Although hospitalized patients with opioid use disorder (OUD) qualify for referral to post-acute care or SNFs at higher rates than patients without OUD, patients with OUD are substantially less likely to be accepted to a SNF. Published in JAMA Network Open, this qualitative study highlights challenges and opportunities for providing evidence-based care for OUD in SNFs through semi-structured interviews from 29 SNF administrators in Rhode Island. Researchers found that gaps in institutional capacity overlap with stigmatizing beliefs about OUD, contributing to discrimination of people with OUD. Adequate SNF funding and staffing combined with OUD-specific interventions (e.g., anti-stigma training, community
partnerships for MOUD and recovery support) have the potential to incentivize SNFs to serve people with OUD and facilitate OUD care consistent with practice guidelines.
February 23, 2024 Journal of Alzheimer's & Dementia
Maricruz Rivera-Hernandez co-authored an article published in the Journal of Alzheimer & Dementia regarding the association between delay in initiation of home health services with race and ethnicity and home health quality ratings for Medicare beneficiaries with dementia. They found that among 262,525 Medicare beneficiaries with dementia, black patients with dementia were more likely to experience delay in home health services initiation. Furthermore, black patients receiving care in home health agencies with lower star ratings experienced a higher likelihood of delayed services. These disparities may be driven by structural inequality and lack of access to high-quality services among black patients. Our results suggest that increasing access to high-quality agencies among racial and ethnic groups with ADRD may be a first step in reducing these disparities and improving access to timely initiation of home health services.
A paper published by Betsy White and team was selected by the Health Affairs Editor-in-Chief as one of the journal's Top Ten papers of 2023. The study team found that nursing home staff working the evening and night shifts had significantly lower testing rates and likelihood of vaccination compared to staff working the day shift. These differences reflect structural barriers to access that must be overcome to improve testing and vaccination among nursing home staff.
The Irwin E. Ginsberg P’84 Aging Research Fund was established as a part of Brown University’s permanent endowment. This Fund supports medical or public health student projects (1) related to aging and (2) mentored by faculty affiliated with the Brown University School of Public Health’s Center for Gerontology & Healthcare Research or Center for Long-Term Care Quality & Innovation.
Together, the Agency for Healthcare Research and Quality and the Patient-Centered Outcomes Research Institute have awarded a 5-year, $5 million grant to create the Learning Health systems training to improve Disability and chronic condition care (LeaHD) center at Brown University.
November 7, 2023 Journal of the American Heart Association
In a cohort study published in the Journal of the American Heart Association of 21,878 older Medicare beneficiaries with multimorbidity residing in nursing homes, Kaley Hayes and her team found that while therapy with standard-dose direct oral anticoagulants was not associated with reductions in mortality or thrombotic events, those on standard dosing experienced 1.4 more major bleeds per 100 person-years compared to those on reduced dosing. Bleeding risks were highest among those aged 80 years or older or those with a body mass index less than 30 kg/m 2 . Given the potential harms and unclear benefits of standard direct oral anticoagulant dosing, our results support the use of reduced-dose direct oral anticoagulants for older adults with multiple comorbidities.
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