Scholars@Duke
Courtney Harold Van Houtven

Courtney Harold Van Houtven

Professor in Population Health Sciences
Population Health Sciences
Courtney.Vanhoutven@duke.edu
Duke Box 3240, Durham, NC 27708
2424 Erwin Rd, Hock Plaza, Durham, NC 27708

Scholarly Works - Journal articles

Consistency of a Dementia Diagnosis Between Systems for Patients Receiving Care Through the VA, Traditional Medicare, and Medicare Advantage.

Journal article Med Care · August 1, 2026 BACKGROUND: Older Veterans receive care through the Department of Veterans Affairs (VA) and Medicare, including Medicare Advantage (MA). We assessed the extent to which a dementia diagnosis recorded in one system is reflected in the other and factors assoc ... Full text Link to item Cite

Empowering Older Veterans Through Self-Directed Care: A Mixed Methods Evaluation of a Technology Enabled Respite Homecare Model Pilot.

Journal article J Appl Gerontol · July 2026 To remain living independently, many older and disabled adults rely on homecare workers, though workforce shortages and turnover can hinder access to care. The Veterans Health Administration piloted a Technology Enabled Respite Homecare Model allowing Vete ... Full text Link to item Cite

Evaluating two implementation approaches to support a nationally mandated caregiver skills training in veterans affairs: a type III hybrid implementation-effectiveness randomized controlled trial.

Journal article Implement Sci Commun · June 11, 2026 BACKGROUND: Few caregiver support interventions have been scaled nationally; thus, gaps remain regarding the optimal level of support needed to successfully adopt caregiver trainings in diverse clinical contexts. We evaluated the effectiveness of two imple ... Full text Link to item Cite

Factors associated with respite care use among veteran caregivers: a machine learning analysis.

Journal article Gerontologist · June 9, 2026 BACKGROUND AND OBJECTIVES: Respite care provides temporary relief to family caregivers yet remains underused, and the factors shaping its utilization among Veteran caregivers are not well understood. This evaluation examined caregiver‑ and Veteran‑specific ... Full text Link to item Cite

Long-Term Perceptions of the Value of Amyloid PET Scans Among Cognitively Impaired Medicare Beneficiaries and Their Care Partners.

Journal article Int J Geriatr Psychiatry · June 2026 OBJECTIVES: The objective of this study was to examine the long-term perceptions of the value of receiving an amyloid PET scan, a test used to diagnose Alzheimer's disease, among Medicare beneficiaries with cognitive impairment and their care partners. MET ... Full text Link to item Cite

Implementation Context of Outpatient Physical Therapy Clinics Preparing to Launch a New Evidence-Based Clinical Program for Knee Osteoarthritis: Findings From a National Multisite Implementation Trial.

Journal article Arch Phys Med Rehabil · May 2026 OBJECTIVE: We evaluated implementation context to identify barriers and facilitators to delivering a new evidence-based clinical program, Group physical therapy (Group PT) for knee osteoarthritis, overall, and by rurality and facility complexity. DESIGN: B ... Full text Link to item Cite

Discontinuation of Medications With Limited Benefit at End of Life in Community-Dwelling Older Veterans.

Journal article J Am Geriatr Soc · May 2026 BACKGROUND: Discontinuation of medications with limited benefits (LBM) in patients nearing the end of life can reduce burden, adverse events, and costs, and enhance quality of life. However, most research on end-of-life prescribing has focused on nursing h ... Full text Link to item Cite

Wellbeing Among Caregivers of Veterans Who Applied for Comprehensive Caregiver Support Through the VA.

Journal article J Gen Intern Med · April 27, 2026 BACKGROUND: In 2011, the Department of Veterans Affairs established the most comprehensive caregiver support services in the United States (US): the Program of Comprehensive Assistance for Family Caregivers (PCAFC). Eligible caregivers receive a stipend, m ... Full text Link to item Cite

Trends in Quality of Life for Older Adults With Cognitive Impairment Across Living and Care Arrangements, 2008-2022.

Journal article J Am Geriatr Soc · April 16, 2026 BACKGROUND: Monitoring trends in key quality of life (QoL) indicators is crucial for effective surveillance and guiding targeted interventions to improve well-being. Few studies have examined population-level trends among older adults with cognitive impair ... Full text Link to item Cite

Amyloid-β PET scans, economic strain and financial decision-making among persons with cognitive impairment and care partners: a mixed-methods analysis of the CARE-IDEAS study.

