Comparing Aging in Place to Home Health Care: Impact of Nurse Care Coordination On Utilization and Costs.

The goal of this study was to compare utilization and cost outcomes of patients who received long-term care coordination in an Aging in Place program to patients who received care coordination as a routine service in home health care. This research offered the unique opportunity to compare two groups of patients who received services from a single home health care agency, using the same electronic health record, to identify the impact of long-term and routine care coordination on utilization and costs to Medicare and Medicaid programs. This study supports that long-term care coordination supplied by nurses outside of a primary medical home can positively influence functional, cognitive, and health care utilization for frail older people.

Cost analysis of a home-based nurse care coordination program.

Objectives: To determine whether a home-based care coordination program focused on medication self-management would affect the cost of care to the Medicare program and whether the addition of technology, a medication-dispensing machine, would further reduce cost.

Design: Randomized, controlled, three-arm longitudinal study.

Setting: Participant homes in a large Midwestern urban area.

Quantifying care coordination using natural language processing and domain-specific ontology.

Objective: This research identifies specific care coordination activities used by Aging in Place (AIP) nurse care coordinators and home healthcare (HHC) nurses when coordinating care for older community-dwelling adults and suggests a method to quantify care coordination.

Methods: A care coordination ontology was built based on activities extracted from 11,038 notes labeled with the Omaha Case management category. From the parsed narrative notes of every patient, we mapped the extracted activities to the ontology, from which we computed problem profiles and quantified care coordination for all patients.

Medication regimens of frail older adults after discharge from home healthcare.

The purpose of this study was to examine the number and types of discrepancy errors present after discharge from home healthcare in older adults at risk for medication management problems following an episode of home healthcare. More than half of the 414 participants had at least one medication discrepancy error (53.2%, n = 219) with the participant's omission of a prescribed medication (n = 118, 30.

Nurse care coordination and technology effects on health status of frail older adults via enhanced self-management of medication: randomized clinical trial to test efficacy.

Background: Self-management of complex medication regimens for chronic illness is challenging for many older adults.

Objectives: The purpose of this study was to evaluate health status outcomes of frail older adults receiving a home-based support program that emphasized self-management of medications using both care coordination and technology.

Design: This study used a randomized controlled trial with three arms and longitudinal outcome measurement.

Predictors of nonpharmacological and pharmacological treatments stopped and started among nursing home residents with dementia.

The purpose of this study was to describe the nonpharmacological and pharmacological treatments stopped and started over 6 weeks among a sample of nursing home residents with moderate to severe dementia and to identify nurse and resident factors associated with starting new and stopping ineffective/unnecessary nonpharmacological and pharmacological treatments. One hundred thirty-four nursing home residents with dementia and 39 nurses from 12 nursing homes in the Midwest participated in this study. Resident and nursing process data were collected on daily tracking forms completed by the primary nurse over a 6-week period.

Aging in place versus nursing home care: comparison of costs to Medicare and Medicaid.

The objective of this study was to compare the community-based, long-term care program called Aging in Place (AIP) and nursing home care, in terms of cost to the Medicare and Medicaid programs. A retrospective cohort design was used in this study of 39 nursing home residents in the Midwest who were matched with 39 AIP participants. The AIP program consisted of a combination of Medicare home health, Medicaid home and community-based services (HCBS), and intensive nurse care coordination.

Length of stay and charges associated with health care-acquired bloodstream infections.

Background: Although many studies have examined outcomes of health care-associated bloodstream infections (HCABSIs), population-based estimates of length of stay (LOS) and costs have seldom been reported.

Objectives: Our objective was to generate US national estimates of LOS and costs associated with HCABSIs using the 2003 National Inpatient Sample (NIS).

Methods: This study utilized a matched case-control design to estimate LOS and costs associated with HCABSIs based on the 2003 (NIS).

The impact of Prenatal Care Coordination on birth outcomes.

Objective: To measure the impact of a Medicaid benefit called Prenatal Care Coordination (PNCC) on healthy birth outcomes.

Design: A cross-sectional design was used to compare the birth outcomes of infants born to women who received Medicaid and PNCC services to the birth outcomes of infants born to women who received Medicaid but did not receive PNCC services.

Setting: Services were provided in community based settings in Wisconsin.

The relationship of community-based nurse care coordination to costs in the Medicare and Medicaid programs.

The purpose of this evaluation was to study the relationship of nurse care coordination (NCC) to the costs of Medicare and Medicaid in a community-based care program called Missouri Care Options (MCO). A retrospective cohort design was used comparing 57 MCO clients with NCC to 80 MCO clients without NCC. Total cost was measured using Medicare and Medicaid claims databases.

Incidence of and risk factors for nosocomial bloodstream infections in adults in the United States, 2003.

Background: Although many studies have examined nosocomial bloodstream infection (BSI), US national estimates of incidence and case-fatality rates have seldom been reported.

Objective: The purposes of this study were to generate US national estimates of the incidence and severity of nosocomial BSI and to identify risk factors for nosocomial BSI among adults hospitalized in the United States on the basis of a national probability sample.

Methods: This cross-sectional study used the US Nationwide Inpatient Sample for the year 2003 to estimate the incidence and case-fatality rate associated with nosocomial BSI in the total US population.

Severe fatigue and depressive symptoms in lower-income urban postpartum women.

The purpose of this study was to identify whether severe postpartum fatigue at 1 and 3 months postpartum was associated with depressive symptomatology at 6 months in lower-income urban women. A convenience sample of 43 lower-income postpartum women completed the Modified Fatigue Symptoms Checklist and Edinburgh Postpartum Depression scale at 1, 3, and 6 months postpartum. Participants who were severely fatigued at both 1 and 3 months postpartum were significantly more likely to exhibit depressive symptomatology at 6 months.