Effect of Pressure Ulcers on the Survival of Long-Term Care Residents

Berlowitz, Dan R.; Brandeis, Gary H.; Anderson, Jennifer; Du, Wei; Brand, Harriet K.

doi:10.1093/gerona/52a.2.m106

Cited by 102 publications

(68 citation statements)

References 21 publications

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“…Since prior individual health status can confound the relationship between waiting for health care and outcomes, we account for multiple measures of prior individual health status following similar models in the literature (Berlowitz et al 1997;Mukamel et al 2000;Porell et al 1998;Selim et al 2002) and our previous work (Prentice et al 2007). 7 Explanatory variables include age, gender, principal diagnoses and the Charlson index as a measure of the number and seriousness of co-morbid conditions (Charlson et al 1987;Deyo et al 1992).…”

Section: Risk Adjustmentmentioning

confidence: 99%

Waiting times and hospitalizations for ambulatory care sensitive conditions

Prentice

Pizer

2007

Health Serv Outcomes Res Method

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Long waits for health care are hypothesized to cause negative health outcomes due to delays in diagnosis and treatment. This study uses administrative data to examine the relationship between time spent waiting for outpatient care and the risk of hospitalization for an ambulatory care sensitive condition (ACSC). Data on the number of days until the next available appointment were extracted from Veterans Affairs (VA) medical centers. Two methodological issues arose. First, the simultaneous determination of individual health status and wait times due to medical triage was overcome by developing an exogenous wait time measure. Second, selection bias due to unobserved case mix differences was minimized by separating in time the sample selection period from the period when wait times and outcomes were measured. Exogenous facility-level wait time was the main variable of interest in a fixed effects stacked heteroskedastic probit regression model that predicted the probability of ACSC hospitalization in each month of a six-month period. There was a significant and positive relationship between facility-level wait times and the probability of experiencing an ACSC hospitalization, especially for facility-level wait times of 29 days or more. Further research is needed to replicate these findings in other populations and among those with different clinical histories. As well, policymakers and researchers need an improved understanding of the causes of long wait times and interventions to decrease wait times.

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Section: Risk Adjustmentmentioning

confidence: 99%

Waiting times and hospitalizations for ambulatory care sensitive conditions

Prentice

Pizer

2007

Health Serv Outcomes Res Method

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“…To maintain anonymity of the focus group participants, each CRN has been given a number (1)(2)(3)(4)(5)(6)(7)(8)(9). However, where there is discussion between members from the one trust (represented by five CRNs), the CRNs have also been labelled a-e.…”

Section: Baseline Datamentioning

confidence: 99%

Pressure relieving support surfaces: a randomised evaluation

Nixon¹,

Nelson²,

Cranny³

et al. 2006

Health Technol Assess

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK.We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA NHS R&D HTA ProgrammeT he research findings from the NHS R&D Health Technology Assessment (HTA) Programme directly influence key decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC) who rely on HTA outputs to help raise standards of care. HTA findings also help to improve the quality of the service in the NHS indirectly in that they form a key component of the 'National Knowledge Service' that is being developed to improve the evidence of clinical practice throughout the NHS.The HTA Programme was set up in 1993. Its role is to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care.The HTA Programme commissions research only on topics where it has identified key gaps in the evidence needed by the NHS. Suggestions for topics are actively sought from people working in the NHS, the public, service-users groups and professional bodies such as Royal Colleges and NHS Trusts.Research suggestions are carefully considered by panels of independent experts (including service users) whose advice results in a ranked list of recommended research priorities. The HTA Programme then commissions the research team best suited to und...

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“…4 PUs are markers of poor overall health and may contribute to premature mortality in some patients. 5,6 Chronic Wound Care Management and Research downloaded from https://www.dovepress.com/ by 34.210.69.67 on 11-May-2018 For personal use only. …”

Section: Introductionmentioning

confidence: 99%

Pressure ulcer treatment in a long-term care setting: wound bed healing with clostridial collagenase ointment versus hydrogel dressing

Waycaster¹,

Gilligan²,

Milne³

2014

CWCMR

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Purpose: To compare clinical outcomes in patients with pressure ulcers (PUs) who were treated with enzymatic debridement using clostridial collagenase ointment (CCO) with those treated with autolytic debridement using a hydrogel dressing. Patients and methods: This prospective, randomized, blinded, single-site trial directly compared the use of CCO and hydrogel dressings for treatment of PUs in patients in a long-term care facility. Changes in wound bed scores (WBS), tissue granulation, wound surface area, and epithelialization were assessed weekly during the 6-week treatment. Effects of treatment time, treatment method, and the combination of treatment time and method on continuous outcomes were analyzed by linear regression; the effects of covariates on epithelialization were analyzed by logistic regression. Results: Overall, 27 patients completed the study; 13 patients were treated with CCO and 14 with hydrogel. Baseline demographic and clinical characteristics were similar between the treatment groups. Patients treated with CCO had a granulation rate approximately twice that of those receiving hydrogel and showed a significantly higher rate of granulation tissue formation at week 6. Treatment duration and the combination of treatment duration and method were significant predictors of granulation tissue formation. WBS improvements from baseline to week 6 were greater in patients who received CCO than in those treated with hydrogel (+4.6 units versus +2.6 units, respectively). Treatment duration and the combination of treatment duration and method were predictors of WBS improvement. Patients treated with CCO showed significant reductions in wound surface area from baseline (10.3 cm 2 ) to week 6 (2.1 cm 2 ). At week 6, epithelialization was numerically higher in patients treated with CCO than in patients treated with hydrogel. Conclusion: Long-term care facility patients with PUs who received enzymatic debridement with CCO had greater improvements in granulation tissue formation, WBS, wound surface area, and wound closure than did those treated with hydrogel.

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Effect of Pressure Ulcers on the Survival of Long-Term Care Residents

Cited by 102 publications

References 21 publications

Waiting times and hospitalizations for ambulatory care sensitive conditions

Waiting times and hospitalizations for ambulatory care sensitive conditions

Pressure relieving support surfaces: a randomised evaluation

Pressure ulcer treatment in a long-term care setting: wound bed healing with clostridial collagenase ointment versus hydrogel dressing

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