Journal article Alzheimers Res Ther · April 14, 2026 BACKGROUND: To explore the relationship between receipt of amyloid-β PET scan results and subsequent experiences of economic strain and financial decision-making for persons with cognitive impairment and their care partners. METHODS: A parallel convergent ... Full text Link to item Cite

Family-involved interventions may offer unique benefits for Veterans with posttraumatic stress disorder (PTSD) experiencing high family strain.

Journal article Psychol Trauma · March 2026 OBJECTIVE: Family strain, which reflects the overall function of the family system, could play an important role in routine posttraumatic stress disorder (PTSD) care. We examined how high/low family strain influences perceptions of a family-involved interv ... Full text Link to item Cite

Multi-Level Factors Impacting Implementation of Outpatient Palliative Care: Perceptions of VA Providers.

Journal article J Appl Gerontol · March 2026 To develop strategies to better meet palliative needs for older adults, it is critical to understand what factors influence the implementation and sustainability of palliative care (PC) in the outpatient setting. This study explored provider perceptions ab ... Full text Link to item Cite

Pain and sleep disturbance were negatively associated with function and community mobility after hospitalization

Journal article Aging and Health Research · March 1, 2026 Background: The inconsistent nature of functional recovery after hospitalization points to gaps in our understanding of its determinants. The goal of this study was to examine associations between post-discharge pain interference and sleep disturbance on f ... Full text Cite

Comparing Approaches to Support Implementation of a Hospital Walking Program: Evidence from a Cluster Randomized Trial.

Journal article J Gen Intern Med · February 26, 2026 BACKGROUND: Hospital mobility programs align with age-friendly care principles by promoting functional recovery for older adults; however, optimal strategies for implementing such programs remain unclear. OBJECTIVE: To compare two approaches for implementi ... Full text Link to item Cite

Categorizing family caregiving experiences across health continuums: a mixed-methods qualitative study

Journal article International Journal of Care and Caring · February 12, 2026 This article presents a caregiver-centered framework that categorizes the experiences of caregivers to align unmet caregiver needs with relevant supports. The study applied a partner-engaged, qualitative, mixed-methods approach. Using findings from ... Full text Cite

A Patient-Informed Framework of Financial Strain Among Adults with Multimorbidity.

Journal article J Gen Intern Med · February 2026 BACKGROUND: Over one-quarter of adults have multimorbidity. Patients with multimorbidity are more likely to struggle to afford their care than patients without multimorbidity, but their experiences with financial strain have not been fully described. OBJEC ... Full text Link to item Cite

Identifying a valid comparison cohort to evaluate the impact of Veterans Affairs caregiver support services

Journal article Health Services and Outcomes Research Methodology · January 1, 2026 We propose an approach to identify a comparison group of family caregivers using patient electronic health record data (EHR) to evaluate the Veterans Affairs (VA) Caregiver Support Program (CSP) Program of General Caregiver Support Services (PGCSS). This p ... Full text Cite

Acceptability of the Veterans Health Administration's Caregiver Health and Wellbeing Coaching Program: Evidence From a Mixed-Methods Evaluation.

Journal article J Appl Gerontol · December 15, 2025 This explanatory, sequential mixed-methods evaluation assessed the acceptability of the Veterans Health Administration's Caregiver Health and Wellbeing Coaching (CHWC) program from the perspectives of caregivers and staff. Guided by the Theoretical Framewo ... Full text Link to item Cite

Dementia Care Research and Psychosocial Factors.

Journal article Alzheimers Dement · December 2025 BACKGROUND: People living with dementia (PLWD) face short-term risks following emergency department (ED) visits. However, the long-term impacts of ED visits on PLWD quality of life are not well characterized. Home time- days alive and outside hospitals or ... Full text Link to item Cite

Home Time Following Emergency Department Visits Among People With Dementia.

Journal article JAMA Netw Open · December 1, 2025 IMPORTANCE: Emergency department (ED) visits for people with dementia often involve care (including the admission or discharge decision) with lasting effects on quality of life. Home time-a claims-based measure of days alive and outside of institutional ca ... Full text Link to item Cite

Enhancing team communication to improve implementation of a supervised walking program for hospitalized veterans: Evidence from a multi-site trial in the Veterans Health Administration.

