Discharge Planning for Hospitalized Older Veterans PDF Download
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Author: Daniel E. Rodell
Publisher:
ISBN:
Category : Military hospitals
Languages : en
Pages : 274
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Book Description
Author: Daniel E. Rodell
Publisher:
ISBN:
Category : Military hospitals
Languages : en
Pages : 274
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Book Description
Author: Stuart Bryson Smith
Publisher:
ISBN:
Category : Mentally ill
Languages : en
Pages : 100
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Book Description
Author: Gladys Miriam Collier
Publisher:
ISBN:
Category : Veterans
Languages : en
Pages : 102
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Book Description
Author: Barbara Stover Gingerich
Publisher: Jones & Bartlett Learning
ISBN: 9780834205727
Category : Health & Fitness
Languages : en
Pages : 274
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Book Description
Discharge Planning for Home Health Care is a comprehensive, step-by-step guide to assessing the needs of patients and establishing a coordinated hospital-to-home discharge plan. The referral format and assessment tools provide the user with an organized and systematic approach for the transition of the patient through the continuum of care. This comprehensive resource is based on current reimbursement and regulatory issues and contains over 150 tools for easy application to a broad spectrum of health care settings.
Author:
Publisher:
ISBN:
Category : Veterans
Languages : en
Pages : 12
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Book Description
Author: Heather Young
Publisher:
ISBN:
Category :
Languages : en
Pages : 81
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Book Description
Author: Sarah H. Harney
Publisher:
ISBN:
Category : Hospitals
Languages : en
Pages : 108
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Book Description
Author: Sarita Harriet Silverman
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
Author: Eleanor McClelland
Publisher: Saunders
ISBN:
Category : Medical
Languages : en
Pages : 290
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Book Description
Author: Lianlian Kim
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
With the aging population, the number of older Americans with dementia is expected to grow rapidly. Patients with dementia are reported to have higher health care utilization and cost compared to those without dementia, or patients with heart disease and cancer. Although dementia is a complex neuropsychiatric illness often accompanied by other medical comorbidities, most care for patients with dementia is provided within primary care. Continuity of care (COC) has been regarded a core attribute of primary care. Recent healthcare reforms promote COC through the Patient Protection and Affordable Care Act's Patient-Centered Medical Home, accountable care organization, and Veterans Health Administration (VHA) Patient-Aligned Care Team (PACT). This dissertation aims to examine the causal impact of continuity of care on health care utilization and cost among community-dwelling older veterans living with dementia. This study uses VHA (enrollment, inpatient and outpatient records, purchased care claims) and Medicare (enrollment and all claims) data linked at the veteran level in fiscal year (FY) 2014-2015 to comprehensively measure COC, health care utilization and cost for veterans. The study cohort is community-dwelling veterans with dementia aged 66 and older and enrolled in Traditional Medicare. This study has three specific aims: (1) to determine the impact of COC on health care cost; (2) to determine the impact of COC on hospitalization; and (3) to determine the impact of COC on successful discharge to community after index hospitalization among community-dwelling older veterans with dementia. COC is measured by the Bice-Boxerman Continuity of Care (BBC) index on a 0-1 scale which measures the dispersion of the veteran's outpatient visits across all primary care providers and dementia-related specialists. This study uses a linear model of health care cost and a probit model of hospitalization and successful community discharge after hospitalization in FY 2015 explained by COC and other covariates (socio-demographics, socio-economic status, risk factors and market characteristics) in FY 2014. An instrumental variable approach is applied to address the endogeneity of COC and health care utilization and cost. The instrument is whether veteran changes residence by more than 10 miles in FY 2014. Results show that better COC results in lower total VHA and Medicare cost; and the mechanism can be explained by higher non-institutional medical and social long-term care cost (e.g. home-based primary care and adult day health care) and lower institutional cost (i.e. acute inpatient, emergency department, and nursing home). Better COC results in less acute hospitalizations, and this effect primarily comes from the reduction in hospitalization for neuro-psychiatric diseases/disorders but not other hospitalization reasons or potentially preventable hospitalization. Better COC results in higher probability of successful community discharge following hospitalization. In conclusion, this dissertation finds that better COC results in lower total health care cost, less hospitalization and greater probability of successful community discharge after hospitalization among community-dwelling older veterans living with dementia. These findings support the important role of COC in health care systems and thus supporting efforts to improve COC as a means to reducing health care cost, curbing hospitalization and increasing successful community discharge after hospitalization among older adults with dementia.
