Evidence map›Paper›PMID 27549337›Full record

ArticleJournal of the American Geriatrics Society2016

Racial Differences in Hospitalizations of Dying Medicare-Medicaid Dually Eligible Nursing Home Residents.

Shubing Cai, Susan C Miller, Dana B Mukamel

Open access · greenAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 4 pooled it
0.9field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 4 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Racial/Ethnic Disparities in Nursing Home End-of-Life Care: A Systematic Review.Journal of the American Medical Directors Association · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 1 country.

Shubing CaiDepartment of Public Health Sciences, University of Rochester School of Medicine, Rochester, New York. Shubing_cai@urmc.rochester.edu.
Susan C MillerCenter for Gerontology and Healthcare Research, Brown University, School of Public Health, Providence, Rhode Island.
Dana B MukamelDivision of General Internal Medicine, Department of Medicine and iTEQC Research Program, University of California at Irvine, Irvine, California.
Brown University · USUniversity of California, Irvine · USUniversity of Rochester · US

Funding

Attributes of nursing home-hospice collaborations & end of life hospitalizationsR03AG042648 · NIA · UNIVERSITY OF ROCHESTER · PI CAI, SHUBING · 2013 to 2014
$170k
The Effect of Payer Status on Nursing Home Residents' HospitalizationsR03AG045495 · NIA · UNIVERSITY OF ROCHESTER · PI CAI, SHUBING · 2013 to 2013
$77k
NIA NIH HHS R03 AG042648NIA NIH HHS R03 AG045495
6 · The paper itself

Abstract

objectivesTo examine whether racial differences in end-of-life (EOL) hospitalizations vary according to the presence of advance directives, specifically do-not-hospitalize (DNH) orders, and individual cognitive status in nursing home (NH) residents.

designNational data, including Medicare data and Minimum Data Set (MDS) 2.0, between January 1, 2007, and September 30, 2010, were linked. EOL hospitalizations were hospitalizations in the last 30 days of life. Linear probability models with an interaction term (between race and DNH) and NH fixed-effects were estimated. The analyses were stratified according to cognitive status.

settingNursing homes in the United States.

participantsDually eligible Medicare-Medicaid decedents enrolled in Medicare fee-for-service plans and long-stay NH residents (in NHs ≥ 90 days before death) (N = 394,948). MEASUREMENTS: Racial difference in EOL hospitalizations from a NH.

resultsEnd-of-life hospitalization rate was 31.7% for whites and 42.8% for blacks. For participants without DNH orders, adjusted probability of EOL hospitalization was higher for blacks than for whites: 2.7 percentage points in those with moderate cognitive impairment (P < .001) and 4.7 percentage points in those with severe cognitive impairment (P < .001). For those with DNH orders, adjusted racial differences in EOL hospitalization were not statistically significant in those with moderate (P = .25) or severe (P = .93) cognitive impairment, but blacks had a higher probability of EOL hospitalization than whites if they had relatively intact cognitive status.

conclusionRacial differences in EOL hospitalization varied with DNH orders and cognitive status in dying residents. Future research is necessary to understand the reasons behind these variations.

Indexed as

Resuscitation OrdersAdvance DirectivesAgedAged, 80 and overBlack or African AmericanBlack PeopleCognitive DysfunctionCross-Sectional StudiesFemaleHomes for the AgedHospitalizationHumansLife Support CareMaleMedicaidMedicareend-of-life hospitalizationnursing homesracial differences

Identifiers

PMID27549337
PMCPMC5026884
OpenAlexW2509259520

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.