Computerized Physician Order Entry with
Clinical Decision Support in Long-Term Care Facilities: Costs and Benefits
to Stakeholders. S. Subramanian, S. Hoover, B. Gilman, et al.,
Journal of the American Geriatrics Society 55:2007, 1451-1457.
Describes the costs and benefits of computerized physician order entry with
clinical decision support for the various stakeholders involved in long-term
care. These include nurses, physicians, the pharmacy, the laboratory, the
payer, nursing home residents, and the long-term care facility. (AHRQ
08-R004)
Developing a Research Agenda for Assisted
Living. R. Kane, K. Wilson, W. Spector, Gerontologist
47(III):2007, 141-154. Describes an approach to identifying knowledge gaps,
research questions, and methodological issues for assisted living research.
(AHRQ 08-R034)
The Development of a CAHPS® Instrument
for Nursing Home Residents (NHCAHPS). J. Sangl, J. Buchanan, C.
Cosenza, et al., Journal of Aging & Social Policy 19(2):2007,
63-82. Describes the development and testing of a survey instrument to measure
residents' experiences with quality of care and quality of life in nursing
homes and discusses lessons learned during the process. (AHRQ 07-R064)
Do Trends in the Reporting of Quality
Measures on the Nursing Home Compare Web Site Differ by Nursing Home
Characteristics? J. Zinn, W. Spector, L. Hsieh, et al., Gerontologist 45(6): December 2005, 720-730. Examines the
relationship between the first set of quality measures published by the
Centers for Medicare and Medicaid Services on the Nursing Home Compare Web
site and five nursing home structural characteristics: ownership, chain
affiliation, size, occupancy, and hospital-based versus freestanding status.
(AHRQ 06-R019)
Effect on Health Outcomes of a
Community-Based Medication Therapy Management Program for Seniors with
Limited Incomes. S. Smith, D. Catellier, E. Conlisk, et al.,
American Journal of Health-System Pharmacy 63: February 15, 2006,
372-376. Evaluates the effects of a novel, comprehensive, community-based
program that integrates medication therapy management services by pharmacists
with prescription drug assistance for seniors with limited incomes. (AHRQ
06-R036)
Effects of Nursing Home Ownership Type and
Resident Payer Source on Hospitalization for Suspected Pneumonia.
R. Konetzka, W. Spector, T. Shaffer, Medical Care 42(10): October
2004, 1001-1008. Examines the role of proprietary status in the decision to
hospitalize residents with suspected pneumonia, controlling for facility- and
resident-level factors. (AHRQ 05-R002)
Gender Differences in Drug Use and
Expenditures in a Privately Insured Population of Older Adults.
R. Correa-de-Araujo, E. Miller, J. Banthin, et al., Journal of Women's
Health 14(1): January 2005, 73-81. Examines gender differences in use
and expenditures for prescription drugs among Medicare and privately insured
adults aged 65 and over, using data on a nationally representative sample of
prescription drug purchases collected for the Medical Expenditure Panel Survey
Household Component. (AHRQ 05-R019)
Hospitalization and Death Associated with
Potentially Inappropriate Medication Prescriptions Among Elderly Nursing
Home Residents. D. Lau, J. Kasper, D. Potter, et al.,
Archives of Internal Medicine 165: January 2005, 68-74. Discusses the
association of potentially inappropriate medication prescriptions with
subsequent adverse outcomes (hospitalization and death), and provides new
evidence of the importance of improving prescribing practices in the nursing
home setting. (AHRQ 05-R024)
Illness Severity and Propensity to Travel
Along the Urban-Rural Continuum. J. Basu, L. Mobley, Health
& Place, Corrected Proof. Available online, May 12, 2006. Examines
whether the relationship between severity of illness and the propensity to
travel greater distance relative to the norm is uniform across the urban-rural
continuum of geography or over time. Focuses on the elderly in New York State
who have been admitted to a hospital for ambulatory care sensitive conditions.
(AHRQ 06-R077)
Inappropriate Medication Use in the
Elderly. C. Zahn, Journal of the Pharmacy Society of
Wisconsin May/June 2005, 29-33. Discusses the definition,
epidemiology, solutions, and new developments on the issue of inappropriate
medication use in the elderly, including the publication of explicit criteria
for screening. (AHRQ 05-R058)
The Influence of Rural Location on
Utilization of Formal Home Care: The Role of Medicaid. W.
McAuley, W. Spector, J. Nostrand, et al., Gerontologist
44(5):2004, 655-664. Examines the impact of rural-urban residence on formal
home-care utilization among older people, and determines whether and how
Medicaid coverage influences the association between ruralurban location and
risk of formal home-care use. (AHRQ 05-R010)
National Estimates of Medication Use in
Nursing Homes: Findings from the 1997 Medicare Current Beneficiary Survey
and the 1996 Medical Expenditure Survey. J. Doshi, T. Shaffer, B.
