There is concern about the adequacy of diagnosis-based risk adjusters for paying health plans that disproportionately enroll frail Medicare beneficiaries. The Medicare Current Beneficiary Survey (MCBS) was used to examine the ability of two risk-adjustment models to predict Medicare costs for groups defined by institutional status and difficulty with activities of daily living (ADLs). Both mode...

Introduction: To implement an integrated health care system is not an easy task and to ensure its sustainability is yet more difficult. Aim: Discuss how a structurationist approach can shed light on the stakes of these processes and guide the managers of such endeavours. Theory and method: Structuration theory [1] has been used by numerous authors to cast new light on complex organizational phe...

BACKGROUND A residential area supportive for walking may facilitate elderly to live longer independently. However, current evidence on area characteristics potentially important for walking among older persons is mixed. This study hypothesized that the importance of area characteristics for transportational walking depends on the size of the area characteristics measured, and older person's fra...

BACKGROUND The accurate measurement of stature is not possible in many frail elderly persons because of problems affecting their ability to stand straight. In such cases, knee height may be used to estimate stature. OBJECTIVE This study was designed to explore the applicability of published regression equations to estimate stature of Puerto Rican and other Hispanic elderly persons living in t...

OBJECTIVES Cognitive and sensory difficulties frequently jeopardize informed consent of frail elderly patients This study is the first to test whether preliminary research experience could enhance geriatric patients' capacity to consent. DESIGN/SETTING A step-wise consent procedure was introduced in a study on fluid balance in geriatric patients. Eligible patients providing verbal consent par...

BACKGROUND Elderly migrants who do not speak the official language of their host country have increased due to extensive international migration, and will further increase in the future. This entails major challenges to ensure good communication and avoid communication barriers that can be overcome by the use of adequate interpreter services. To our knowledge, there are no previous investigatio...

BACKGROUND Prior studies measuring fidelity of complex interventions have mainly evaluated adherence, and not taken factors affecting adherence into consideration. A need for studies that clarify the concept of fidelity and the function of factors moderating fidelity has been emphasized. The aim of the study was to systematically evaluate implementation fidelity and possible factors influencing...

BACKGROUND Elderly patients admitted to Geriatric Assessment Units (GAU) typically have complex health problems that require multi-professional care. Considering the scope of human and technological resources solicited during hospitalization, as well as the many risks and discomforts incurred by the patient, it is important to ensure the communication of pertinent information for quality follow...

OBJECTIVES The aim was to psychometrically evaluate the Swedish version of the Multidimensional Pain Inventory (MPI-S) and the "brief screening version of MPI-S" for use in an elderly sample. METHODS This study comprised 175 people aged 76-99 years reporting pain and in need of help to manage daily living. The instrument's factor structures were investigated through factor analyses, convergen...