Stroke affects more than 500,000 older persons each year in the United States. This study including HIP Investigator Dr. Maureen Smith sought to compare utilization and outcomes after stroke in Medicare HMO and FFS by reviewing administrative data in 11 regions from Medicare and a large national health plan. This data suggests that rehospitalization can… Read more »
As our health care system evolves, emphasis is increasingly being placed on delivering cost-effective care for high-cost populations. Care has shifted from expensive settings, such as hospitals and nursing homes, to lower cost settings, such as outpatient clinics, adult day care, and home care. Although the financial and quality impact of these new settings on… Read more »
The goal of this study by HIP Investigator Dr. Maureen Smith was to develop a quality assessment tool for care rendered to enrollees in the Program for All-inclusive Care of the Elderly (PACE) that can discriminate care quality ratings across PACE sites. Structured implicit review (SIR) of medical records by trained geriatricians and geriatric nurse… Read more »
The number of older patients enrolling in health maintenance organizations (HMOs) is increasing. Concerns have been raised that older patients may be targeted by HMOs for more stringent cost-containment mechanisms, including reduced access to expensive specialty care. In this study by HIP Investigator Dr. Maureen Smith, they investigated the relationship between membership in an HMO… Read more »
Although recent advances have been made in the treatment of acute stroke, patients often arrive at the hospital too late to receive the maximum benefit from these new therapies. This study by HIP Investigator Dr. Maureen Smith aimed to investigate characteristics that influence the time from symptom onset to hospital arrival (delay time) for patients… Read more »
Recent decades have seen several advances in medical care for acute stroke patients, but there has been little systematic documentation of these changes. This study by HIP Investigator Dr. Maureen Smith examined changes in technology use and medical therapies for hospitalized acute stroke during the 1980s using discharge diagnosis lists from Minneapolis-St Paul metropolitan hospitals.… Read more »
The decline in stroke mortality it the United States may have resulted from declining incidence improved survival of stroke patients, or both. In this study HIP Investigator Dr. Maureen Smith examined trends in the rate of hospitalized stroke in Minneapolis/ St Paul between 1980 and 1990. This was done through obtaining lists of discharge codes… Read more »
Peer assessments have traditionally been used to judge the quality of care, but a major drawback has been poor interrater reliability. The goal of this study by HIP Investigator Dr. Maureen Smith was to compare the interrater reliability for outcome and process assessments in a population of frail older adults and to identify systematic sources… Read more »
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