Publications by authors named "Peter Khang"
Introduction: In an effort to identify improvement opportunities for earlier dementia detection and care within a large, integrated health care system serving diverse Medicare Advantage (MA) beneficiaries, we examined where, when, and by whom Alzheimer's disease and related dementias (ADRD) diagnoses are recorded as well as downstream health care utilization and life care planning.
Methods: Patients 65 years and older, continuously enrolled in the Kaiser Foundation health plan for at least 2 years, and with a first ADRD diagnosis between January 1, 2015, and December 31, 2018, comprised the incident cohort. Electronic health record data were used to identify site and source of the initial diagnosis (clinic vs hospital-based, provider type), health care utilization in the year before and after diagnosis, and end-of-life care.
The term polypharmacy in older adults is generally used in a pejorative context in the medical literature. Because of its link to geriatric syndromes and disability, the avoidance of polypharmacy is usually recommended in older adults as a strategy to optimize functional status. However, there are many polypharmacy regimens based on high-quality trials that clearly reduce the risk of disability in older adults.
View Article and Find Full Text PDFObjectives: The current evidence base regarding the effectiveness of home-based palliative care (HomePal) on outcomes of importance to multiple stakeholders remains limited. The purpose of this study was to compare end-of-life care in decedents who received HomePal with two cohorts that either received hospice only (HO) or did not receive HomePal or hospice (No HomePal-HO).
Design: Retrospective cohorts from an ongoing study of care transition from hospital to home.
Article Synopsis
- The study investigates how inpatient palliative care (IPC) impacts the quality of end-of-life care and healthcare usage among patients who died between 2012 and 2014 in Kaiser Permanente Southern California.
- Patients who received IPC were more likely to enroll in home-based palliative care or hospice and were less likely to die in hospitals or intensive care units compared to those who did not receive IPC.
- However, those receiving IPC had a higher chance of being rehospitalized and visiting emergency departments, suggesting that increased healthcare utilization may be influenced by existing patient needs rather than the care itself.
Objectives: Examine the association between completion of an outpatient visit with a physician or advanced practice provider (PCP) within 7 days of discharge from a short skilled nursing facility (SNF) stay and 30-day readmission and determine if functional status at discharge moderates visit effectiveness.
Design: Retrospective cohort study.
Setting: Large integrated health care system.
Objective: Explore patterns in patients' disclosures of supplement use and identify provider and patient characteristics associated with disclosures.
Methods: Cross-sectional study of 61 outpatient primary care, integrative medicine, and complementary medicine providers, and 603 of their patients. Primary outcomes were supplement disclosures (based on audio recorded office visits, post-visit patient surveys and medical record abstractions for the day of the visits).