Journal article PM R · November 2025 INTRODUCTION: The timely translation of evidence-based programs into real-world clinical settings is a persistent challenge due to complexities related to organizational context and team function, particularly in inpatient settings. Strategies are needed t ... Full text Link to item Cite

Caregiver Emotional Wellbeing Is Related to Nursing Home Admissions Among Veterans.

Journal article J Am Geriatr Soc · November 2025 BACKGROUND: Approximately 14 million US adults require long-term care; most of this care is provided in the community by family caregivers. High intensity care can decrease caregiver wellbeing; caregiver burden is a determinant of nursing home admission. T ... Full text Link to item Cite

Quality-of-life factors at home and in health care settings for people living with dementia.

Journal article Gerontologist · October 22, 2025 BACKGROUND AND OBJECTIVES: Person-centered "home time" measures track time spent in health care versus home using claims data. These measures can indicate patient preferences, quality of care, or quality of life. However, for people living with dementia, t ... Full text Link to item Cite

Do Caregivers of Asian Patients with Advanced Cancer Help or Hinder Patient Understanding of Illness and Involvement in Decision Making?

Journal article Med Decis Making · October 2025 PurposeIt is unclear whether caregivers help or hinder patients' involvement in decision making and understanding of illness. We thus investigated the extent to which caregivers' preferred level of patient involvement in decision making and understanding o ... Full text Open Access Link to item Cite

Implementation of Group Physical Therapy for Knee Osteoarthritis: A Cluster Randomized Clinical Trial.

Journal article JAMA Netw Open · October 1, 2025 IMPORTANCE: Group-based physical therapy (PT) for knee osteoarthritis is an effective, efficient strategy for delivering care, but little is known about optimal strategies for implementing new clinical programs like group PT. OBJECTIVE: To compare 2 implem ... Full text Link to item Cite

Home-Based Care Outcomes: Does the Care Provider Matter?

Journal article Health Econ · August 2025 Long-term services in the home are predominately provided by family or friends, with a growing proportion of individuals receiving formal care, or paid care by a professional, or a combination of both. However, the relative benefits to the care recipient o ... Full text Link to item Cite

A Proposed Universal "Home Time" Quality of Life Measure for Older Adults.

Journal article J Am Geriatr Soc · August 2025 BACKGROUND: Researchers and insurers use "home time," or an individual's time at home compared to time in different health care settings, as a population-level quality of life (QoL) or quality of care measure. With varying definitions, it is unknown which ... Full text Link to item Cite

Support for Care Partners and Caregivers: 2023 Summit Session 5.

Journal article Alzheimers Dement · June 2025 INTRODUCTION: We report on Session 5 of the 2023 NIA National Research Summit on care, services, and supports for persons living with dementia and their care partners/caregivers, "Support for Care Partners and Caregivers." METHODS: The session included sch ... Full text Link to item Cite

Economic costs of family caregiving for persons with advanced stage cancer: a longitudinal cohort study.

Journal article J Cancer Surviv · February 2025 PURPOSE: To form a multifaceted picture of family caregiver economic costs in advanced cancer. METHODS: A multi-site cohort study collected prospective longitudinal data from caregivers of patients with advanced solid tumor cancers. Caregiver survey and ou ... Full text Link to item Cite

Trajectories of Disability and Long-Term Care Utilization After Acute Health Events.

Journal article J Aging Soc Policy · January 2, 2025 Hip fractures, strokes, and heart attacks are common acute health events that can lead to long-term disability, care utilization, and unmet needs. However, such impacts, especially in the long term, are not fully understood. Using data from the Health and ... Full text Link to item Cite

Geriatrics-Focused vs Traditional Primary Care in the Veterans Affairs Health Care System.

Journal article JAMA Netw Open · January 2, 2025 IMPORTANCE: Older adults often require specialized health care expertise, but the effects of geriatrics-focused models of primary care have not been fully evaluated. OBJECTIVE: To compare the effects of geriatrics-focused primary care vs traditional primar ... Full text Link to item Cite

Medicaid Spending in Coordination-Only Dual-Eligible Special Needs Plans.

Journal article JAMA Netw Open · January 2, 2025 IMPORTANCE: More than 4 million Medicare beneficiaries have enrolled in dual-eligible Special Needs Plans (D-SNPs), and coordination-only D-SNPs are common. Little is known about the impact of coordination-only D-SNPs on Medicaid-covered services and spend ... Full text Link to item Cite

"There has to be more caring": patient and care partner experiences of the disclosure of amyloid-β PET scan results.

