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
Using a national longitudinal sample of nursing homes residents we examine whether physical restraint use contributes to subsequent physical or psychological health decline.
Journal Article
Evaluates changes in private and public prices for annual nursing home care from 1977 to 2004, and compares nursing home price growth to overall price growth and growth in the price of medical care.
Journal Article
To adapt the Assessing Care of Vulnerable Elders project nursing home (NH) specific quality indicators (QIs), for use with routinely collected data, and to evaluate which clinical conditions and types of care were inadequately measured using these data sources.
Journal Article
Test how the implementation of new Medicare post-acute payment systems affected the use of inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and home health agencies.
Journal Article
Tests the predictive properties of the Vulnerable Elders-13 Survey (VES-13), a short tool that predicts functional decline and mortality over a 1- to 2-year follow-up interval over a 5-year interval.
Journal Article
Evaluates a draft preference assessment tool designed to replace the current Customary Routine section of the Minimum Data Set (MDS) for nursing homes.
Journal Article
Life expectancy for U.S. men and women in 2050 may be higher than predicted in official government forecasts, with the result that the costs of Medicare and Social Security could be significantly higher than currently estimated.
Journal Article
Twice-daily feeding assistance promotes food and fluid intake and weight gain in nursing home residents at risk for weight loss. Delivery of snacks between meals requires less staff time than at mealtime and thus may be more practical to implement.
Journal Article
This study found that a high percentage of nursing home residents hospitalized for hip fracture and stroke (80% and 64% respectively) used Medicare-paid skilled nursing facilities, yet had outcomes similar to those who did not use such care.
Research Brief
This fact sheet summarizes a study using the 1992-1999 Medicare Current Beneficiary Survey to investigate whether age directly affects health care costs, or whether life expectancy would produce more accurate estimates of future expenditures.
Research Brief
This fact sheet describes a model of constrained choice that explains how policy decisions at the family, work, community, and government levels can have unintended consequences that ultimately produce differences in men's and women's health.
Research Brief
Vulnerable elders receive on average only half of recommended care; for conditions that affect primarily the elderly, they receive appropriate care less than one-third of the time. Interventions based on ACOVE indicators can improve the care physicians provide to older adults.
Project
Vulnerable elders receive on average only half of recommended care; for conditions that affect primarily the elderly, they receive appropriate care less than one-third of the time. Interventions based on ACOVE indicators can improve the care physicians provide to older adults.
Journal Article
Weak empirical evidence exists showing that nursing home staffing levels influence quality of care.
Journal Article
Data from a large sample of nursing homes were used to examine the cross-sectional association between use of agency staff, regular staff, and quality.
Journal Article
Rates of severe disability, measured by the inability to perform basic activities of daily living, have been rising in working age populations.
Journal Article
Even in a system known for high-quality chronic illness care, documentation of advance care planning and proxies for health decisions at end of life was infrequent. Involvement of outpatient primary care and geriatric providers may improve care.
Journal Article
Investigates the role of pain dynamics in dynamics of self-reported work disability and of employment patterns of older workers in the United States. In addition to high pain prevalence, there are many transitions in and out of pain at these ages.
Journal Article
Presents data to support implementation of Functional Family Therapy, an evidence-based family prevention and intervention program for adolescents with conduct disorder or oppositional defiant disorder, in family and child mental health services.
Journal Article
Finds that using life expectancy rather than age results in lower projections of future health care expenditures. This result suggests that increases in longevity might be less costly than models based on the current age profile of spending would predict.
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