ArticleJournal of the American Geriatrics Society2017
Preventing Hospitalization with Veterans Affairs Home-Based Primary Care: Which Individuals Benefit Most?
Article in Journal of the American Geriatrics Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of Intensive Primary Care Interventions: A Systematic Review.Journal of general internal medicine · 2017Pooled it
- Ambulatory Intensive Care for Medically Complex Patients at a Health Care Clinic for Individuals Experiencing Homelessness: The SUMMIT Randomized Clinical Trial.JAMA network open · 2023Trial
- Article
- The quality of home-based primary care delivered by nurse practitioners: A national Medicare claims analysis.Journal of the American Geriatrics Society · 2024Observational
- Primary Care's Effects on Costs in the US Veterans Health Administration, 2016-2019: an Observational Cohort Study.Journal of general internal medicine · 2022Observational
- Outpatient Care Fragmentation and Acute Care Utilization in Veterans Affairs Home-Based Primary Care.JAMA network open · 2022Article
- National Cohort Study of Homebound Persons Living With Dementia: Antibiotic Prescribing Trends and Opportunities for Antibiotic Stewardship.Open forum infectious diseases · 2022Article
- Outcomes of a randomized quality improvement trial for high-risk Veterans in year two.Health services research · 2021Article
- "Eyes in the Home": Addressing Social Complexity in Veterans Affairs Home-Based Primary Care.Journal of general internal medicine · 2021Article
- Care Transitions Program for High-Risk Frail Older Adults is Most Beneficial for Patients with Cognitive Impairment.Journal of hospital medicine · 2019Article
- Discharge home health services referral and 30-day all-cause readmission in older adults with heart failure.Archives of medical science : AMS · 2018Article
- The Effect of Primary Care Visits on Total Patient Care Cost: Evidence From the Veterans Health Administration.Journal of primary care & community healthArticle
- Examining the Influence of Integrated Home and Community Care Programs on Quadruple Aim and Health Equity Outcomes Across the Health Care System: A Scoping Review.International journal of integrated careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
objectivesTo examine how medical complexity modifies the relationship between enrollment in Department of Veterans Affairs (VA) home-based primary care (HBPC) and hospitalization for ambulatory care-sensitive conditions (ACSC) for veterans with diabetes mellitus and whether the effect of HBPC on hospitalizations varies according to clinical condition.
designRetrospective cohort study.
settingVA and non-VA hospitals.
participantsVA beneficiaries aged 67 and older with diabetes mellitus and enrolled in Medicare (N = 364,972). MEASUREMENTS: Instrumental variables regression models were used to estimate the effect of HBPC enrollment on hospitalization for ACSCs (defined according to the Agency for Healthcare Research and Quality Prevention Quality Indicators) overall and in subgroups stratified according to medical complexity. Models were also estimated for each ACSC to determine which conditions were most sensitive to HBPC. Distance from the veteran's residence to the nearest HBPC site was used as the instrumental variable.
resultsHBPC was associated with fewer ACSC hospitalizations (odds ratio (OR) = 0.35 per person-month, 95% confidence interval (CI) = 0.30-0.42). For veterans in the highest quartile of medical complexity, HBPC enrollment was associated with fewer ACSC hospitalizations (OR = 0.43, 95% CI = 0.19-0.93), whereas for those in the lowest quartile, HBPC was associated with more ACSC hospitalizations (OR = 33.2, 95% CI = 4.6-240.1). HBPC enrollment was associated with fewer hospitalizations for a range of ACSCs.
conclusionHBPC enrollment was associated with fewer hospitalizations for a range of ACSCs in veterans with diabetes mellitus but only in the most medically complex individuals. This demonstrates the importance of appropriate targeting and suggests that the effect of HBPC is attributable to its comprehensive approach rather than condition-specific interventions.
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