Comprehensive Geriatric Assessment

The Centers for Medicare & Medicaid Services (CMS) Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents—Payment Reform enabled participating NFs to bill Medicare for providing on-site care to eligible long-stay residents meeting specified severity criteria due to any of 6 medical conditions, as an alternative to hospitalization. For billing purposes, residents were required to meet clinical criteria severe enough to warrant hospitalization.

Our findings lend support to the practice of treating residents for these 6 conditions on-site, when clinically appropriate, instead of transferring to a hospital. It is advisable that NF medical directors consider our findings and be reassured that treatment within the facility is often the better choice for residents and their health outcomes. Further research is warranted to develop best practice criteria to guide decisions as to when to treat residents with these conditions on-site vs in the hospital. In addition to outcomes measured in this study, there are other benefits to treating nursing facility residents on-site, such as supporting continuity of care and supporting residents to remain in a stable, familiar environment.

IntroducciónDada la creciente adopción de la ecografía clínica en medicina,

Wearable Technologies in Cardiovascular Medicine This article reviews the use of digital wearable technologies for monitoring of three common cardiovascular conditions: hypertension, hear

The 10 steps are as follows: (1) select every variable that measures a health problem; (2) exclude variables with more than 5% missing values; (3) recode the responses to 0 (no deficit) through 1 (deficit); (4) exclude variables when coded deficits are too rare (< 1%) or too common (> 80%); (5) screen the variables for association with age; (6) screen the variables for correlation with each other; (7) count the variables retained; (8) calculate the frailty index scores; (9) test the characteristics of the frailty index; (10) use the frailty index in analyses. In our worked example, we created a 61-item frailty index following these 10 steps

In the present study, the use of telemedicine in the management of

nursing home residents requiring a call to the EMCC decreased the

number of dispatches to the ED by 18%.

By reducing the number of dispatches to our ED, the implementation of telemedicine in nursing homes could prevent 450 unplanned admissions per year in our ED and 65,000 admissions per year in all French EDs. There are many benefits to be expected, both individually in terms of morbidity of older individuals by avoiding cognitive decline, iatrogenic complications, and other adverse events commonly associated with unplanned hospital admissions and collectively by limiting inappropriate hospitalizations and their associated costs.

Las admisiones en urgencias por ACSC procedentes de entornos residenciales suponen un impacto significativo tanto en la frecuencia como en los costes. La disminución de estas enfermedades mediante la aplicación de intervenciones específicas podría redirigir los costes evitados hacia la mejora del apoyo asistencial en los entornos residenciales.

eFI is the best-performing VEFM; however, based on our analysis of an average UK GP practice, it would return a high number of false-positive results. In conclusion, existing electronic frailty tools may not be appropriate for primary care-based population screening.

Assessment of health system performance is a complex task, especially amid major political change, structural reforms, and a global pandemic. The Health Policy paper by Felicia Marie Knaul and colleagues1 in The Lancet identifies many challenges to improving the performance of the Mexican health system in the 21st century. Their analysis seeks to illustrate how successful implementation of health reform requires continuous efforts at improvement and careful political management of key stakeholder groups.