Briesacher, Journal of the American Geriatrics Society 53(3): July
2005, 438-443. Provides the first nationwide estimates of medication use in
nursing homes and introduces a new data set for examining drug use in
long-term care facilities. (AHRQ 05-R057)
Nursing Home Spending Patterns in the 1990s:
The Role of Nursing Home Competition and Excess Demand. D.
Mukamel, W. Spector, A. Bajorska, HSR: Health Services Research
40(4): August 2005, 1040-1055. Examines nursing home expenditures on clinical,
hotel, and administrative activities during the 1990s and determines the
association between nursing home competition and excess demand on
expenditures. (AHRQ 05-R068)
Nursing Homes' Response to the Nursing Home
Compare Report Card. D. Mukamel, W. Spector, J. Zinn, et al.,
Journal of Gerontology 62B(4):2007, S218-S225. Examines the initial
reactions of nursing homes to publication of the Nursing Home Compare report
card by the Centers for Medicare & Medicaid Services and evaluates the
impact of the report card on quality improvement activities. (AHRQ
07-R080)
OBRA 1987 and the Quality of Nursing Home
Care. V. Kumar, E. Norton, W. Encinosa, International Journal
of Health Care Finance Economics 6:2006, 49-81. Presents a general
theory of how government regulation of quality of care may affect different
market segments, particularly the nursing home market. (AHRQ 06-R069)
Observed Association Between Antidepressant
Use and Pneumonia Risk Was Confounded by Comorbidity Measures. S.
Hennessy, W. Bilker, C. Leonard, et al., Journal of Clinical
Epidemiology 60:2007, 911-918. Examines the association between
antidepressant use by elderly individuals and their subsequent risk of
hospitalization for pneumonia. (AHRQ 08-R011)
On-Time Quality Improvement for Long-Term
Care. Agency for Healthcare Research and Quality and the
California Healthcare Foundation. The goal of this initiative is to turn daily
documentation into useful information that enhances clinical care planning in
long-term care facilities. A key objective is the reduction of in-house
pressure ulcer rates. Case Studies, May 2007, 3 pp.
Summarizes three case studies from this initiative: implementation of digital
pen technology, importance of daily care documentation, and use of handheld
computers. (AHRQ 07-0058-3) Frequently Asked
Questions, May 2007, 2 pp. Uses a question-and-answer
format to describe the On-Time Quality Improvement for Long-Term Care
initiative and how facilities can participate. (AHRQ 07-0058-2).
Pneumonia in Nursing Home Residents: Factors
Associated with In-Home Care of EverCare Enrollees. T. Rector, W.
Spector, T. Shaffer, et al. Journal of the American Geriatrics
Society 53(3): March 2005, 472-477. Identifies determinants of
whether nursing home residents enrolled in EverCare were admitted to in-home
intensive service days rather than a hospital when they were thought to have
pneumonia. (AHRQ 05-R055)
Potentially Inappropriate Medication
Prescriptions Among Elderly Nursing Home Residents: Their Scope and
Associated Resident and Facility Characteristics. D. Lau, J.
Kasper, D. Potter, et al., Health Services Research 39(5): October
2004, 1257-1276. Finds that, at minimum, 50 percent of all residents aged 65
or older with a nursing home stay of 3 months or longer received at least one
potentially inappropriate medication prescription in 1996. Factors associated
with lower odds of potentially inappropriate medication prescriptions were
fewer medications, residents with communication problems, and being an
accredited nursing home. (AHRQ 05-R022)
Reducing Hospitalizations from Long-Term Care
Settings. R. Konetzka, W. Spector, M. Limcangco, Medical Care
Research and Review 65(1): February 2008, 40-66. Reviews the evidence
from 55 peer-reviewed articles on interventions that potentially reduce
hospitalizations from formal long-term care settings. (AHRQ 08-R020)
Risk Factors Associated with the Occurrence
of Fractures in U.S. Nursing Homes: Resident and Facility Characteristics
and Prescription Medications. W. Spector, T. Shaffer, D. Potter,
et al., Journal of the American Geriatrics Society 55:2007, 327-333.
Uses data from the Medical Expenditure Panel Survey to examine the effects of
resident and facility characteristics and the use of certain prescribed
medicines on the occurrence of fractures among nursing home residents. (AHRQ
07-R047).
Severity of Illness, Race, and Choice of
Local Versus Distant Hospitals Among the Elderly. J. Basu,
Journal of Health Care for the Poor and Underserved 16:2005,
391-405. Examines travel patterns for hospitalization among elderly patients
to address whether there are differences by age and race/ethnicity, and
whether the differences persist even when a severe illness occurs. Focuses on
New York residents in the 65-and-over age group who are hospitalized in New
York or neighboring States. (AHRQ 05-R054)
Suboptimal Prescribing in Elderly
Outpatients: Potentially Harmful Drug-Drug and Drug-Disease
Combinations. C. Zhan, R. Correa-de-Araujo, A. Bierman, et al.,
Journal of the American Geriatrics Society 53(2): February 2005,
262-267. Measures incidences of six drug-drug combinations and 50 drug-disease
combinations that can place elderly patients at risk for adverse events
according to expert consensus panels. (AHRQ 05-R041)
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