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Mild cognitive impairment as a predi...

Callahan, Kathryn E.

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Mild cognitive impairment as a predictor of hospital utilization and readmissions.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Mild cognitive impairment as a predictor of hospital utilization and readmissions./
作者:	Callahan, Kathryn E.
面頁冊數:	88 p.
附註:	Source: Masters Abstracts International, Volume: 53-04.
Contained By:	Masters Abstracts International53-04(E).
標題:	Medicine. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=1561749
ISBN:	9781321074697

Mild cognitive impairment as a predictor of hospital utilization and readmissions.
Callahan, Kathryn E.

Mild cognitive impairment as a predictor of hospital utilization and readmissions. - 88 p.

Source: Masters Abstracts International, Volume: 53-04.

Thesis (M.S.)--Wake Forest University, 2014.

This item is not available from ProQuest Dissertations & Theses.

Although frequent hospitalization and unplanned hospital readmissions are considered a marker of poor quality care for older adults, healthcare studies have neglected mild cognitive impairment (MCI) as a potential contributor to high cost utilization. This study explored whether a) older adults classified with MCI experience increased rates of index hospitalization compared to those with normal cognition; b) those with MCI are at greater risk of 30-day readmission to the hospital compared with older adults with normal cognition; and c) living with a proxy modifies the effect of MCI on hospital utilization.

ISBN: 9781321074697Subjects--Topical Terms:

641104
Medicine.

Mild cognitive impairment as a predictor of hospital utilization and readmissions.
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245 1 0 $a Mild cognitive impairment as a predictor of hospital utilization and readmissions.
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500 $a Source: Masters Abstracts International, Volume: 53-04.
500 $a Adviser: Jeff D. Williamson.
502 $a Thesis (M.S.)--Wake Forest University, 2014.
506 $a This item is not available from ProQuest Dissertations & Theses.
520 $a Although frequent hospitalization and unplanned hospital readmissions are considered a marker of poor quality care for older adults, healthcare studies have neglected mild cognitive impairment (MCI) as a potential contributor to high cost utilization. This study explored whether a) older adults classified with MCI experience increased rates of index hospitalization compared to those with normal cognition; b) those with MCI are at greater risk of 30-day readmission to the hospital compared with older adults with normal cognition; and c) living with a proxy modifies the effect of MCI on hospital utilization.
520 $a These analyses utilized data from the Ginkgo Evaluation of Memory Study (GEMS). Kaplan Meier curves and proportional hazards regression analysis explored rates of index hospitalization in those with baseline MCI (n=428) versus normal cognition (n=2314). We compared the proportion of those with MCI who experienced a 30-day readmission versus those with normal cognition. We then used logistic regression to model the association between MCI and 30-day readmission. Analyses adjusted for age, sex, race, education, clinic site, trial assignment status, comorbidities, number of prescription medications, and whether participants lived with their identified proxy.
520 $a MCI conferred a 17% increase in the rate of index hospitalizations as compared with participants with normal cognition (unadjusted HR 1.245, 1.091 - 1.420; adjusted HR 1.170, 1.021 - 1.342). In participants who lived with their proxy, MCI increased the rate of index hospitalization by 39% compared with those with normal cognition (adjusted HR 1.392, 1.169 - 1.657). No association appeared between MCI and index hospitalization in those not living with their proxy (adjusted HR 0.936, 0.758 - 1.155). No significant difference appeared in the proportion of 30-day readmissions by baseline MCI status; 13.5% (MCI) versus 11.7% (normal cognition), p=0.423. Baseline MCI was not associated with increased odds of 30-day readmission in any logistic regression model investigated (adjusted OR 0.902, 0.598 - 1.363).
520 $a MCI increased the rate of index hospitalization by 17%, with the association driven by those individuals who lived with their identified proxy (HR 1.39). No association appeared with 30-day readmissions. MCI may represent a target condition for healthcare providers to provide care coordination and ambulatory support services in an effort to reduce healthcare acute utilization and subsequent disability.
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