Journal article Aging Ment Health · January 2025 OBJECTIVES: To explore patient and care partner experiences of receiving an amyloid scan result, with a focus on how clinician disclosure practices influenced patient and care partner emotional responses to the scan result and/or diagnosis. METHODS: Semi-s ... Full text Link to item Cite

Development and Delivery of Enhanced Implementation Support to Disseminate a National Caregiver Skills Training Program.

Journal article Innov Aging · 2025 BACKGROUND AND OBJECTIVES: As the population ages there is an increasing need for caregiver training programs, but little is known about how to deliver implementation support for diverse sites in large-scale implementation efforts. External group-based imp ... Full text Link to item Cite

Long-term care insurance within married couples: Can't insure one without the other?

Journal article Rev Econ Househ · 2025 Although long-term care remains one of the largest uninsured risks facing older Americans, demand for insurance remains low. While there is a long literature estimating a variety of factors that contribute to this low demand, much of it has overlooked the ... Full text Link to item Cite

Feasibility of a family-involved intervention to increase engagement in evidenced-based psychotherapies for posttraumatic stress disorder: A pilot study.

Journal article Psychol Trauma · December 2024 OBJECTIVE: To assess the feasibility of a family-involved intervention, family support in mental health recovery (FAMILIAR), for veterans with posttraumatic stress disorder (PTSD) seeking psychotherapy at a single Veterans Administration Health System. MET ... Full text Link to item Cite

The business case for hospital mobility programs in the veterans health care system: Results from multi-hospital implementation of the STRIDE program.

Journal article Health Serv Res · December 2024 OBJECTIVE: To conduct a business case analysis for Department of Veterans Affairs (VA) program STRIDE (ASsisTed EaRly MobIlization for hospitalizeD older VEterans), which was designed to address immobility for hospitalized older adults. DATA SOURCES AND ST ... Full text Link to item Cite

Implementation outcomes from a multi-site stepped wedge cluster randomized family caregiver skills training trial.

Journal article Health Serv Res · December 2024 OBJECTIVE: To assess whether a team collaboration strategy (CONNECT) improves implementation outcomes of a family caregiver skills training program (iHI-FIVES). DATA SOURCES AND STUDY SETTING: iHI-FIVES was delivered to caregivers at eight Veterans Affairs ... Full text Link to item Cite

Adaptations and early adoption of a family caregiver intervention in the Veterans Affairs Health Care System: A multimethod pragmatic approach for national scaling.

Journal article Health Serv Res · December 2024 OBJECTIVE: To examine the relationship between site-level adaptation and early adoption of Caregivers Finding Important Resources, Support, and Training (FIRST) training during national implementation across diverse Veteran Health Administration (VA) medic ... Full text Link to item Cite

A stepped wedge cluster randomized trial to evaluate the effectiveness of a multisite family caregiver skills training program.

Journal article Health Serv Res · December 2024 OBJECTIVE: To assess the effects of an evidence-based family caregiver training program (implementation of Helping Invested Families Improve Veteran Experiences Study [iHI-FIVES]) in the Veterans Affairs healthcare system on Veteran days not at home and fa ... Full text Link to item Cite

Economic Value of Unpaid Family Caregiver Time Following Hospital Discharge and at End of Life.

Journal article J Pain Symptom Manage · December 2024 CONTEXT: Family caregivers (FCGs) play a crucial role in care for people with serious illness, yet unpaid care is often overlooked in estimates of care recipient (CR) care costs. OBJECTIVES: This study quantifies the economic value of unpaid caregiving by ... Full text Link to item Cite

Veterans' use of inpatient and outpatient palliative care: The national landscape.

Journal article J Am Geriatr Soc · November 2024 BACKGROUND: Palliative care improves the quality of life for people with life-limiting conditions, which are common among older adults. Despite the Veterans Health Administration (VA) outpatient palliative care expansion, most research has focused on inpat ... Full text Link to item Cite

Beta amyloid PET scans for dementia diagnoses: Practice and research implications from CARE-IDEAS.

Journal article J Am Geriatr Soc · October 2024 Beta amyloid PET scans are a minimally invasive biomarker that may inform Alzheimer's disease (AD) diagnosis. The Caregiver's Reactions and Experience (CARE) study, an IDEAS supplement, aimed to understand experiences of PET scan recipients and their care ... Full text Link to item Cite

The association between social risks and days at home for older veterans.

