Dataset Information

Multiple Chronic Conditions and Hospitalizations Among Recipients of Long-Term Services and Supports.

ABSTRACT: BACKGROUND:Among older adults receiving long-term services and supports (LTSS), debilitating hospitalizations is a pervasive clinical and research problem. Multiple chronic conditions (MCCs) are prevalent in LTSS recipients. However, the combination of MCCs and diseases associated with hospitalizations of LTSS recipients is unclear. OBJECTIVE:The purpose of this analysis was to determine the association between classes of MCCs in newly enrolled LTSS recipients and the number of hospitalizations over a 1-year period following enrollment. METHODS:This report is based on secondary analysis of extant data from a longitudinal cohort study of 470 new recipients of LTSS, 60 years and older, receiving services in assisted living facilities, nursing homes, or through home- and community-based services. Using baseline chronic conditions reported in medical records, latent class analysis was used to identify classes of MCCs and posterior probabilities of membership in each class. Poisson regressions were used to estimate the relative ratio between posterior probabilities of class membership and number of hospitalizations during the 3-month period prior to the start of LTSS (baseline) and then every 3 months forward through 12 months. RESULTS:Three latent MCC-based classes named Cardiopulmonary, Cerebrovascular/Paralysis, and All Other Conditions were identified. The Cardiopulmonary class was associated with elevated numbers of hospitalizations compared to the All Other Conditions class (relative ratio [RR] = 1.88, 95% CI [1.33, 2.65], p < .001). CONCLUSION:Older LTSS recipients with a combination of MCCs that includes cardiopulmonary conditions have increased risk for hospitalization.

SUBMITTER: Van Cleave JH

PROVIDER: S-EPMC5147488 | biostudies-literature | 2016 Nov/Dec

REPOSITORIES: biostudies-literature

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Multiple Chronic Conditions and Hospitalizations Among Recipients of Long-Term Services and Supports.

Van Cleave Janet H JH Egleston Brian L BL Abbott Katherine M KM Hirschman Karen B KB Rao Aditi A Naylor Mary D MD

Nursing research 20161101 6

<h4>Background</h4>Among older adults receiving long-term services and supports (LTSS), debilitating hospitalizations is a pervasive clinical and research problem. Multiple chronic conditions (MCCs) are prevalent in LTSS recipients. However, the combination of MCCs and diseases associated with hospitalizations of LTSS recipients is unclear.<h4>Objective</h4>The purpose of this analysis was to determine the association between classes of MCCs in newly enrolled LTSS recipients and the number of ho ...[more]

PMID: 27801713

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Project description:OBJECTIVE:The aim of this study was to validate a new generic patient-reported outcome measure, the Long-Term Conditions Questionnaire (LTCQ), among a diverse sample of health and social care users in England. DESIGN:Cross-sectional validation survey. Data were collected through postal surveys (February 2016-January 2017). The sample included a healthcare cohort of patients recruited through primary care practices, and a social care cohort recruited through local government bodies that provide social care services. PARTICIPANTS:1211 participants (24% confirmed social care recipients) took part in the study. Healthcare participants were recruited on the basis of having one of 11 specified long-term conditions (LTCs), and social care participants were recruited on the basis of receiving social care support for at least one LTC. The sample exhibited high multimorbidity, with 93% reporting two or more LTCs and 43% reporting a mental health condition. OUTCOME MEASURES:The LTCQ's construct validity was tested with reference to the EQ-5D (5-level version), the Self-Efficacy for Managing Chronic Disease scale, an Activities of Daily Living scale and the Bayliss burden of morbidity scale. RESULTS:Low levels of missing data for each item indicate acceptability of the LTCQ across the sample. The LTCQ exhibits high internal consistency (Cronbach's ?=0.95) across the scale's 20 items and excellent test-retest reliability (intraclass correlation coefficient=0.94, 95%?CI 0.93 to 0.95). Associations between the LTCQ and all reference measures were moderate to strong and in the expected directions, indicating convergent construct validity. CONCLUSIONS:This study provides evidence for the reliability and validity of the LTCQ, which has potential for use in both health and social care settings. The LTCQ could meet a need for holistic outcome measurement that goes beyond symptoms and physical function, complementing existing measures to capture fully what it means to live well with LTCs.

Dataset Information

Multiple Chronic Conditions and Hospitalizations Among Recipients of Long-Term Services and Supports.

Publications

Multiple Chronic Conditions and Hospitalizations Among Recipients of Long-Term Services and Supports.

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