Regenstrief Institute

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.

Efficiency, comprehensiveness and cost-effectiveness when comparing dictation and electronic templates for operative reports.

Abstract: Surgeons typically document operative events using dictation services Dictated reports are frequently incomplete or delayed Electronic note templates could potentially improve this process Using a study design of alternating four week blocks, we compared the timeliness and comprehensiveness of operative notes created through the use of electronic templates (structured text documents for reuse) versus dictation services for five surgical procedures Templates resulted in dramatically faster times to the presence of a verified operative report in the medical record compared to dictation services (mean 28 v 22,440 minutes) Templates increased overall compliance with national standards for operative note documentation and avoided transcription costs Documentation with templates took slightly more time than dictation (mean 677 v 596 minutes; P=0036), not including the additional time necessary to subsequently verify dictated reports We conclude that electronic note templates can improve the timeliness and comprehensiveness of operative documentation, while decreasing transcription costs and requiring minimal additional effort on the part of surgeons

Age and the Sense of Control among Older Adults

Abstract: Older adults are expected and frequently found to report less control than younger adults. In this study, we decompose this negative relationship between age and sense of control using nested multivariable linear regression models that serially introduce sociodemographic characteristics, socioeconomic factors, health status, and subjective religiosity and religious beliefs in a sample of 1,051 older adults attending the general medicine clinics of a major medical center. The results indicate that the effect of age is suppressed in the bivariable model. In the final multivariable model, educational attainment has the largest relative effect (i.e., beta; .253), followed by age (-.210), mental health (.174), subjective religiosity (.113), being an African American (-.100), perceived health (.082), and being Catholic (.068). Future research should focus on the inflection point in the relationship between age and the sense of control that apparently occurs at about 50 years of age.

Association of Anticholinergic Burden with Cognitive Impairment and Health Care Utilization Among a Diverse Ambulatory Older Adult Population.

Abstract: tudy Objective To determine the association between Anticholinergic Cognitive Burden (ACB) score and both cognitive impairment and health care utilization among a diverse ambulatory older adult population. Design Retrospective cohort study. Data Source Medication exposure and other clinical data were extracted from the Regenstrief Medical Record System (RMRS), and cognitive diagnosis derived from a dementia screening and diagnosis study. Patients A total of 3344 community-dwelling older adults (aged ≥ 65 years) who were enrolled in a previously published dementia screening and diagnosis study; of these, 3127 were determined to have no cognitive impairment, and 217 were determined to have cognitive impairment. Measurements and Main Results The study followed a two-phase screening and comprehensive neuropsychiatric examination to determine cognitive diagnosis, which defined cognitive impairment as dementia or mild cognitive impairment. The ACB scale was used to identify anticholinergics dispensed in the 12 months prior to screening. A total daily ACB score was calculated by using pharmacy dispensing data from RMRS; each anticholinergic was multiplied by 1, 2, or 3 consistent with anticholinergic burden defined by the ACB scale. The sum of all ACB medications was divided by the number of days with any medication dispensed to achieve the total daily ACB score. Health care utilization included visits to inpatient, outpatient, and the emergency department and was determined by using visit data from the RMRS. The overall population had a mean age of 71.5 years, 71% were female, and 58% were African-American. Each 1-point increase in mean total daily ACB score was associated with increasing risk of cognitive impairment (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.004–1.27, p=0.043). Each 1-point increase in mean total daily ACB score increased the likelihood of inpatient admission (OR 1.11, 95% CI 1.02–1.29, p=0.014) and number of outpatient visits after adjusting for demographic characteristics, number of chronic conditions, and prior visit history (estimate 0.382, standard error 0.113; p=0.001). The number of visits to the emergency department was also significantly different after similar adjustments (estimate 0.046, standard error 0.023, p=0.043). Conclusion Increasing total ACB score was correlated with an increased risk for cognitive impairment and more frequent health care utilization. Future work should study interventions that safely reduce ACB and evaluate impact on brain health and health care costs. This article is protected by copyright. All rights reserved.

Exchanging Health Information: Local Distribution, National Coordination

Abstract: The fragmentation of our health care system, our need to accommodate the diversity of existing health information exchanges, the lack of consistent implementation of clinical information standards,...