A prediction rule for the use of postdischarge medical services

Fairchild, David G.; Hickey, Mairead L.; Cook, E. Francis; McCarthy, Rita; Rossi, Laura; Timmons, Samantha C.; Mangione, Carol M.; Lee, Thomas H.

doi:10.1046/j.1525-1497.1998.00025.x

Cited by 23 publications

(23 citation statements)

References 26 publications

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“…In addition, this association showed a dose-response with the increase in odds of increasing dependence increased gradually with increasing age. In the elderly, patient-reported functional limitation predicts mortality 22 , post-discharge medical services usage 23 , and nursing home placement 24 . These functional limitations were seen in a third of all patients at 2- and 5-years after primary THA, which indicates a significant burden of disability in these elderly patients after primary THA.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Activity Limitation and Dependence on Walking Aids After Primary Total Hip Arthroplasty

Singh

Lewallen

2010

J American Geriatrics Society

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OBJECTIVES To study function outcomes and their predictors after primary total hip arthroplasty (THA). DESIGN Prospective Cohort Study SETTING Single Institution PARTICIPANTS All patients who underwent primary THA at our institution between 1993 and 2005 and were alive at the time of follow-up. MEASUREMENTS Whether sex, age, body mass index (BMI), comorbidity, anxiety, and depression predict moderate to severe activity limitation (limitation in ≥3 activities) and complete dependence on waling aids 2 and 5 years after primary THA was examined. Multivariable logistic regression adjusted for operative diagnosis, American Society of Anesthesiologists score, implant type, and distance from medical center. RESULTS At 2 years, 30.3% of participants reported moderate to severe activity limitation; at 5 years, 35% of participants reported moderate to severe activity limitation. Significant predictors of moderate to severe activity limitations at 2-year follow-up were female sex (odds ratio (OR)=1.2, 95% confidence interval (CI)=1.1–1.4), aged 71 to 80 (OR=2.0, 95% CI=1.6–2.5), aged 80 and older (OR=4.5, 95% CI=3.4–6.0), depression (OR=2.1, 95% CI=1.6–2.7), and BMI greater than 30. At 5-year follow-up, significant predictors were aged 71 to 80 (OR=1.7, 95% CI=1.3–2.2), older than 80 (OR=4.3, 95% CI=2.8–6.6), depression (OR=2.3, 95% CI=1.6–3.4), and BMI greater than 30.Significant predictors of complete dependence on walking aids at 2 years were female sex (OR=2.0, 95% CI=1.4–2.7), aged 71 to 80 (OR=2.4, 95% CI=1.4–4.2), older than 80 (OR=11.4, 95% CI=6.0–21.9), higher Deyo-Charlson score (OR=1.5, 95% CI=(1.1–1.2) for 5-point increase, depression (OR=2.0, 95% CI=1.2–3.4), and BMI greater than 35. Each of these factors also significantly predicted complete dependence on walking at 5-year follow-up, with similar odds ratios, except that BMI 30–34.9 was not significantly associated. CONCLUSION Higher BMI, depression, older age, and female sex predict activity limitation and complete dependence on walking aids 2 and 5 years after primary THA.

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Section: Discussionmentioning

confidence: 99%

Predictors of Activity Limitation and Dependence on Walking Aids After Primary Total Hip Arthroplasty

Singh

Lewallen

2010

J American Geriatrics Society

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“…Using the National Long Term Care Survey, Murtaugh and Litke (2002) found a prevalence rate of 24 percent for potential transition-related problems over a two-year time period, defined as emergency department visits, hospital admissions, and returns to an institutional setting following discharge to the community. Fairchild and colleagues developed a predictive index designed to identify patients who may require the use of postdischarge medical services; however, the index was constructed using a single study population (i.e., patients hospitalized at an urban teaching hospital) and relied on predictor variables that are not routinely available in the hospital setting (Fairchild et al 1998). Prior studies have demonstrated that indices that utilize administrative or self-reported data have similar rates of predictive accuracy (Coleman et al 1998;Roblin et al 1999;Fethke, Smith, and Johnson 1986;Anderson and Steinberg 1985;Mukamel et al 1997;Roos et al 1988).…”

Section: Discussionmentioning

confidence: 99%

Posthospital Care Transitions: Patterns, Complications, and Risk Identification

Coleman

Min²,

Chomiak³

et al. 2004

Health Services Research

367

289

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Posthospital care transitions are common among Medicare beneficiaries and patterns of care vary greatly. A significant number of beneficiaries experienced complicated care transitions-a finding that has important implications for both patient safety and cost-containment efforts. Patients at risk for complicated care patterns can be identified using data available at the time of hospital discharge.

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“…In addition, patient-centered HRQoL measures are used as global assessments of functional status and overall perceptions of health [2], and have been proposed as measures of disease severity. For example, the SF-36 predicts mortality in patients following coronary artery bypass graft surgery [3], successful treatment of chronic low back pain [4], and postdischarge medical services [5]. The SF-36 also has been used to predict 1-year total health plan expenses in a health maintenance organization [6,7].…”

Section: Introductionmentioning

confidence: 99%