The Health Status of Elderly Veteran Enrollees in the Veterans Health Administration

Selim, Alfredo J.; Berlowitz, Dan R.; Fincke, Graeme; Cong, Zhongxiao; Rogers, William H.; Haffer, Samuel C.; Ren, Xinhua S.; Lee, Austin; Qian, Shirley; Miller, Donald R.; Spiro, Avron; Selim, Bernardo J.; Kazis, Lewis E.

doi:10.1111/j.1532-5415.2004.52355.x

Cited by 106 publications

(96 citation statements)

References 16 publications

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“…In particular, aspects of mental health did not appear to decline with increasing age, as seen with the VR-36 MCS (p = 0.10). A decline in physical function with increasing age, without a corresponding decline in mental health, corresponds with what might be expected, based on previous work (Selim et al, 2004). HRQoL scores varied by the respondent's sex (Table 3.7).…”

Section: Chapter Three Analytic Methods and Results: Validation Of Isupporting

confidence: 83%

Patient-Reported Outcome–Based Performance Measures for Older Adults with Multiple Chronic Conditions

Edelen¹,

Rose²,

Bayliss³

et al. 2017

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This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions.The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest.RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.Support RAND Make a tax-deductible charitable contribution at www.rand.org/giving/contribute www.rand.org For more information on this publication, visit www.rand.org/t/RR2176This study was conducted in response to contract HHSN271201500064C NIH NIA (AG).Published by the RAND Corporation, Santa Monica, Calif. © Copyright 2017 RAND CorporationR® is a registered trademark.iii Preface Ensuring patients' survival and curing disease are no longer the sole goals of patient care; functional status and well-being must also be optimized. Standardized assessments through patient-reported outcome (PRO) performance measures (PMs) allow evaluators to see how well these aspects of care are being delivered and compare the performance of health care systems and different provider groups.To meaningfully assess health-related quality of life, PMs must align with patients' goals. Most PMs in current use assess technical quality of care, the benefit of which can take years to realize. These sorts of measures might not be particularly salient to older adults (especially age 80 and older) with multiple chronic conditions (MCC) because their expectations for long-term survival are limited. The desire of such patients to maximize quality of life for the remainder of their life spans is obviously undiminished. However, no PMs have been formally developed or validated for use in this population. Therefore, policymakers and researchers who focus on quality of health care are especially interested in developing PRObased PMs to measure the care delivered to older adults with MCC.This project aimed to address this gap in validated PRO-based PMs through the completion of two aims. The first aim was to determine whether the Patient-Reported Outcomes Measurement Information System 29-item (PROMIS-29) profile instrument is valid for use in this population. The second aim was to study how well PMs based on PROs, specifically the Veterans RAND 36 Item Health Survey (VR-36) and the PROMIS-29, measure functional status and well-being in the same population. This report summarizes our analyses and provides recommendations for future efforts to develo...

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Section: Chapter Three Analytic Methods and Results: Validation Of Isupporting

confidence: 83%

Patient-Reported Outcome–Based Performance Measures for Older Adults with Multiple Chronic Conditions

Edelen¹,

Rose²,

Bayliss³

et al. 2017

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“…Even fewer older adults met these guidelines; among older adults aged 65 to 74, only 16 percent met the guidelines for moderate-intensity exercise and 13 percent met the guidelines for vigorous-intensity exercise [2]. Although U.S. veterans are more physically active than nonveterans across all age groups, many veterans also do not meet Federal recommendations for weekly moderate physical activity [3][4]. In an analysis of a national sample of veterans, Littman et al found that 45.6 percent of veterans aged 50 to 59 and 40.7 percent of veterans 70 years met daily physical activity level recommendations [4].…”

Section: Introductionmentioning

confidence: 99%

Feasibility study of home telerehabilitation for physically inactive veterans

Harada¹,

Dhanani²,

Elrod³

et al. 2010

JRRD

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Abstract-The aim of this study was to develop a system for and determine the feasibility of monitoring home exercise for physically inactive older adults using a Health Buddy (HB) text messaging device (Robert Bosch Healthcare; Palo Alto, California). Questions and messages related to exercise adherence are displayed on the HB screen and participants choose a response by pressing the corresponding button on the device. Responses are transmitted through a landline connection and high-risk responses are highlighted by the system for followup. We developed the questions and messages based on input from patient and clinician focus groups. We evaluated feasibility by administering the intervention to inpatient and outpatient adults aged 60 or older. We gave participants a choice of exercise monitoring by HB (n = 20) or telephone (n = 18). The results showed that home exercise monitoring by HB and telephone is safe, as evidenced by low adverse event rates. We saw a decline in exercise adherence rates to both the HB and telephone after 8 weeks, although adherence was better for HB than telephone. Taken together, the results demonstrate the feasibility of using text messaging to monitor home exercise adherence in physically inactive older adults.Clinical Trial Registration: ClinicalTrials.gov; Home Telerehabilitation for Deconditioned Older Adults, NCT00386256;

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“…In initial studies comparing VA and non-VA patients after acute myocardial infarction (AMI), veterans were shown to have more comorbidities, worse overall health status, and lower socioeconomic status than non-veterans. [24][25][26][27][28] Veterans were also reported as having a higher one-year mortality rate after AMI than non-veterans, [27][28] and were less likely to receive coronary angiography. 26 To address these reported disparities in the quality of cardiovascular care received by veterans and provide a mechanism by which the Congressional mandate could be met, the VA introduced a multi-layered plan to improve cardiovascular care by opening new catheterization labs, adopting national VA performance measures, and developing a national quality improvement program for cardiac catheterization procedures.…”

Section: Background Health It Implementation In the United Statesmentioning

confidence: 99%

Strategies from a Nationwide Health Information Technology Implementation: The VA CART STORY

et al. 2010

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The VA Cardiovascular Assessment, Reporting, and Tracking (CART) system is a customized electronic medical record system which provides standardized report generation for cardiac catheterization procedures, serves as a national data repository, and is the centerpiece of a national quality improvement program. Like many health information technology projects, CART implementation did not proceed without some barriers and resistance. We describe the nationwide implementation of CART at the 77 VA hospitals which perform cardiac catheterizations in three phases: (1) strategic collaborations; (2) installation; and (3) adoption. Throughout implementation, success required a careful balance of technical, clinical, and organizational factors. We offer strategies developed through CART implementation which are broadly applicable to technology projects aimed at improving the quality, reliability, and efficiency of health care.

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The Health Status of Elderly Veteran Enrollees in the Veterans Health Administration

Cited by 106 publications

References 16 publications

Patient-Reported Outcome–Based Performance Measures for Older Adults with Multiple Chronic Conditions

Patient-Reported Outcome–Based Performance Measures for Older Adults with Multiple Chronic Conditions

Feasibility study of home telerehabilitation for physically inactive veterans

Strategies from a Nationwide Health Information Technology Implementation: The VA CART STORY

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The Health Status of Elderly Veteran Enrollees in the Veterans Health Administration

Cited by 106 publications

References 16 publications

Patient-Reported Outcome&ndash;Based Performance Measures for Older Adults with Multiple Chronic Conditions

Patient-Reported Outcome&ndash;Based Performance Measures for Older Adults with Multiple Chronic Conditions

Feasibility study of home telerehabilitation for physically inactive veterans

Strategies from a Nationwide Health Information Technology Implementation: The VA CART STORY

Contact Info

Product

Resources

About

Patient-Reported Outcome–Based Performance Measures for Older Adults with Multiple Chronic Conditions

Patient-Reported Outcome–Based Performance Measures for Older Adults with Multiple Chronic Conditions