Cited by 59Geriatric Care and Nursing HomesCardiac Health and Mental HealthHospital Admissions and Outcomes

Post-Acute Care Services Received by Older Adults Following a Cardiac Event: A Population-Based Analysis

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Dolansky, Mary A., Xu, Fang, Zullo, Melissa, Shishehbor, Mehdi, Moore, Shirley M., Rimm, Alfred A.·2010·Journal of Cardiovascular Nursing

Abstract

BACKGROUND: Post-acute care (PAC) is available for older adults who need additional services after hospitalization for acute cardiac events. With the aging population and an increase in the prevalence of cardiac disease, it is important to determine current PAC use for cardiac patients to assist health care workers to meet the needs of older cardiac patients. The purpose of this study was to determine the current PAC use and factors associated with PAC use for older adults following hospitalization for a cardiac event that includes coronary artery bypass graft and valve surgeries, myocardial infarction (MI), percutaneous coronary intervention (PCI), and heart failure (HF). METHODS AND RESULTS: A cross-sectional design and the 2003 Medicare part A database were used for this study. The sample (n = 1493521) consisted of patients 65 years and older discharged after their first cardiac event. Multinomial logistic regression was used to examine factors associated with PAC use. Overall, PAC use was 55% for cardiac valve surgery, 50% for MI, 45% for HF, 44% for coronary artery bypass graft, and 5% for PCI. Medical patients use more skilled nursing facility care, and surgical patients use more home health care. Only 0.1% to 3.4% of the cardiac patients use intermediate rehabilitation facilities. Compared with those who do not use PAC, those who use home health care and skilled nursing facility care are older and female, have a longer hospital length of stay, and have more comorbidity. Asians, Hispanics, and Native Americans were less likely to use PAC after hospitalization for an MI or HF. CONCLUSIONS: The current rate of PAC use indicates that almost half of nondisabled Medicare patients discharged from the hospital following a cardiac event use one of these services. Health care professionals can increase PAC use for Asians, Hispanics, and Native Americans by including culturally targeted communication. Optimizing recovery for cardiac patients who use PAC may require focused cardiac rehabilitation strategies.

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  1. [9]Centers for Medicare and Medicaid Services Medicare Benefit Coverage: Chapter 15- Covered Medical and Other Health Services. Internet 2009 2009 Available at URL: http//aging.senate.gov/crs/medicare1.pdf 26110197
  2. [24]Kleinbaum DG Klein M Logistic Regression: A Self-Learning Text 2002 Springer-Verlag New York 2nd edition

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Authors
Dolansky, M. A., Xu, F., Zullo, M., Shishehbor, M., Moore, S. M., & Rimm, A. A.
Affiliations
National Institutes of Health (US)
Corresponding author
Dolansky, Mary A.
Venue
Journal of Cardiovascular Nursing
Published
2010-07
Volume
25
Issue
4
Pages
342-349
ISSN
0889-4655 (ISSN-L)
OpenAlex
W1987586760
Cited by
59
References
32
Citations by year
2026: 3 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 7 · 2020: 5 · 2019: 5 · 2018: 2 · 2017: 9 · 2016: 2 · 2015: 4 · 2014: 2 · 2013: 3 · 2012: 3
FWCI
5.69
Type
journal article
Language
en
Open access
Locations
  • The Journal of Cardiovascular Nursing (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5kl2rr024990-05)
  • National Center for Research Resources (KL2-RR-024990, K12RR023264)
Topics
  • Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
Keywords
post-acute care, older adults, cardiac events, myocardial infarction, heart failure, coronary artery bypass grafting, heart valve surgery, percutaneous coronary intervention, home health care, Medicare Part A, racial and ethnic disparities, comorbidities, length of hospital stay, cardiac rehabilitation
MeSH terms
Aftercare, Aged, Cross-Sectional Studies, Female, Heart Diseases, Home Care Services, Humans, Intermediate Care Facilities, Length of Stay, Male, Patient Acceptance of Health Care, Patient Discharge, Skilled Nursing Facilities, United States, Nursing Methodology Research, Comorbidity, Logistic Models, Medicare Part A, Hospital Costs, Community Health Planning, Health Care Surveys, Needs Assessment

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