Strategies and Outcomes of Age-Friendly Health System Implementation in Outpatient Settings: A Systematic Review

INQUIRY The Journal of Health Care Organization Provision and Financing, Год журнала: 2025, Номер 62

Опубликована: Янв. 1, 2025

The Age-Friendly Health System (AFHS) movement has spread widely in recent years, with nearly 5000 healthcare organizations across the country recognized as Age-Friendly. Despite this broad recognition, there is little focus on how AFHS are implemented and impact of implementation. objectives study were to describe strategies employed support implementation outpatient settings identify measures used evaluate effectiveness. We conducted a systematic review literature from multiple databases spanning 2015 March 2024, identified eligible studies using predefined inclusion/exclusion criteria, extracted key data (eg, design, population, strategies, outcomes/measures). ten primary care clinics (N = 8), convenient 1) cancer center 1). over 65 98 outcomes or measures. vast majority mapped components 4Ms (Mobility, Mentation, Medication, What Matters), up per M category. Five had reporting discrepancies four did not fully define outcomes. included serve clear examples for need more evidence settings. Existing research lacks strategy specification standardization present gaps opportunities advance “recognition” impact.

Язык: Английский

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4 Steps to 4Ms: A Navigation Guide for a Hospital-Based Composite Measure of 4Ms Care and the Implications for Outcomes Assessment

INQUIRY The Journal of Health Care Organization Provision and Financing, Год журнала: 2025, Номер 62

Опубликована: Янв. 1, 2025

The 4Ms Framework is the foundation of Age-Friendly Health System (AFHS) movement. While framework based on standalone evidence for each M, there limited about impact outcomes when practiced as a set. A composite measure capturing adherence to many care processes that comprise necessary but complex component closing gap. We offer navigation guide addresses key considerations developing hospital-based care. Institute Healthcare Improvement operationalizes minimum set Assessment and Act On processes. In inpatient adherence, we 4 step with associated discussion related type (eg, continuous, dichotomous), synchrony within across Ms containing these Using real-world electronic health record data process in implementation at large academic hospital, illustrate considerations, report implications sample size scoring. also present our selected measure-a dichotomous delineating all encounter-level (those needing be done only once during hospital encounter) are followed day- shift-level least 50% days. no single, standard approach create this early stage AFHS movement, organizations develop their measure(s), suggest should serve inform support progress toward meaningful measurement.

Язык: Английский

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Effect of Age-Friendly Care on Days at Home Post-Hospital Discharge for Traditional Medicare Patients: A Cross-Sectional Study

INQUIRY The Journal of Health Care Organization Provision and Financing, Год журнала: 2025, Номер 62

Опубликована: Янв. 1, 2025

The Bundled Payment for Care Improvement Advanced (BPCI-A) model encourages value-based care by bundling 90-day healthcare-related costs into a single payment eligible service codes and procedures traditional Medicare Part A B beneficiaries. Our institution, an Age-Friendly Health Systems Level 2 certified academic health center, participated in the BPCI-A from 2018 to 2022. This study aimed determine differences days spent at home 30- post-hospitalization period older patients program based on status. Descriptive analyses assessed among who received (n = 275) those did not 348). Zero-one-inflated beta regression models with propensity score matching compared probability of spending between groups. Sensitivity were conducted. recipients tended be males non-emergent admissions lower risk-adjusted mortality scores ( P < .05). No significant shown groups 90-days post-discharge original analysis. found all facility 30-days post discharge significantly higher receiving Admissions least 3Ms resulted less within 30 discharge. highlights importance patient-centered during hospital stay. Future studies should continue explore as outcome measure how comprehensive impacts larger cohort.

Язык: Английский

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Applying difference‐in‐differences design in quality improvement and health systems research

Journal of the American Geriatrics Society, Год журнала: 2024, Номер unknown

Опубликована: Сен. 6, 2024

See the related reply by Bruke et al.

Язык: Английский

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