Visiting Nurse Service of New York, New York, NY, USA.
Vital Statistics Consulting, LLC, Maplewood, NJ, USA.
J Appl Gerontol. 2022 Feb;41(2):534-544. doi: 10.1177/0733464821999225. Epub 2021 Mar 20.
Home health care (HHC) clinicians serving individuals with Alzheimer's disease and related dementias (ADRD) do not always have information about the person's ADRD diagnosis, which may be used to improve the HHC plan of care. This retrospective cohort study examined characteristics of 56,652 HHC patients with varied documentation of ADRD diagnoses. Data included clinical assessments and Medicare claims for a 6-month look-back period and 4-year follow-up. Nearly half the sample had an ADRD diagnosis observed in the claims either prior to or following the HHC admission. Among those with a prior diagnosis, 63% did not have it documented on the HHC assessment; the diagnosis may not have been known to the HHC team or incorporated into the care plan. Patients with ADRD had heightened risk for adverse outcomes (e.g., urinary tract infection and aspiration pneumonia). Interoperable data across health care settings should include ADRD-specific elements about diagnoses, symptoms, and risk factors.
家庭保健（HHC）临床医生为患有阿尔茨海默病和相关痴呆症（ADRD）的个人提供服务，但他们并不总是了解患者的 ADRD 诊断信息，而这些信息可能有助于改善 HHC 护理计划。本回顾性队列研究调查了 56652 名 HHC 患者的特征，这些患者的 ADRD 诊断记录存在差异。数据包括 6 个月回溯期和 4 年随访期间的临床评估和医疗保险索赔。样本中近一半的人在 HHC 入院前或入院后从索赔中观察到 ADRD 诊断。在有既往诊断的患者中，63%的患者在 HHC 评估中没有记录该诊断；该诊断可能不为 HHC 团队所知，也未纳入护理计划。患有 ADRD 的患者发生不良后果（如尿路感染和吸入性肺炎）的风险更高。医疗保健环境中的互操作数据应包括关于诊断、症状和风险因素的 ADRD 特定元素。
