The increased needs of patients in nursing homes and patients receiving home health care

The New England Journal of Medicine
P W Shaughnessy, A M Kramer

Abstract

To evaluate the effects of Medicare's prospective payment system and Medicaid's preadmission regulations on long-term care, we constructed clinical profiles in 1982 and 1986 of about 500 randomly selected patients from each of three types of facilities: nursing homes with relatively high proportions of Medicare patients (high-Medicare nursing homes; n = 23), traditional nursing homes (n = 19), and home health agencies (n = 18). Data were obtained directly from the care givers on the medical problems, problems requiring skilled nursing, and functional problems of these representative patients from 12 states. For Medicare patients in high-Medicare nursing homes, the prevalence of medical problems and problems requiring skilled nursing increased substantially, whereas the prevalence of functional problems remained relatively unchanged. For example, from 1982 to 1986 there was a marked increase in the frequency of tube feedings (21 to 29 percent), oxygen use (6 to 14 percent), urinary tract infection (7 to 13 percent), and diastolic hypertension (1 to 10 percent), but not difficulty in eating (48 to 51 percent) or speaking (28 to 29 percent). In contrast, in traditional nursing homes there was an increase in the prevalence of funct...Continue Reading

References

Sep 10, 1987·The New England Journal of Medicine·S F Jencks, A Dobson
Nov 24, 1988·The New England Journal of Medicine·J F FitzgeraldR S Dittus
Nov 24, 1988·The New England Journal of Medicine·B C Vladeck
Oct 1, 1987·The New England Journal of Medicine·J FederS Zuckerman
Apr 3, 1986·The New England Journal of Medicine·M J Koren
Mar 28, 1985·The New England Journal of Medicine·J W Rowe
May 23, 1985·The New England Journal of Medicine·R A Kane, R L Kane
Nov 1, 1984·The New England Journal of Medicine·L H Aiken, K D Bays
Dec 27, 1984·The New England Journal of Medicine·L Z RubensteinR L Kane
Nov 15, 1984·The New England Journal of Medicine·G S Omenn, D A Conrad
Dec 20, 1984·The New England Journal of Medicine·H L Smits, R E Watson

❮ Previous
Next ❯

Citations

May 1, 1992·Journal of General Internal Medicine·P Starer, L S Libow
Jun 12, 2009·Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz·U Heudorf, D Schulte
Dec 29, 2000·Comprehensive Therapy·R R Muder
Jan 1, 1996·Patient Education and Counseling·P S HoutsJ A Bucher
Aug 8, 2002·Journal of the American Geriatrics Society·Peter W ShaughnessyKaren Engle
Feb 28, 1991·The New England Journal of Medicine·P Kemper, C M Murtaugh
Aug 1, 1996·The New England Journal of Medicine·H G WelchW P Welch
May 15, 2002·Journal of Palliative Medicine·Susan C Miller, Vince N T Mor
Apr 30, 2005·Journal of Palliative Medicine·S C MillerA C Petrisek
Sep 1, 1990·Special Care in Dentistry : Official Publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry·K Shay
Oct 16, 2002·American Journal of Respiratory and Critical Care Medicine·Ali A El-SolhJoan Davies
Jan 1, 1994·Journal of Community Health Nursing·D F Mahoney, R Shippee-Rice
Dec 8, 1997·Home Health Care Services Quarterly·C P Thomas, S M Payne
Oct 28, 1999·Home Health Care Services Quarterly·C E WoodsonR Slavensky
Aug 29, 2003·Journal of Health & Social Policy·James H Swan, Ruth B Pickard
Mar 19, 2005·Journal of Health & Social Policy·Charlene HarringtonNancy Miller
Jul 31, 2004·American Journal of Public Health·Debra SalibaRaynard S Kington
Sep 1, 2010·Disaster Medicine and Public Health Preparedness·David DosaVincent Mor
Jul 17, 2012·Journal of the American Medical Directors Association·Debra Saliba, Joan Buchanan
Jun 7, 2011·Clinics in Geriatric Medicine·S Liliana OakesDavid Espino
Jul 14, 2010·The American Journal of Geriatric Pharmacotherapy·Daniel J CrespinRichard A Hansen
Aug 1, 1996·Journal of Gerontological Nursing·J Johnson-Pawlson, D L Infeld
Dec 17, 2008·Journal of the American Medical Directors Association·David M DosaVincent Mor
Mar 29, 2002·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Angelica G Belasco, Ricardo Sesso
Dec 12, 2007·The Milbank Quarterly·David C Grabowski
Apr 20, 2010·Journal of the American Geriatrics Society·Xinzhi ZhangAnn Albright
Dec 1, 1995·Archives of Physical Medicine and Rehabilitation·W J Haffey, J H Welsh
Apr 1, 1992·Journal of the American Geriatrics Society·M Gordon
Jul 1, 1991·Journal of the American Geriatrics Society·R Lavizzo-MoureyL Taylor
Aug 1, 1992·Journal of the American Geriatrics Society·N Bergstrom, B Braden
Mar 1, 1996·Journal of the American Geriatrics Society·R L KaneM Moskowitz
Jan 1, 1993·Journal of the American Geriatrics Society·A L SiuH Morgenstern
May 1, 1996·Journal of the American Geriatrics Society·R L KaneJ Sangl
Jul 1, 1994·Journal of the American Geriatrics Society·J R Burton
Oct 1, 1994·Journal of the American Geriatrics Society·R FelderM Reveal
Dec 16, 1998·Journal of the American Geriatrics Society·R L KaneM Moskowitz
Feb 22, 2000·Journal of the American Geriatrics Society·D SalibaL Rubenstein
Feb 1, 1993·Journal of the American Geriatrics Society·B BernardiniA Guaita
Jan 1, 1991·International Journal of Health Services : Planning, Administration, Evaluation·M Holstein, M Minkler
Apr 1, 1995·Research in Nursing & Health·P A PrescottM Griggs
Nov 10, 2016·Ciência & saúde coletiva·Laércio Almeida de MeloKenio Costa de Lima
Sep 1, 1995·Medical Care Research and Review : MCRR·W E AaronsonM D Rosko
Apr 14, 2000·Clinical Rehabilitation·R C Chan
Jun 1, 1996·Medical Care Research and Review : MCRR·N G Castle, V Mor

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.