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Biomedical subjects

S Allison-Cooke

Publications and source records attributed to S Allison-Cooke.

6 recordsLinked to original sources
PubMed1977

Factors affecting nursing home medical review Implications for program and facility planning.

A system for the Medical Review of nursing home patients has been fully operational in the state of Rhode Island since 1973. This study examines recommendations as to the appropriate level of care required by each of 1,309 skilled nursing patients reviewed during the system's first full year of operation and relates these recommendations to a number of other factors, including patient and facility characteristics. Variables measuring patient medical condition and need for skilled nursing care correlated strongly with level of care recommendations made by the team of professional reviewers. In addition, facility licensing status emerged as a significant influence in the decision-making process concerning appropriate level of care assignments. Skilled nursing patients in multi-level (SN/ICF) facilities were much more likely to be recommended for less intensive, intermediate levels of nursing care than were patients residing in single-level (SN) facilities. This relationship persisted after controlling for variations in patient characteristics, but was strongest among those patients for whom the need for continued SN care seemed most dubious. The authors conclude that 1) the relationship can be attributed to a reluctance on the part of the review team to physically relocate aged patients, and 2) long-term care patients with complexly intertwining medical and social needs might be most appropriately placed in facilities which offer a spectrum of services and multiple levels of care.

Activities of Daily Living↗
PubMed1976

22. Some successes and failures with long-term care data systems: the Rhode Island experience.

A project by Rhode Island Health Services Research (SEARCH) to develop, adapt, and improve data systems in several Rhode Island long-term care settings includes skilled nursing and intermediate care facilities, two chronic care hospitals, mental health institutions, and home health agencies. A successful medical review system was developed for Medicaid nursing home patients which is now a program funded by the state, as well as a good abstracting system for the two chronic hospitals. Also, steps were taken to correct omissions and inaccuracies found in mental health data used in the Multi-State Information System (MSIS), and to modify a limited management information system used by home health agencies. In retrospect, the project would have been better served had it attempted to be less comprehensive and instead focused its resources in areas of high visibility and unequivocal public concern. The approach would have given the state population-based information of much greater power than is currently available, despite the recognized successes of the project in the nursing home and chronic hospital areas.

Chronic Disease↗