摘要:

Mark Rudman has been editor of Pequod Magazine for 10 years and is one of America's brilliant young poet-essayists. He has received numerous awards and a fellowship from the Poets, Essayists, and Novelists translation center. His essays have appeared in Best American Essays, 1991 and conversant essays, as well as American Poetry Review, The Nation, The New York Times Book Review, and the Times Literary Supplement. Mr. Rudman has published a book of criticism on Robert Lowell and two books of poetry, By Contraries and The Nowhere Steps. His poetry can be found in many magazines, including The New Yorker. Mr. Rudman lives in New York City where he teaches at Columbia University and New York University.

ISSN:0882-7524    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Given the increasingly frequent use of functional scale data, it is of particular importance that clinicians make an effort to understand problems in interpretation and use of that data so they may be used appropriately. This article addresses issues that involve objectivity of the data and difficulties inherent in mathematical manipulation of that data. The importance of retaining perspective as rehabilitationists by including measures that reflect quality of life issues in our scale instruments is discussed. Key words: functional outcome scales, ordinal scales, outcome measurement.

ISSN:0882-7524    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

This article summarizes the logical process underlying the development of simple assessment procedures for geriatric patients at the beginning of their hospital stay and at discharge and for nursing home residents. The relationship of predictors to the main outcomes, ie, mortality, disability, and length of stay of inpatients, is discussed and its relevance in planning health and social care clarified. Limits of the predictive models are discussed, and possible guidelines for future studies are provided. Key words: disability, inpatient mortality, geriatric assessment, geriatric evaluation unit, longstay.

ISSN:0882-7524    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Previous work suggests that serial functional assessment can focus treatment and anticipate outcome, reducing geriatric inpatient length of stay (LOS) and improving the care provided. Two hundred forty-five serial geriatric admissions to a 424-bed community teaching hospital in New York City were randomized in a 9-week case-controlled study comparing a treatment group with age, comorbidity, and DRG-matched controls and identical DRG-matched patients from the previous year. Comparison with DRG-specific LOSs showed an average decrease of 30% for eight combined target DRGs (P < 0.05) and 22% overall. Multiple regression analysis controlling for age and DRG found treatment a significant factor in reducing LOS within eight target DRGs (P < 0.01). Treatment group discharged functional scores were higher than control group in four of six DRGs despite the treatment group's significantly earlier discharge. Although prehospitalization comorbidity was equal, inhospital morbidity was significantly lower in treatment group patients (P < 0.01). Twelve treatment group patients (8.5%) and 25 control group patients died during the study. Hospital discharges increased by more than 1,400 for the year of the project, yielding a greater than $7,000,000 rise in efficiency. The program cost was under $120,000 for the year.

ISSN:0882-7524    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Knowledge of the demographics of the population of aging individuals with stroke is of vital importance. Treatment plans may be significantly altered by demographic factors unique to the individual and the cohort group. A large database of 6,047 patient charts was analyzed. There were 2,682 charts of patients with strokes (44%) that were abstracted retrospectively for a clearly defined 6-month period. The database provides demographic information for the geriatric patient with stroke focusing on gender, side of hemiplegia, comorbidity, length of stay variables, and disposition. Information from this review serves to define the characteristics of the cohort group of geriatric patients with stroke.

ISSN:0882-7524    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

This article considers the neglected problem of assessment of family function relevant to the placement and level of care for persons with long-term disabilities. An examination of both practical clinical issues and policy shows the need for improved means of assessing families. A review of the literature on family assessment shows the mixed success of past attempts to quantify family structure, dynamics, and support. Data from a prospective study involving an experimental measure of Family Help Available (FHA) are then presented. FHA was found to be a strong predictor of nursing home placement and disability support costs. Nursing home versus home residence could be predicted with 94% accuracy, but only by using both FHA and disability. Greater FHA was essential to compensate for greater patient disability. One can neither place a disabled patient nor understand disability-related costs without assessment of family support.

ISSN:0882-7524    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The presence of social support has been shown to promote health in a variety of populations and situations. However, the understanding of social support is still far from complete. This article attempts to explain the effects of age and disability on social support by studying support in two distinct groups of adults with disabilities. The total sample consists of 210 individuals, with ages ranging from 18 to 70 years. Ninety of these individuals had a stroke, and 120 had a spinal cord injury. Using a multidimensional approach, the results indicate that both age and disability have small but significant effects on specific aspects of social support. Age was found to be related to higher levels of professional social support. Disability, on the other hand, was related to social support in a number of ways. The extent of disability was related to support from community individuals and from professionals, as well as to overall satisfaction with both quality and quantity of support. Furthermore, the two different types of disability (ie, stroke versus spinal cord injury) were shown to affect social support in different ways. In this sample, those with spinal cord injuries had more of all three types of support (instrumental, informational, and emotional) than those with strokes; these persons also had more support from individuals in their communities. The findings are discussed with implications for community health professionals working with the elderly and individuals with disabilities.

ISSN:0882-7524    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

There has been considerable progress in functional assessment and functional outcome analysis with evolution from use of the Barthel index to the functional independence measure. Aggregation of large numbers of patients in various disability categories (stroke in this case) undergoing medical rehabilitation enables statistical analysis of predictive measures that may prove useful for predicting more accurately those patients likely to benefit from rehabilitation intervention, analyzing program effectiveness and efficiency, and serving as a basis for rationally allocating limited (and expensive) rehabilitation resources in an era of cost containment and likely capitated reimbursement systems.

ISSN:0882-7524    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0882-7524    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0882-7524    

出版商:OVID    

年代:1994

数据来源: OVID