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Geriatric Assessment Predicts Hospitalization Frequency and Long-Term Care Use in Older Adult Cancer Survivors.
- Source :
-
Journal of Oncology Practice . May2019, Vol. 15 Issue 5, pe399-e409. 11p. - Publication Year :
- 2019
-
Abstract
- PURPOSE: The association between geriatric assessment (GA)–identified impairments and long-term health care use in older cancer survivors remains unknown. Our objective was to evaluate whether a GA performed at cancer diagnosis was predictive of hospitalizations and long-term care (LTC) use in older adult cancer survivors. METHODS: Older adults with GA performed between 3 months before through 6 months after diagnosis were included (N = 125). Patients with Medicare Parts A and B coverage and no managed care were identified. Hospitalizations and LTC use (skilled nursing or assisted living) were assessed up to 5 years postdiagnosis. GA risk measures were evaluated in separate Poisson models estimating the relative risk (RR) for hospital and LTC visits, adjusting for age and Charlson comorbidity score. RESULTS: The mean age of patients was 74 years, and the majority were female (80%) and white (90%). Breast cancer (64%) and early-stage disease (stages 0 to III, 77%) were common. Prefrail/frail status (RR, 2.5; P <.001), instrumental activities of daily living impairment (RR, 5.47; P <.001), and limitations in climbing stairs (RR, 2.94; P <.001) were associated with increased hospitalizations. Prefrail/frail status (RR, 1.86; P <.007), instrumental activities of daily living impairment (RR, 4.58; P <.001), presence of falls (RR, 6.73; P <.001), prolonged Timed Up and Go (RR, 5.45; P <.001), and limitations in climbing stairs (RR, 1.89; P <.005) were associated with LTC use. CONCLUSION: GA-identified impairments were associated with increased hospitalizations and LTC use among older adults with cancer. GA-focused interventions should be targeted toward high-risk patients to reduce long-term adverse health care use in this vulnerable population. [ABSTRACT FROM AUTHOR]
- Subjects :
- *BREAST tumor diagnosis
*NURSING audit
*TUMOR diagnosis
*AGE distribution
*GERIATRIC assessment
*HOSPITAL care of older people
*CANCER patients
*CONGREGATE housing
*LONG-term health care
*MEDICARE
*RISK assessment
*TUMOR classification
*WHITE people
*ACTIVITIES of daily living
*RELATIVE medical risk
*STAIR climbing
*OLD age
Subjects
Details
- Language :
- English
- ISSN :
- 15547477
- Volume :
- 15
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Journal of Oncology Practice
- Publication Type :
- Academic Journal
- Accession number :
- 136383947
- Full Text :
- https://doi.org/10.1200/JOP.18.00368