Biomedical subjects

J S Osberg

Publications and source records attributed to J S Osberg.

27 records · Page 2Linked to original sources

PubMed1988

Predicting long-term outcome among post-rehabilitation stroke patients.

This paper examines correlates of long-term outcome in a sample of 89 stroke patients discharged from medical rehabilitation. Patients in this study were recruited in 1984 and followed prospectively for a 12-month period postdischarge. This analysis builds on previous studies which have called researchers to move beyond single-outcome studies which use only bivariate analysis. Multivariate techniques are used to evaluate the influence of a number of predictor variables on three measures of long-term outcome: 1) a composite variable that includes functional status, mortality and discharge disposition (home v nursing home); 2) life satisfaction; and 3) medical charges. The results show that 1) multivariate analyses present a different picture from that obtained when using bivariate analysis; and 2) the same predictor variables are not equally important in predicting different outcome variables. From 30-42% of the variance in the three dependent variables is explained by severity of illness, function at admission, age, wheelchair use and in- and out-of-house social supports.

Cerebrovascular Disorders↗

PubMed1988

Total charges for inpatient medical rehabilitation.

Descriptive information on inpatient charges for a sample of 151 individuals discharged from three Boston area medical rehabilitation facilities is presented in this article. The total charges for inpatient rehabilitation were nearly $3 million, and the mean charge was $19,568. Also presented are a description of how charges vary by medical, demographic, social, and external factors and an identification of predictors of total charges for inpatient medical rehabilitation. These results establish a reference point for developing prospective payment systems for inpatient medical rehabilitation.

Analysis of Variance↗

PubMed1987

Life satisfaction and quality of life among disabled elderly adults.

This paper investigates predictors of life satisfaction and quality of life among severely disabled elderly adults. Markides and Martin's (1979) path analysis model was adapted specifically to elderly persons with severe disabilities. The study group comprised 97 patients discharged from three medical rehabilitation facilities in metropolitan Boston during 1984. The adapted model explained about 40% of the variance in quality of life among both men and women, with functional capacity being the most important predictor.

Aged↗

PubMed1987

Predicting charges for inpatient medical rehabilitation using severity, DRG, age, and function.

We examined the effectiveness of using diagnosis related groups (DRGs), Severity of Illness Index (SII), age and function at admission to predict inpatient charges for medical rehabilitation. Data from our sample of 199 indicate that DRGs alone explained approximately 12 per cent of the variation in charges for inpatient rehabilitation while SII explained 26 per cent of the variation. SII, DRG, and age together yielded the highest regression coefficient, accounting for nearly 39 per cent of the variation in total charges; SII and age accounted for 36 per cent of the variation. Within DRG categories, SII was the only important predictor of inpatient charges accounting for 23 per cent of the variation in charges among stroke patients (DRG 014) and 28 per cent of the variation in charges among hip fracture patients (DRG 210). Function at admission was not a useful predictor of inpatient rehabilitation charges within DRGs. These results suggest that SII and age may be useful in developing a DRG-based prospective payment system for inpatient medical rehabilitation.

Activities of Daily Living↗

PubMed1986

Program evaluation of physical medicine and rehabilitation departments using self-report Barthel.

The Barthel Index measures performance of personal care (feeding, dressing, hygiene) and mobility (transferring, walking/wheeling) activities. Since its inception, several revisions of this index have increased its accuracy in measuring functional ability of patients during medical rehabilitation. However, this activities of daily living (ADL) scale is rarely used to determine the abilities of individuals after discharge, leaving assessment of functional outcome incomplete. In this study this index has been converted to a self-report format, which can be completed easily by the patient or family member both during the rehabilitation stay and after discharge. The reliability of the self-report version is examined, by comparing the assessments of patients to those made by the health professionals. A sample of persons at an inpatient rehabilitation facility, who could both read and write, completed the self-report during the week before discharge. Results comparing the assessment of professionals and patients showed a statistically significant difference with p less than 0.001. This paper will suggest reasons for the difference and explore the possibility of using this self-report version as a means to evaluate both the short-and long-term outcomes of rehabilitation programs.

Activities of Daily Living↗

PubMed1984

Aging and health: a longitudinal study.

A set of double jeopardy hypotheses predicting there is a double health disadvantage in growing old and being a member of an ethnic minority, female, of lower socioeconomic status, and unmarried is tested with data from a 4-yr longitudinal study of older Mexican Americans and Anglos. With the exception of socioeconomic status, little support is found for the double jeopardy predictions in a multivariate analysis of change in health. When subjects who died during the study interval were included in the analysis by assigning them the lowest score on health, the results changed somewhat: the relationship between age and decline in health was strengthened and the effect of sex changed from a direction suggesting that women show greater declines in health with age to a direction suggesting that men experience greater declines in health with age. Implications of the effect of decreased dropouts for studies on aging and health are discussed.

Aged↗

PubMed1982

Political implications of the 'new ageism'.

The research tradition of old age stereotypes has typically been limited to a social psychological perspective of their dysfunctional consequences. This exploratory study examines the possible functions served by such stereotypes from a sociocultural frame of reference, in particular, testing the hypothesis of Richard Kalish and Carroll Estes that problem-oriented conceptions of older persons are part of an emerging political ideology. Using the responses of the Louis-Harris-NOCA "The Myth and Reality of Aging in America" survey, the relation between aging stereotypes and attitudes toward federal support of the aged are reported.

Adolescent↗

PubMedDate not supplied

Trauma-rehabilitation connections: discharge and admission decisions for children.

Paediatric discharge coordinators and rehabilitation admission coordinators were surveyed about how children are selected for rehabilitation. The following areas are covered: (1) the decision process, and how children are selected for rehabilitation; (2) who is involved in making acute-care discharge and rehabilitation admission decisions; (3) factors that guide selection of children for rehabilitation; and (4) satisfaction with referral practices. Surveys were completed by 30 trauma discharge and rehabilitation admission coordinators, recruited from paediatric trauma units and paediatric/general rehabilitation units nationwide. Most respondents were satisfied with transfers, although some voiced concerns about constraints placed on referrals by insurance. Even when inpatient rehabilitation was clearly needed, 40% said insurance status still affected whether children were admitted. There was little evidence that any uniform criteria are used to make decisions. Half had no training in discharge/admission planning and half did not base decisions on functional assessments. Although guidelines are increasingly used in clinical decision-making, few are available concerning critical decisions about which children receive inpatient rehabilitation following trauma.

Ambulatory Care↗

PubMedDate not supplied

Admitting paediatric trauma patients to rehabilitation following acute care: decision making practices in the USA and Australia.

Paediatric patient access to rehabilitation services following trauma has significant long-term implications for clients, their families and the community. The aim of this research was to examine and compare the process by which patients are discharged from acute care and enter rehabilitation in the USA and Australia. The subjects were 31 American and 29 Australian discharge and rehabilitation admission coordinators. Subjects were surveyed about how they currently make trauma to rehabilitation referrals for children. Clinicians in both countries considered the severity of a child's injury and their social situation the most important factors when determining placement for a child. However, there were differences between Australian and US respondents in terms of how important they considered the factor 'medical coverage'. In addition, it was found that clinicians are not consistently using both standardized assessments and formal guidelines to assist them to determine which children should receive rehabilitation following acute care. Benefits of this research include a greater understanding of clinician discharge and admission decision making, and the equity of such decisions. However, further research is required on the influence of payment systems on access to paediatric rehabilitation.

Analysis of Variance↗