The Changing Landscape of Post-acute and Rehabilitative Care

Virtually every society worldwide is seeing a growth in the number and proportion of older persons in its population. As growth occurs, medical care resources must be increasingly dedicated to prevention, detection, and management of chronic diseases such as congestive heart failure, and to problems of aging such as frailty and multimorbidity. As part of this process, after-hospital care has become an increasingly important component of health care systems and health care costs. At least 5 key forces have been at play:
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Tags: Post-acute Care and Rehabilitation Source Type: research

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Type 2 diabetes mellitus and congestive heart failure are highly prevalent diseases with significant morbidity and mortality. These 2 diseases often occur concurrently because of shared risk factors such as coronary artery disease, and also because type 2 diabetes mellitus has direct cardiotoxic effects. Type 2 diabetes mellitus likely has a causative role in the development and prognosis of patients with heart failure. Optimal prevention and treatment of type 2 diabetes mellitus and heart failure likely involves identifying and treating their shared pathophysiologic features.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
DISCUSSION: ED utilization after outpatient hand surgery is low, with postoperative pain being the most common cause of an ED visit at all time points. Nearly 98% of patients presenting to the ED for postoperative pain are subsequently discharged home. LEVEL OF EVIDENCE: Level III, Retrospective Cohort. PMID: 31714419 [PubMed - as supplied by publisher]
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
Importance: Hospitals that serve poorer populations have higher readmission rates. It is unknown whether these hospitals effectively lowered readmission rates in response to the Hospital Readmissions Reduction Program (HRRP). Objective: To compare pre-post differences in readmission rates among hospitals with different proportion of dual-eligible patients both generally and among the most highly penalized (ie, low performing) hospitals. Design: Retrospective cohort study using piecewise linear model with estimated hospital-level risk-standardized readmission rates (RSRRs) as the dependent variable and a change poin...
Source: Medical Care - Category: Health Management Tags: Original Articles Source Type: research
Publication date: Available online 13 November 2019Source: Pharmacological ResearchAuthor(s): Juthipong Benjanuwattra, Natthaphat Siri-Angkul, Siriporn C. Chattipakorn, Nipon C. hattipakornAbstractThe cancer burden on health and socioeconomics remains exceedingly high, with more than ten million new cases reported worldwide in 2018. The financial cost of managing cancer patients has great economic impact on both an individual and societal levels. Currently, many chemotherapeutic agents are available to treat various malignancies. One of these agents is doxorubicin, which was isolated from Streptomyces peucetius in the 1960...
Source: Pharmacological Research - Category: Drugs & Pharmacology Source Type: research
Conclusion: An interactive cost-benefit analyses provides insights regarding the financial implications of a clinical strategy that implements predictive analytics. PMID: 30815149 [PubMed - indexed for MEDLINE]
Source: AMIA Annual Symposium Proceedings - Category: Bioinformatics Tags: AMIA Annu Symp Proc Source Type: research
Authors: Yatomi A, Mori S, Kawauchi H, Shono A, Shimoyama S, Tanaka H, Okano T, Inoue T, Jimbo N, Morinobu A, Hirata KI Abstract A 72-year-old woman was referred to our institution with decompensated congestive heart failure owing to subacute severe aortic regurgitation and mitral regurgitation. Her blood sample tested positive for myeloperoxidase anti-neutrophil cytoplasmic antibody (ANCA). Cardiac computed tomography revealed abnormal thickening and shortening of the aortic valvar leaflets as well as wall thickening of the sinuses of Valsalva. Based on the diagnosis of ANCA-associated vasculitis, predominantly in...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
ConclusionsIn patients with RA, the relative increase in etanercept-associated risk of experiencing congestive heart failure, serious infection, non-melanoma skin cancer, or interstitial lung disease was similar between elderly and non-elderly.
Source: Drugs and Aging - Category: Geriatrics Source Type: research
ConclusionsA history of MST is common among older women veterans and associated with a range of medical and mental health diagnoses. These findings call attention to the need for additional research in this understudied population, and the importance of trauma-informed care approaches for women across the lifespan.
Source: Journal of General Internal Medicine - Category: Internal Medicine Source Type: research
Publication date: Available online 9 November 2019Source: Multiple Sclerosis and Related DisordersAuthor(s): Elizabeth S. Gromisch, Aaron P. Turner, Steven L. Leipertz, John Beauvais, Jodie K. HaselkornAbstractBackground: Missed appointments can have negative effects on several facets of healthcare, including disruption of services, worse patient health outcomes, and increased costs. The influence of demographic and clinical factors on missed appointments has been studied in a number of chronic conditions, but not yet in multiple sclerosis (MS). Engagement in healthcare services is a particular concern with this population...
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
Publication date: Available online 9 November 2019Source: The Annals of Thoracic SurgeryAuthor(s): Zaid M. Abdelsattar, Elizabeth Habermann, Bijan J. Borah, James P. Moriarty, Ricardo L. Rojas, Shanda H. BlackmonAbstractBACKGROUNDData on failure to rescue (FTR) after esophagectomy are sparse. We sought to better understand the patient factors associated with FTR, and assessed whether FTR is associated with hospital volume.METHODSWe identified all patients undergoing esophagectomy between 2010 and 2014 from the AHRQ Nationwide Readmission Database. We defined FTR as mortality after a major complication. Multiple logistic re...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
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