patients with Low Computer Proficiency.

Introduction: Despite the investment in public reporting for a number of healthcare settings, evidence indicates that consumers do not routinely use available data to select providers. This suggests that existing reports do not adequately incorporate recommendations for consumer-facing reports or web applications.

Methods: Healthcentric Advisors and Brown University undertook a multi-phased approach to create a consumer-facing home health web application in Rhode Island.

Long-Term Services and Supports for Older Adults: A Review of Home and Community-Based Services Versus Institutional Care.

Despite a shift from institutional services toward more home and community-based services (HCBS) for older adults who need long-term services and supports (LTSS), the effects of HCBS have yet to be adequately synthesized in the literature. This review of literature from 1995 to 2012 compares the outcome trajectories of older adults served through HCBS (including assisted living [AL]) and in nursing homes (NHs) for physical function, cognition, mental health, mortality, use of acute care, and associated harms (e.g.

The Minimum Data Set 3.0 Cognitive Function Scale.

Background: The Minimum Data Set (MDS) 3.0 introduced the Brief Interview for Mental Status (BIMS), a short performance-based cognitive screener for nursing home (NH) residents. Not all residents are able to complete the BIMS and are consequently assessed by staff.

Functional Improvement Among Short-Stay Nursing Home Residents in the MDS 3.0.

Objectives: To examine the completeness of the activities of daily living (ADL) items on admission and discharge assessments and the improvement in ADL performance among short-stay residents in the newly adopted Minimum Data Set (MDS) 3.0.

Design: Retrospective analysis of MDS admission and discharge assessments.

A qualitative study of choosing home health care after hospitalization: the unintended consequences of 'patient choice' requirements.

Background: Although hospitals are increasingly held accountable for patients' post-discharge outcomes, giving them incentive to help patients choose high-performing home health agencies, little is known about how quality reports inform decision making.

Objective: We aimed to learn how quality reports are used when choosing home care in one northeast state (Rhode Island) .

Design: The study consisted of focus groups with home health consumers and structured interviews with hospital case managers.

Finding Gertrude: The resident's voice in Minimum Data Set 3.0.

Purpose: The new Minimum Data Set 3.0 was designed to improve the assessment process by requiring nursing home (NH) staff to attempt to interview residents with scripted questions to assess subjective states such as pain, mood, and cognitive functioning. Although the case has been made that resident self-report is important, it is unknown whether facilities are doing so in practice.

The association between long-term care setting and potentially preventable hospitalizations among older dual eligibles.

Objective: To compare the probability of experiencing a potentially preventable hospitalization (PPH) between older dual eligible Medicaid home and community-based service (HCBS) users and nursing home residents.

Data Sources: Three years of Medicaid and Medicare claims data (2003-2005) from seven states, linked to area characteristics from the Area Resource File.

Study Design: A primary diagnosis of an ambulatory care sensitive condition on the inpatient hospital claim was used to identify PPHs.

Hospitalization of elderly Medicaid long-term care users who transition from nursing homes.

Objectives: To compare hospitalizations of dually eligible older adults who had an extended Medicaid nursing home (NH) stay and transitioned out to receive Medicaid home- and community-based services (HCBS) with hospitalizations of those who remained in the NH.

Design: Retrospective matched cohort study using Medicaid and Medicare claims and NH assessment data.

Setting: Community (receiving Medicaid HCBS) or NH.

Does home- and community-based care affect nursing home use?

A study was conducted to assess change in numbers, expenditures, and case mix of nursing home residents as Medicaid investment in home- and community-based services (HCBS) 1915(c) waivers increased in seven states. The seven states provided Medicaid expenditure and utilization data from 2001 to 2005, including waiver and state plan utilization. The Minimum Data Set was used for nursing home residents.

Effect of long-term care use on Medicare and Medicaid expenditures for dual eligible and non-dual eligible elderly beneficiaries.

Background: Dual eligible Medicare and Medicaid beneficiaries consume disproportionate shares of both programs.

Objectives: To compare Medicare and Medicaid expenditures of elderly dual eligible beneficiaries with non-dual eligible beneficiaries based on their long-term care (LTC) use.

Research Design: Secondary analysis of linked MAX and Medicare data in seven states.

Diagnosed prevalence and health care expenditures of mental health disorders among dual eligible older people.

Purpose: Little is known about mental health disorders (MHDs) and their associated health care expenditures for the dual eligible elders across long-term care (LTC) settings. We estimated the 12-month diagnosed prevalence of MHDs among dual eligible older adults in LTC and non-LTC settings and calculated the average incremental effect of MHDs on medical care, LTC, and prescription drug expenditures across LTC settings.

Methods: Participants were fee-for-service dual eligible elderly beneficiaries from 7 states.

Whole-body vibration therapy for osteoporosis: state of the science.

Clinical guidelines for osteoporosis recommend dietary and pharmacologic interventions and weight-bearing exercise to prevent bone fractures. These interventions sometimes have low adherence and can cause adverse effects. A proposed alternative or adjunctive treatment is whole-body vibration therapy (WBV), in which energy produced by a forced oscillation is transferred to an individual from a mechanical vibration platform.