PubMed Health⌕ Search

Biomedical subjects

M D Mezey

Publications and source records attributed to M D Mezey.

14 recordsLinked to original sources
PubMed1989

The teaching nursing home program. Outcomes of care.

Increased patient acuity, relative absence of professional providers, and isolation of nursing homes from the mainstream of health care precipitated the initiation of Teaching Nursing Home Programs (TNHP). The Robert Wood Johnson Foundation TNHP provided funding for 11 schools of nursing in collaboration with 12 nursing homes for the purpose of upgrading clinical care in nursing homes, creating an environment supportive of education, and promoting clinical research. A complete evaluation of a TNHP requires consideration of outcome, process, and structure. Quality of care and professional decision making are discussed as two of four areas by which TNHPs were evaluated.

Clinical Nursing Research↗
PubMed1987

Differences in outcome between black and white elderly hip fracture patients.

Because blacks make up a small proportion of the hip fracture population, little is known about how blacks' experience following hip fracture compares to that of whites. This study, a retrospective review of the medical records of 119 community residing subjects, 60 years of age and older, 37% of whom were black, admitted with a diagnosis of hip fracture to a large urban teaching hospital, investigated differences between black and white patients in factors associated with outcome following hip fracture and outcomes at time of hospital discharge. Blacks were significantly more likely than whites to exhibit a high total number of diagnoses, urinary incontinence following surgery, low admission hemoglobins and mental impairment. Blacks experienced significantly longer hospitalizations than whites, were significantly more likely to be nonambulatory at discharge and showed different patterns of discharge destination. Multiple regression and logistic regression indicated that the greater amount of illness of blacks is a consistent significant predictor of these differences in outcomes, but that race, delays to surgery and non-surgical treatment also make independent significant contributions. These findings indicate the importance of planning for the in-hospital care of black hip fracture patients, and the examination of the financial consequences of DRG's for hospitals serving black or poor populations.

Black or African American↗
PubMed1987

Mental impairment of elderly hospitalized hip fracture patients.

Mental impairment recorded at admission, following surgery and at discharge was assessed by studying the hospital records of 98 community residing persons, 60 years and older (mean age 76.2), hospitalized for a hip fracture and discharged alive. Of the total sample, the proportion mentally impaired following surgery was 33%. In a subsample of 74 patients for whom data were known at admission and after surgery, 15% were identified as persistently mentally impaired at admission and post-surgery, 26% were impaired only post-surgically and 59% had no recorded impairment either at admission or after surgery. Length of hospitalization (LOS) differed significantly among these three impairment groups, with persistently impaired having significantly longer stays (mean number of days = 53) than the never impaired (mean number of days = 24) and the newly impaired (mean number of days = 38) falling in between (p less than 0.005). Mental impairment continued to exhibit a significant and independent relationship with length of stay even when age and total diagnoses were held constant. The substantial prevalence of mental impairment during hospitalization, coupled with the increased length of stay in patients exhibiting impairment persisting from time of admission or newly evident after surgery, underscore the importance of mental status for recovery. Findings suggest that assessing the progression of mental impairment over the course of a hospital stay yields more accurate information about the relationship of mental status to recovery indicators and that accurate assessment of impairment at admission identifies a patient group at high risk for increased lengths of stay.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