Institution
Regenstrief Institute
Nonprofit•Indianapolis, Indiana, United States•
About: Regenstrief Institute is a nonprofit organization based out in Indianapolis, Indiana, United States. It is known for research contribution in the topics: Health care & Population. The organization has 742 authors who have published 2042 publications receiving 96966 citations.
Papers published on a yearly basis
Papers
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TL;DR: Percutaneous endoscopic gastrostomy has become the preferred method to provide enteral tube feeding to older adults who have difficulty eating, but the impact of PEG on patient outcomes is poorly understood.
Abstract: OBJECTIVE: Percutaneous endoscopic gastrostomy (PEG) has become the preferred method to provide enteral tube feeding to older adults who have difficulty eating, but the impact of PEG on patient outcomes is poorly understood. The objective of this study was to describe changes in nutrition, functional status, and health-related quality of life among older adults receiving PEG.
DESIGN: A prospective cohort study.
SETTING: A small community of approximately 60,000 residents served by two hospital systems.
PARTICIPANTS: One hundred fifty patients aged 60 and older receiving PEG from one of the four gastroenterologists practicing in the targeted community.
MEASUREMENTS: Patients were assessed at baseline and every 2 months for 1 year to obtain clinical characteristics, process of care data, physical and cognitive function, subjective health status, nutritional status, complications, and mortality.
RESULTS: Over a 14-month period, 150 patients received PEG tubes in the targeted community; the mean age was 78.9. The most frequent indications for the PEG were stroke (40.7%), neurodegenerative disorders (34.7%), and cancer (13.3%). All measures of functional status, cognitive status, severity of illness, comorbidity, and quality of life demonstrated profound and life-threatening impairment; 30-day mortality was 22% and 1-year mortality was 50%. Among patients surviving 60 days or more, at least 70% had no significant improvement in functional, nutritional, or subjective health status. Serious complications were rare, but most patients experienced symptomatic problems that they attributed to the enteral tube feeding.
CONCLUSIONS: PEG tube feeding in severely and chronically ill older adults can be accomplished safely. However, there are important patient burdens associated with the PEG and there was limited evidence that the procedure improves functional, nutritional, or subjective health status in this cohort of older adults. The issues raised in this descriptive study provide impetus for a randomized trial of PEG tube feeding compared with alternative methods of patient care for older adults with difficulty eating.
221 citations
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TL;DR: A systematic literature review of the published literature comparing EUS and CT for preoperative assessment of pancreatic cancer concluded that the sensitivity of EUS was superior to CT.
221 citations
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TL;DR: Transitions in care of persons with dementia with attention to nursing facility transitions is described to describe transitions in cared for with focus on residential facility transitions.
Abstract: Objectives: To describe transitions in care of persons with dementia with attention to nursing facility transitions.
Design: Prospective cohort.
Setting: Public health system.
Participants: Four thousand one hundred ninety-seven community-dwelling older adults.
Measurements: Participants� electronic medical records were merged with Medicare claims, Medicaid claims, the Minimum Data Set (MDS), and the Outcome and Assessment Information Set (OASIS) from 2001 to 2008 with a mean follow-up of 5.2 years from the time of enrollment.
Results: Older adults with prevalent (n = 524) or incident (n = 999) dementia had greater Medicare (44.7% vs 44.8% vs 11.4%, P < .001) and Medicaid (21.0% vs 16.8% vs 1.4%, P < .001) nursing facility use, greater hospital (76.2% vs 86.0% vs 51.2%, P < .001) and home health (55.7% vs 65.2% vs 27.3%, P < .001) use, more transitions in care per person-year of follow-up (2.6 vs 2.7 vs 1.4, P < .001), and more mean total transitions (11.2 vs 9.2 vs 3.8, P < .001) than those who were never diagnosed (n = 2,674). For the 1,523 participants with dementia, 74.5% of transitions to nursing facilities were transfers from hospitals. For transitions from nursing facilities, the conditional probability was 41.0% for a return home without home health care, 10.7% for home health care, and 39.8% for a hospital transfer. Of participants with dementia with a rehospitalization within 30 days, 45% had been discharged to nursing facilities from the index hospitalization. At time of death, 46% of participants with dementia were at home, 35% were in the hospital, and 19% were in a nursing facility.
Conclusion: Individuals with dementia live and frequently die in community settings. Nursing facilities are part of a dynamic network of care characterized by frequent transitions.
218 citations
23 Jun 2010
TL;DR: In this paper, a patient-physician race/ethnicity and language concordance may improve medication adherence and reduce disparities in cardiovascular disease (CVD) by fostering trust and improved patientphysician communication.
Abstract: Background
Patient–physician race/ethnicity and language concordance may improve medication adherence and reduce disparities in cardiovascular disease (CVD) by fostering trust and improved patient–physician communication.
216 citations
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TL;DR: The idea that champions are crucial to effective healthcare-related implementation has gained broad acceptance; yet the champion construct has been hampered by inconsistent use of acro... as mentioned in this paper, 2015.
Abstract: Background/aims:The idea that champions are crucial to effective healthcare-related implementation has gained broad acceptance; yet the champion construct has been hampered by inconsistent use acro...
216 citations
Authors
Showing all 752 results
Name | H-index | Papers | Citations |
---|---|---|---|
Earl S. Ford | 130 | 404 | 116628 |
Andrew J. Saykin | 122 | 887 | 52431 |
Michael W. Weiner | 121 | 738 | 54667 |
Terry M. Therneau | 117 | 447 | 59144 |
Ting-Kai Li | 109 | 494 | 39558 |
Kurt Kroenke | 107 | 478 | 110326 |
E. John Orav | 100 | 379 | 34557 |
Li Shen | 84 | 558 | 26812 |
William M. Tierney | 84 | 423 | 24235 |
Robert S. Dittus | 82 | 252 | 32718 |
C. Conrad Johnston | 80 | 177 | 30409 |
Matthew Stephens | 80 | 216 | 98924 |
Morris Weinberger | 78 | 367 | 23600 |
Richard M. Frankel | 74 | 334 | 24885 |
Patrick J. Loehrer | 73 | 279 | 21068 |