[Show abstract][Hide abstract] ABSTRACT: The risk scoring system was tested for predictive validity in both cohorts. Patients at different risk levels were com- pared for loss of function in activities of daily living (ADLs) at discharge and three months later, as well as for recovery of function in ADLs and institutionalization at three months after discharge. The rates of decline in ability to perform ADLs at discharge in the low-, interme- diate- and high-risk groups were similar in both cohorts: 17%, 28%, and 56% in the development cohort and 19%, 31%, and 55% in the validation cohort. Patients in the high-risk groups were three times more likely to expe- rience decreases in their abilities to perform ADLs than those in the low-risk groups; they were also more likely to be discharged to a nursing home. The developers of the Hospital Admission Risk Profile (HARP) advocate more research to permit iden- tification of functional status and risk for decline across the care continuum. 1
[Show abstract][Hide abstract] ABSTRACT: This chapter has presented an overview of research and evidence-based practices for elderly care during hospitalization to prevent functional decline. A number of other chapters in this book further address related areas, such as averting patient falls, preventing pressure ulcers, symptom management, and other aspects of care for the hospitalized elder. Continued research and dissemination of best practices will lead to additional strategies that nurses can use to improve the quality of health care and outcomes for hospitalized elders. Assessment of function and targeting interventions during hospitalization are critically important to acute care of older adults.71 The impact of functional decline on resource utilization and health care costs may further reinforce the need to assess and intervene to prevent functional decline.72 Additional research on factors influencing functional decline will also provide information for nurses to present to administrators to develop programs to identify and mitigate functional decline in the hospitalized elderly.
Patient Safety and Quality: An Evidence-Based Handbook for Nurses, Edited by Ronda G Hughes, 01/2008: chapter Chapter 11; Agency for Healthcare Research and Quality (US).
[Show abstract][Hide abstract] ABSTRACT: Abstract The expectation that aging leads to a progressive deterioration of biological functions leading to higher healthcare costs is known as the healthcare cost creep due to age creep phenomenon. The authors empirically test the validity of this phenomenon in the context of hospitalization costs based on more than 8 million hospital inpatient records from 1,056 hospitals in the United States. The results question the existence of cost creep due to age creep after the age of 65 years as far as average hospitalization costs are concerned. The authors discuss implications for potential knowledge transfer for cost minimization and medical tourism.
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