The rising number of geriatric patients with complex, chronic, and often multiple health conditions presents numerous policy challenges. RAND has conducted the most comprehensive examination of the quality of medical care provided to the vulnerable elderly and coordinates interdisciplinary research centers to develop and study innovative clinical and health services interventions to improve health care outcomes for geriatric patients.
Journal Article
Vulnerable older adults enrolled in plans that use nurse care managers receive, on average, 69% of recommended care for geriatric conditions, compared with 53% for elders in plans without nurse care managers.
Journal Article
Better quality of care for falls and urinary incontinence was associated with measurable improvement in participant-reported outcomes in less than 1 year.
Journal Article
Having a usual source of care was associated with lower depression prevalence and higher realized access among community-dwelling Medicare beneficiaries.
Journal Article
Recently, late-life disability rates have declined in several countries of the Organisation for Economic Co-operation, but no national-level trend analysis for England has been available.
News Release
Home health care technology may provide one important solution to global concerns about how to sustain health care systems threatened by rising costs and manpower shortages, but such a change faces multiple obstacles to adoption.
Journal Article
This study evaluates the effects of a multicomponent intervention to reduce fecal incontinence and urinary incontinence.
Journal Article
This descriptive study of nursing home characteristics found that facilities targeted by a CMS improvement initiative typically have fewer nurses and nurse aides and higher rates of quality of care citations.
Research Brief
Results of a pilot program in RAND Health's Assessing Care of Vulnerable Elders-2 project indicate that quality indicators for dementia care are improved when primary care practices are coupled with links to local Alzheimer's Association chapters.
News Release
New results from a major initiative on the quality of cancer care in the U.S. have found that patients with a common type of colon cancer—especially older patients—often are not treated as aggressively with chemotherapy as research shows is necessary to improve survival.
Journal Article
This pilot study suggests that a practice-based intervention can increase referral to Alzheimer's Association chapters and improve quality of dementia care.
Journal Article
Evaluate adjuvant chemotherapy use and outcomes for older patients with stage III colon cancer from well-defined population-based settings and health care systems.
Journal Article
The proportion of people ages 50-64 who reported needing help with personal care activities increased significantly from 1997 to 2007. The proportions needing help with routine household chores indicating difficulty with physical functions were stable. These patterns contrast with reported declines in disability among the population age 65 and older. Particularly concerning among those ages 50-64 are significant increases of limitation in specific mobility-related activities, such as getting into and out of bed.
Journal Article
Primary care practices in sociodemographically vulnerable neighborhoods were more likely than other practices to have medical home capabilities (e.g., interpreters, multilingual physicians), making them potentially eligible for enhanced payments
Journal Article
Functional status has a dramatic impact on life expectancy. 75-year-olds without limitations can expect to live 5 years longer than those with limitations in performing daily activities and more than 1 year longer than those with limited mobility.
Journal Article
Lower rates of lobectomy (resection of early-stage non-small-cell lung carcinomas) among older patients do not seem to be explained by age-related biases among surgeons for otherwise healthy patients.
Journal Article
Although not all decision-making tasks showed age-related declines in performance, older adults perceived themselves as worse decision makers.
Journal Article
Redesign of primary care practices, based on quality indicators from the Assessing Care of Vulnerable Elders project, improved care for older patients with falls and urinary incontinence.
Journal Article
An economic evaluation was undertaken in which NICE reference case standards were applied to data collected in the RESPECT trial.
Multimedia
The RAND Summer Institute consists of conferences addressing critical issues facing our aging population. Select sessions from the 15th Annual RAND Summer Institute, held July 7-10, 2008 in Santa Monica, California, are available for online viewing.
Journal Article
Data from a large sample of nursing homes were used to examine the cross-sectional association between workplace injuries and organizational factors, caregiver staffing levels, and quality.
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