Citation

O'Connor M, Hanlon A, Mauer E, Meghani S, Masterson-Creber R, Marcantonio S, Coburn K, Van Cleave J, Davitt J, Riegel B, Bowles KH, Keim S, Greenberg SA, Sefcik JS, Topaz M, Kong D, Naylor M. Geriatr. Nurs. 2017; 38(6): 510-519.

Affiliation

NewCourtland Center for Transitions in Health, University of Pennsylvania School of Nursing, USA.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.gerinurse.2017.03.013

PMID

28479081

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 © 2017 Elsevier Inc. All rights reserved.

Language: en

Keywords

Chronic illness; Community-dwelling older adults; Latent class analysis; Nurse care management model; Risk profiles