Adding Functional Ability Measures to a Mortality Algorithm to Support Palliative Care Eligibility Decisions.

IF 1.1 4区医学 Q3 NURSING

Research in Gerontological Nursing Pub Date : 2025-06-10 DOI:10.3928/19404921-20250522-01

Elizabeth A Luth, Carlin Brickner, Harivony Rakotoarivelo, Oude Gao, Kathryn H Bowles

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引用次数: 0

Abstract

Purpose: To codify functional ability measures using administrative claims data to identify individuals for palliative care and examine their associations with mortality.

Method: A retrospective cohort analysis of July 2022-June 2023 administrative claims data for 6,625 Medicare Advantage plan enrollees identified functional ability measures-activities of daily living (ADL), feeding and respiratory support, physical therapy and occupational therapy (PT/OT), and skilled nursing-as key mortality predictors. Logistic regression tested associations between functional ability and mortality.

Results: One hundred eighty-six (4.6%) individuals died during the study period. PT/OT services were associated with lower odds of mortality (adjusted odds ratio = 0.74, 95% confidence interval [0.65, 0.85]). ADL support, skilled nursing, and pain management were associated with higher odds of mortality.

Conclusion: Attention to whether a seriously ill individual is receiving PT/OT, ADL support, or skilled nursing may help make timely referrals to palliative care. [Research in Gerontological Nursing, xx(x), xx-xx.].

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在死亡率算法中增加功能能力测量以支持姑息治疗资格决策。

目的：利用行政索赔数据编纂功能能力测量，以确定接受姑息治疗的个体，并检查其与死亡率的关系。方法：回顾性队列分析2022年7月至2023年6月6625名医疗保险优势计划参保者的行政索赔数据，确定功能能力测量-日常生活活动（ADL），喂养和呼吸支持，物理治疗和职业治疗（PT/OT）以及熟练护理-作为关键死亡率预测因素。逻辑回归检验了功能能力和死亡率之间的关系。结果：研究期间有186人（4.6%）死亡。PT/OT服务与较低的死亡率相关（调整后的优势比= 0.74,95%可信区间[0.65,0.85]）。ADL支持、熟练护理和疼痛管理与较高的死亡率相关。结论：关注重症患者是否接受PT/OT、ADL支持或熟练护理可能有助于及时转介到姑息治疗。[老年护理研究，xx(x)， xx-xx.]

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来源期刊

Research in Gerontological Nursing NURSING-

CiteScore

2.30

自引率

6.20%

发文量

审稿时长

>12 weeks

期刊介绍： Research in Gerontological Nursing is a forum for disseminating peer-reviewed, interdisciplinary, cutting-edge gerontological nursing research and theory to investigators, educators, academicians, clinicians, and policymakers involved with older adults in all health care settings. The Journal accepts manuscripts reporting research, theory, integrative and systematic reviews, instrument development, and research methods with the aims of improving the wellness and quality of care of the older adult population. Theory papers should advance gerontological knowledge, and integrative reviews should provide an analysis of the state of the science and provide direction for future research.