Document Type

Journal Article

Date of this Version

5-4-2017

Embargo Date

1-1-2019

Publication Source

Geriatric Nursing

Volume

38

Issue

6

Start Page

510

Last Page

519

DOI

10.1016/j.gerinurse.2017.03.013

Abstract

Preventing adverse events among chronically ill older adults living in the community is a national health priority. The purpose of this study was to generate distinct risk profiles and compare these profiles in time to: hospitalization, emergency department (ED) visit or death in 371 community-dwelling older adults enrolled in a Medicare demonstration project. Guided by the Behavioral Model of Health Service Use, a secondary analysis was conducted using Latent Class Analysis to generate the risk profiles with Kaplan Meier methodology and log rank statistics to compare risk profiles. The Vuong-Lo-Mendell-Rubin Likelihood Ratio Test demonstrated optimal fit for three risk profiles (High, Medium, and Low Risk). The High Risk profile had significantly shorter time to hospitalization, ED visit, and death (p < 0.001 for each). These findings provide a road map for generating risk profiles that could enable more effective targeting of interventions and be instrumental in reducing health care costs for subgroups of chronically ill community-dwelling older adults.

Copyright/Permission Statement

© 2017 Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/

Keywords

Chronic Disease, Emergency Service, Hospital, Female, Hospitalization, Humans, Independent Living, Male, Medicare, Outcome Assessment (Health Care), Risk Assessment, United States

Available for download on Tuesday, January 01, 2019

Share

COinS
 

Date Posted: 06 August 2018

This document has been peer reviewed.