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Long‐term outcomes after rehabilitation in Medicare Advantage and fee‐for‐service beneficiaries
Kenneth Lam, Hannah Kleijwegt, Evan Bollens‐Lund, Lauren Hersch Nicholas, Kenneth E. Covinsky, Claire K. Ankuda. Journal of the American Geriatrics Society, 2024-04-10
Topic: Risk, prevention and care in population studies
Plain-language summary
Among 738 MA and 1488 FFS participants, weighted mean age was 76 years (SD 7.0), 59% were female, and 9% had probable dementia. MA beneficiaries were more likely to be Black (9% vs. 6%) or Hispanic/other race (15% vs. 10%), be on Medicaid (14% vs. 10%), have lower income (median $35,000 vs. $48,000), and receive <1 month of rehabilitation (30% vs. 23%). MA beneficiaries had a similar decline in SPPB (-0.46 [SD 1.8] vs. -0.21 [SD 2.7], p-value 0.069) and adapted FIM (-1.05 [SD 3.7] vs. -1.13 [SD 5.45], p-value 0.764) compared to FFS. MA beneficiaries were less likely to report improved function during rehabilitation (61% [95% CI 56-67] vs. 70% [95% CI 67-74], p-value 0.006). Other outcomes and analyses restricted to inpatient rehabilitation participants were non-significant. CONCLUSIONS AND RELEVANCE: MA enrollment was associated with lower likelihood of self-reported functional improvement during rehabilitation but no clinically or statistically significant differences in annual changes of physical performance or function. As MA expands, future studies must monitor implications on rehabilitation coverage and older adults' independence.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Lam, K., Kleijwegt, H., Bollens‐Lund, E., Nicholas, L. H., Covinsky, K. E., & Ankuda, C. K. (2024). Long‐term outcomes after rehabilitation in Medicare Advantage and fee‐for‐service beneficiaries. Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.18917
Vancouver
Lam K, Kleijwegt H, Bollens‐Lund E, Nicholas LH, Covinsky KE, Ankuda CK. Long‐term outcomes after rehabilitation in Medicare Advantage and fee‐for‐service beneficiaries. Journal of the American Geriatrics Society. 2024. doi:10.1111/jgs.18917. PMID: 38597342.
BibTeX
@article{lam2024-38597342,
author = {Lam, Kenneth and Kleijwegt, Hannah and Bollens‐Lund, Evan and Nicholas, Lauren Hersch and Covinsky, Kenneth E. and Ankuda, Claire K.},
title = {{Long‐term outcomes after rehabilitation in Medicare Advantage and fee‐for‐service beneficiaries}},
journal = {Journal of the American Geriatrics Society},
year = {2024},
doi = {10.1111/jgs.18917},
pmid = {38597342},
url = {https://doi.org/10.1111/jgs.18917}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Among 738 MA and 1488 FFS participants, weighted mean age was 76 years (SD 7.0), 59% were female, and 9% had probable dementia.
- MA beneficiaries were more likely to be Black (9% vs. 6%) or Hispanic/other race (15% vs. 10%), be on Medicaid (14% vs. 10%), have lower income (median $35,000 vs. $48,000), and receive <1 month of rehabilitation (30% vs. 23%).
- MA beneficiaries had a similar decline in SPPB (-0.46 [SD 1.8] vs. -0.21 [SD 2.7], p-value 0.069) and adapted FIM (-1.05 [SD 3.7] vs. -1.13 [SD 5.45], p-value 0.764) compared to FFS.
- MA beneficiaries were less likely to report improved function during rehabilitation (61% [95% CI 56-67] vs. 70% [95% CI 67-74], p-value 0.006).
- Other outcomes and analyses restricted to inpatient rehabilitation participants were non-significant.
Why it matters
This study found that Medicare Advantage enrollees were less likely to report improved function during rehabilitation than fee-for-service beneficiaries, but there were no significant differences in annual changes in physical performance or function. It does not test any treatment, cure, or prevention for Alzheimer's disease.
Study details
- Study designcohort study
- Evidence strengthModerate
How this study scored 46/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | 3 / 4 | Journal of the American Geriatrics Society: journal h-index 344 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2024 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.2 citations a year over 4 year(s) since 2024 |
| Impact for its field and year | 1 / 6 | Cited 0.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Claire K. Ankuda: h-index 21 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, San Francisco: institution h-index 1,915 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 38597342) |
| Free to read | 2 / 2 | Free to read |
| Total | 46 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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