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Disability and decline in physical function associated with hospital use at end of life
Kelley AS, Ettner SL, Morrison RS, Du Q, Sarkisian CA.. Journal of general internal medicine, 2012-03-02
Topic: Risk, prevention and care in population studies
Background Hospital use near the end of life is often undesirable to patients, represents considerable Medicare cost, and varies widely across regions. Objective To concurrently examine regional and patient factors, including disability and functional decline, associated with end-of-life hospital use. Design/participants We sampled decedents aged 65 and older (n = 2,493) from the Health and Retirement Study (2000-2006), and linked data from individual Medicare claims and the Dartmouth Atlas of Health Care. Two-part regression models estimated the relationship between total hospital days in the last 6 months and patient characteristics including physical function, while adjusting for regional resources and hospital care intensity (HCI). Key results Median hospital days was 7 (range = 0-183). 53% of respondents had functional decline. Compared with decedents without functional decline, those with severe disability or decline had more regression-adjusted hospital days (range 3.47-9.05, depending on category). Dementia was associated with fewer days (-3.02); while chronic kidney disease (2.37), diabetes (2.40), stroke or transient ischemic attack (2.11), and congestive heart failure (1.74) were associated with more days. African Americans and Hispanics had more days (5.91 and 4.61, respectively). Those with family nearby had 1.62 fewer days and hospice enrollees had 1.88 fewer days. Additional hospital days were associated with urban residence (1.74) and residence in a region with more specialists (1.97) and higher HCI (2.27). Conclusions Functional decline is significantly associated with end-of-life hospital use among older adults. To improve care and reduce costs, health care programs and policies should address specific needs of patients with functional decline and disability.
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APA 7th
Kelley, A. S., Ettner, S. L., Morrison, R. S., Du, Q., & Sarkisian, C. A. (2012). Disability and decline in physical function associated with hospital use at end of life. Journal of general internal medicine. https://doi.org/10.1007/s11606-012-2013-9
Vancouver
Kelley AS, Ettner SL, Morrison RS, Du Q, Sarkisian CA. Disability and decline in physical function associated with hospital use at end of life. Journal of general internal medicine. 2012. doi:10.1007/s11606-012-2013-9. PMID: 22382455.
BibTeX
@article{kelley2012-22382455,
author = {Kelley, A. S. and Ettner, S. L. and Morrison, R. S. and Du, Q. and Sarkisian, C. A.},
title = {{Disability and decline in physical function associated with hospital use at end of life}},
journal = {Journal of general internal medicine},
year = {2012},
doi = {10.1007/s11606-012-2013-9},
pmid = {22382455},
url = {https://doi.org/10.1007/s11606-012-2013-9}
}
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Key findings
- Objective To concurrently examine regional and patient factors, including disability and functional decline, associated with end-of-life hospital use.
- Key results Median hospital days was 7 (range = 0-183). 53% of respondents had functional decline.
- Compared with decedents without functional decline, those with severe disability or decline had more regression-adjusted hospital days (range 3.47-9.05, depending on category).
- Dementia was associated with fewer days (-3.02); while chronic kidney disease (2.37), diabetes (2.40), stroke or transient ischemic attack (2.11), and congestive heart failure (1.74) were associated with more days.
- Additional hospital days were associated with urban residence (1.74) and residence in a region with more specialists (1.97) and higher HCI (2.27).
Study details
- Participants2,493
- Evidence strengthLow
How this study scored 47/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 27 of the 58 points we could judge it on, which is 47 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of general internal medicine) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2012 — within 20 year(s) of the newest study here |
| Sample size | 3 / 4 | 2,493 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 22382455) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 27 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 27 of the 58 points we could judge it on is 47 out of 100. |
| Total | 47 / 100 | — |
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