Identifying distinct risk profiles to predict adverse events among community-dwelling older adults

被引：4

作者：

O'Connor, Melissa ^{[1
,2
]}

Hanlon, Alexandra ^{[1
]}

Mauer, Elizabeth ^{[3
]}

Meghani, Salimah ^{[1
]}

Masterson-Creber, Ruth ^{[4
]}

Marcantonio, Sherry

Coburn, Ken ^{[5
]}

Van Cleave, Janet ^{[1
,6
]}

Davitt, Joan ^{[1
,7
]}

Riegel, Barbara ^{[1
]}

Bowles, Kathryn H. ^{[1
,8
]}

Keim, Susan ^{[1
]}

Greenberg, Sherry A. ^{[1
,6
]}

Sefcik, Justine S. ^{[1
]}

Topaz, Maxim ^{[9
]}

Kong, Dexia ^{[1
]}

Naylor, Mary ^{[1
]}

机构：

[1] Univ Penn, NewCourtland Ctr Transit Hlth, Sch Nursing, Philadelphia, PA 19104 USA

[2] Villanova Univ, Coll Nursing, Villanova, PA 19085 USA

[3] Weill Cornell Med, Dept Healthcare Policy & Res, New York, NY USA

[4] Columbia Univ, Sch Nursing, New York, NY 10027 USA

[5] Hlth Qual Partners LLC, Honolulu, HI USA

[6] NYU, Coll Nursing, New York, NY 10003 USA

[7] Univ Maryland, Sch Social Work, Baltimore, MD 21201 USA

[8] Visiting Nurse Serv New York, Ctr Home Care Res & Policy, New York, NY USA

[9] Harvard Med Sch, Boston, MA USA

来源：

GERIATRIC NURSING | 2017年 / 38卷 / 06期

关键词：

Community-dwelling older adults; Chronic illness; Nurse care management model; Risk profiles; Latent class analysis; EARLY HOSPITAL READMISSION; HEALTH-CARE UTILIZATION; MEDICARE BENEFICIARIES; TRANSITIONAL CARE; SELF-REPORT; MORTALITY; DISCHARGE; COMORBIDITIES; SERVICES;

D O I：

10.1016/j.gerinurse.2017.03.013

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Preventing adverse events among chronically ill older adults living in the community is a national health priority. The purpose of this study was to generate distinct risk profiles and compare these profiles in time to: hospitalization, emergency department (ED) visit or death in 371 community-dwelling older adults enrolled in a Medicare demonstration project. Guided by the Behavioral Model of Health Service Use, a secondary analysis was conducted using Latent Class Analysis to generate the risk profiles with Kaplan Meier methodology and log rank statistics to compare risk profiles. The Vuong-Lo-Mendell-Rubin Likelihood Ratio Test demonstrated optimal fit for three risk profiles (High, Medium, and Low Risk). The High Risk profile had significantly shorter time to hospitalization, ED visit, and death (p < 0.001 for each). These findings provide a road map for generating risk profiles that could enable more effective targeting of interventions and be instrumental in reducing health care costs for subgroups of chronically ill community-dwelling older adults. (C) 2017 Elsevier Inc. All rights reserved.

引用

页码：510 / 519

页数：10

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