Observational studyJournal of the American Medical Directors Association2019
Rehabilitation Therapy for Nursing Home Residents at the End-of-Life.
Observational study in Journal of the American Medical Directors Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Therapy-based allied health delivery in residential aged care, trends, factors, and outcomes: a systematic review.BMC geriatrics · 2022Pooled it
- A Systematic Review of Nursing Home Palliative Care Interventions: Characteristics and Outcomes.Journal of the American Medical Directors Association · 2020Pooled it
- Skilled Nursing Facility Rehabilitation Intensity and Successful Discharge in Persons with Dementia.Journal of the American Medical Directors Association · 2024Article
- Allied health in residential aged care: Using routinely collected data to improve funding opportunities.Australasian journal on ageing · 2023Article
- Post-acute care transitions and outcomes among Medicare beneficiaries with dementia: Associations with race/ethnicity and dual status.Health services research · 2023Observational
- Forced to Choose: When Medicare Policy Disrupts End-of-Life Care.Journal of aging & social policy · 2022Article
- Implementing Primary Palliative Care in Post-acute nursing home care: Protocol for an embedded pilot pragmatic trial.Contemporary clinical trials communications · 2021Article
- Impact of the Physician Orders for Life-Sustaining Treatment (POLST) Program Maturity Status on the Nursing Home Resident's Place of Death.The American journal of hospice & palliative care · 2021Article
- Functional outcome in home health: Do racial and ethnic minority patients with dementia fare worse?PloS one · 2020Article
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 at 2 institutions in 1 country.
Funding
Abstract
objectiveUltrahigh therapy use has increased in SNFs without concomitant increases in residents' characteristics. It has been suggested that this trend may also have influenced the provision of high-intensity rehabilitation therapies to residents who are at the end of life (EOL). Motivated by lack of evidence, we examined therapy use and intensity among long-stay EOL residents.
designAn observational study covering a time period 2012-2016. SETTING AND
participantsNew York State nursing homes (N = 647) and their long-stay decedent residents (N = 55,691).
methodsData sources included Minimum Data Set assessments, vital statistics, Nursing Home Compare website, LTCfocus, and Area Health Resource File. Therapy intensity in the last month of life was the outcome measure. Individual-level covariates were used to adjust for health conditions. Facility-level covariates were the key independent variables of interest. Multinomial logistic regression models with facility random effects were estimated.
resultsOverall, 13.6% (n = 7600) of long-stay decedent residents had some therapy in the last month of life, 0% to 45% across facilities. Of those, almost 16% had very high/ultrahigh therapy intensity (>500 minutes) prior to death. Adjusting for individual-level covariates, decedents in the for-profit facilities had 18% higher risk of low/medium therapy [relative risk ratio (RRR) = 1.182, P < .001], and more than double the risk of high/ultrahigh therapy (RRR = 2.126, P < .001), compared to those with no therapy use in the last month of life. In facilities with higher physical therapy staffing, decedents had higher risk (RRR = 16.180, P = .002) of high/ultrahigh therapy, but not of low/medium therapy intensity. The use of high/ultrahigh therapy in this population has increased over time. CONCLUSIONS AND RELEVANCE: This is a first study to empirically demonstrate that facility characteristics are associated with the provision of therapy intensity to EOL residents. Findings suggest that facilities with a for-profit mission, and with higher staffing of therapists, may be more incentivized to maximize therapy use, even among the sickest of the residents.
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Registered trials
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