| Title |
Hospitalization Risk and Potentially Inappropriate Medications among Medicare Home Health Nursing Patients
|
|---|---|
| Published in |
Journal of General Internal Medicine, August 2017
|
| DOI | 10.1007/s11606-017-4157-0 |
| Pubmed ID | |
| Authors |
Matthew C. Lohman, Brandi P. Cotton, Alexandra B. Zagaria, Yuhua Bao, Rebecca L. Greenberg, Karen L. Fortuna, Martha L. Bruce |
| Abstract |
Hospitalizations and potentially inappropriate medication (PIM) use are significant and costly issues among older home health patients, yet little is known about the prevalence of PIM use in home health or the relationship between PIM use and hospitalization risk in this population. To describe the prevalence of PIM use and association with hospitalization among Medicare home health patients. Cross-sectional analysis using data from 132 home health agencies in the US. Medicare beneficiaries starting home health nursing services between 2013 and 2014 (n = 87,780). Prevalence of individual and aggregate PIM use at start of care, measured using the 2012 Beers criteria. Relative risk (RR) of 30-day hospitalization or re-hospitalization associated with individual and aggregate PIM use, compared to no PIM use. In total, 30,168 (34.4%) patients were using at least one PIM, with 5969 (6.8%) taking at least two PIMs according to the Beers list. The most common types of PIMs were those affecting the brain or spinal cord, analgesics, and medications with anticholinergic properties. With the exception of nonsteroidal anti-inflammatory drugs (NSAIDs), PIM use across all classes was associated with elevated risk (10-33%) of hospitalization compared to non-use. Adjusting for demographic and clinical characteristics, patients using at least one PIM (excluding NSAIDs) had a 13% greater risk (RR = 1.13, 95% CI: 1.09, 1.17) of being hospitalized than patients using no PIMs, while patients using at least two PIMs had 21% greater risk (RR = 1.21, 95% CI: 1.12, 1.30). Similar associations were found between PIMs and re-hospitalization risk among patients referred to home health from a hospital. Given the high prevalence of PIM use and the association between PIMs and hospitalization risk, home health episodes represent opportunities to substantially reduce PIM use among older adults and prevent adverse outcomes. Efforts to address medication use during home health episodes, hospitalizations, and care transitions are justified. |
X Demographics
The data shown below were collected from the profiles of 15 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 4 | 27% |
| Spain | 2 | 13% |
| Sweden | 1 | 7% |
| Australia | 1 | 7% |
| Unknown | 7 | 47% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 10 | 67% |
| Scientists | 2 | 13% |
| Practitioners (doctors, other healthcare professionals) | 2 | 13% |
| Science communicators (journalists, bloggers, editors) | 1 | 7% |
Mendeley readers
The data shown below were compiled from readership statistics for 74 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 74 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 9 | 12% |
| Other | 8 | 11% |
| Student > Master | 8 | 11% |
| Student > Ph. D. Student | 8 | 11% |
| Student > Postgraduate | 6 | 8% |
| Other | 13 | 18% |
| Unknown | 22 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Pharmacology, Toxicology and Pharmaceutical Science | 16 | 22% |
| Nursing and Health Professions | 15 | 20% |
| Medicine and Dentistry | 10 | 14% |
| Social Sciences | 4 | 5% |
| Agricultural and Biological Sciences | 2 | 3% |
| Other | 3 | 4% |
| Unknown | 24 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 12. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 November 2021.
All research outputs
#2,944,916
of 24,257,370 outputs
Outputs from Journal of General Internal Medicine
#2,174
of 7,886 outputs
Outputs of similar age
#53,622
of 319,950 outputs
Outputs of similar age from Journal of General Internal Medicine
#24
of 74 outputs
Altmetric has tracked 24,257,370 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 7,886 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.9. This one has gotten more attention than average, scoring higher than 72% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 319,950 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 83% of its contemporaries.
We're also able to compare this research output to 74 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.