Our health and social systems are ill-equipped to meet the needs of the growing population of older adults with chronic conditions and their family caregivers. We are living longer, but are we living better?
As the largest single source of health care spending, hospitals have drawn considerable attention from policymakers. Efforts to reduce costs have led to decreased lengths of hospital stays, but far less attention has been paid to where those patients go immediately after discharge. Medicare payment reforms implemented in the wake of the Affordable Care Act, such as hospital readmissions penalties and bundled payments, have made hospitals accountable for care beyond their walls, including institutional post-acute care.
‘Sharing things with people that I don’t even know’: Help-seeking for Psychological Symptoms in Injured Black Men in Philadelphia
Abstract [from journal]
Objectives: Psychological distress is common in survivors of traumatic injury, yet across United States’ trauma systems, it is rare that standard injury care integrates psychological evaluation and professional...
Surgical patients age 65 and over with Alzheimer’s disease and related dementias (ADRD) were more likely to die within 30 days of admission and to die after a complication than those without ADRD. Having better-educated nurses in the hospital improved the likelihood of good outcomes for all surgical patients, but had a much greater effect in individuals with ADRD. Specifically, a 10% increase in the proportion of nurses with a Bachelor of Science in Nursing (BSN) degree or higher was associated with 10% lower odds of death and 10% lower odds of dying after a complication for surgical patients with ADRD.
A new study in Health Services Research from Penn MSHP alumna Kristin Rising, Penn LDI Adjunct Senior Fellow Brendan Carr, and their colleagues at Jefferson University quantifies something that seems like common sense – patients don’t stick to just one health system for emergency care.
Practice transformation and payment reform are defining features of contemporary health policy debates. The story goes like this: new provider organizations, such as Accountable Care Organizations (ACOs) are transforming care delivery from fragmented and volume driven to integrated and optimized for quality; meanwhile, innovative payment models, such as bundled payments and risk-based contracting, herald a national transition from fee-for-service (FFS) to value-based payments.
The Association Between Obesity and Disability in Survivors of Joint Surgery: Analysis of the Health and Retirement Study
Abstract [from journal]
Obesity is associated with osteoarthritis and the need for joint surgery. Obese patients who undergo joint surgery may have a higher risk of morbidity compared with normal or overweight patients but less is known about their risk of postoperative disability. The primary objective of our study was to determine the association between obesity and the development of new dependence in activities of daily living within 2 years after joint surgery.
Exploring Opportunities to Prevent Cirrhosis Admissions in the Emergency Department: A Multicenter Multidisciplinary Survey
In Hepatology Communications, Shazia Mehmood Siddique and colleagues investigate nonmedical factors that influence inpatient admission for patients with cirrhosis who present to the emergency department. They also explore provider perspectives on patients presenting to the emergency department with low-acuity conditions, such as ascites and hepatic encephalopathy. The authors survey emergency medicine and hepatology providers, including attending physicians, house staff, and advanced practitioners, in four liver transplant centers.
From the 186 responses analyzed, they...