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Hospital-level predictors of outcome...

University of Washington.

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Hospital-level predictors of outcomes in elderly patients with lower extremity injuries.

紀錄類型:	書目-語言資料,印刷品 : Monograph/item
正題名/作者:	Hospital-level predictors of outcomes in elderly patients with lower extremity injuries./
作者:	Adams, Annette L.
面頁冊數:	131 p.
附註:	Adviser: Melissa A. Schiff.
Contained By:	Dissertation Abstracts International70-01B.
標題:	Health Sciences, Epidemiology. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoeng/servlet/advanced?query=3345629
ISBN:	9781109000870

Hospital-level predictors of outcomes in elderly patients with lower extremity injuries.
Adams, Annette L.

Hospital-level predictors of outcomes in elderly patients with lower extremity injuries. - 131 p.

Adviser: Melissa A. Schiff.

Thesis (Ph.D.)--University of Washington, 2008.

The objective of this project was to examine relationships between one-year patient outcomes and two hospital-level multidisciplinary processes of care focusing on management of comorbid conditions and psychosocial issues. The patient outcomes studied are survival, rehospitalization rates, and outpatient visit rates for a cohort of Medicare recipients hospitalized with lower extremity injuries in Oregon hospitals during 2002.

ISBN: 9781109000870Subjects--Topical Terms:

1019544
Health Sciences, Epidemiology.

Hospital-level predictors of outcomes in elderly patients with lower extremity injuries.
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245 1 0 $a Hospital-level predictors of outcomes in elderly patients with lower extremity injuries.
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500 $a Adviser: Melissa A. Schiff.
500 $a Source: Dissertation Abstracts International, Volume: 70-01, Section: B, page: 0190.
502 $a Thesis (Ph.D.)--University of Washington, 2008.
520 $a The objective of this project was to examine relationships between one-year patient outcomes and two hospital-level multidisciplinary processes of care focusing on management of comorbid conditions and psychosocial issues. The patient outcomes studied are survival, rehospitalization rates, and outpatient visit rates for a cohort of Medicare recipients hospitalized with lower extremity injuries in Oregon hospitals during 2002.
520 $a Hospital characteristics were ascertained by survey of all Oregon hospitals. The association between routine consultations, defined as consultation between attending physician and medical specialists, such as geriatricians, hospitalists, internists, or primary care physicians, and the outcomes were modeled using generalized estimating equation methods. The odds of dying by one-year post-injury were reduced by 31% for persons treated in a setting where physician consultation was routine (odds ratio [OR] = 0.69, 95% confidence interval [CI]: 0.57-0.83), reducing one-year mortality risk from 32.5% to 27.2%. Rehospitalization rates and outpatient visit rates among younger patients, aged 67-84 years, treated in routine consultation settings were greater than those of patients not treated in such settings (rehospitalization incident rate ratio [IRR] = 1.48, 95% CI: 1.12-1.96; outpatient visit IRR = 1.17, 95% CI: 1.11-1.22). Patients with any comorbid condition treated in routine consultation settings also had greater rehospitalization rates and outpatient visit rates (rehospitalization IRR = 2.15, 95% CI: 1.57-2.94; outpatient visit IRR = 1.38, 95% CI 1.32-1.45).
520 $a Multidisciplinary care conferences, defined as routine meetings involving nursing staff, occupational or physical therapists, and social work or discharge planning staff, were not associated with any differences in mortality at one-year post-injury. Care conferences, however, were associated with reductions in rehospitalization rates (IRR = 0.84, 95% CI: 0.76-0.95) and outpatient visit rates (IRR = 0.90, 95% CI 0.88-0.91).
520 $a In this study, routine consultation between attending physicians and medicine specialists is associated with reduced mortality, but with increased resource utilization post-injury for certain subgroups of patients. Multidisciplinary care conferences were not associated with differences in mortality, but were associated with reduced resource utilization post-injury.
590 $a School code: 0250.
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791 $a Ph.D.
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