Journal article J Am Geriatr Soc · October 2024 BACKGROUND: Many health systems are trying to support the ability of older adults to remain in their homes for as long as possible. Little is known about the relationship between patient-reported social risks and length of time spent at home. We assessed h ... Full text Link to item Cite

Site-initiated adaptations in the implementation of an evidence-based inpatient walking program.

Journal article J Am Geriatr Soc · October 2024 BACKGROUND: There is increasing recognition of the importance of maximizing program-setting fit in scaling and spreading effective programs. However, in the context of hospital-based mobility programs, there is limited information on how settings could con ... Full text Link to item Cite

Is more care recipient time at home also a family caregiver-centered quality of life measure?

Journal article J Am Geriatr Soc · October 2024 BACKGROUND: Time in healthcare facilities is associated with worse patient quality of life (QoL); however, impact on family caregiver QoL is unknown. We evaluate care recipient days not at home-days in the emergency department (ED), inpatient (IP) care, an ... Full text Link to item Cite

Medicaid Expansion and the Mental Health of Spousal Caregivers

Journal article Review of Economics of the Household · September 1, 2024 Health insurance expansions can exert wellbeing effects on individuals who provide informal care to their loved ones, reducing their experience of depression. This study exploits evidence from the Patient Protection and Affordable Care Act’s Medicaid expan ... Full text Cite

Correction to: Medicaid Expansion and the Mental Health of Spousal Caregivers (Review of Economics of the Household, (2024), 22, 3, (1047-1084), 10.1007/s11150-023-09673-7)

Journal article Review of Economics of the Household · September 1, 2024 The original version of this article unfortunately contained errors in Author group, Abstract and in the text. The third author’s name should be Courtney H. Van Houtven instead it was published incorrectly as Courtney van-Houtven and the correct order of a ... Full text Cite

Healthcare use and out-of-pocket costs for rural family caregivers and care recipients in a randomized controlled trial.

Journal article J Am Geriatr Soc · August 2024 BACKGROUND: Rural family caregivers (FCGs) in the United States often experience high economic costs. This randomized controlled trial compared a transitional palliative care intervention (TPC) to support FCGs of seriously ill care recipients (CRs) to an a ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know About Caring for Family Caregivers.

Journal article J Palliat Med · July 2024 Family and friend caregivers play critical roles in ensuring that persons with serious illness receive high-quality care, and their responsibilities often increase as patients transition from receiving solely curative-focused care to primarily palliative-f ... Full text Link to item Cite

Family Involvement in the Care of Hospitalized Older Adults: Protocol for a Qualitative Evidence Synthesis.

Journal article JMIR Res Protoc · May 10, 2024 BACKGROUND: Older adults are frequently hospitalized. Family involvement during these hospitalizations is incompletely characterized in the literature. OBJECTIVE: This study aimed to better understand how families are involved in the care of hospitalized o ... Full text Link to item Cite

Comprehensive Caregiver Supports and Ascertainment and Treatment of Veteran Pain.

Journal article Med Care Res Rev · April 2024 Disabled Veterans commonly experience pain. The Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides training, a stipend, and services to family caregivers of eligible Veterans to support their caregiving role. We compared ascertainme ... Full text Link to item Cite

Association between results of an amyloid PET scan and healthcare utilization in individuals with cognitive impairment.

Journal article J Am Geriatr Soc · March 2024 BACKGROUND: The Imaging Dementia Evidence for Amyloid Scanning (IDEAS) study reports that amyloid PET scans help providers diagnose and manage Alzheimer's disease and related dementias (ADRD). Using CARE-IDEAS, an IDEAS supplemental study, we examined the ... Full text Link to item Cite

The impact of informal caregiving on U.S. Veterans Health Administration utilization and expenditures.

Journal article Soc Sci Med · March 2024 Few studies have examined the effect of informal care receipt on health care utilization and expenditures while accounting for the potentially endogenous relationship between informal and formal care, and none have examined these relationships for U.S. Vet ... Full text Link to item Cite

Opportunities for Integration in the Dual Medicare-Medicaid Population: North Carolina Landscape Analysis.

Journal article N C Med J · March 2024 BACKGROUND: NC Medicaid is amid a transformation to value-based care models. The transformation requires the consideration of models that may best serve the 1 in 5 NC Medicaid beneficiaries who are dually enrolled in Medicare. The lack of integration of Me ... Full text Link to item Cite

Evaluation of strategies to support implementation of a hospital walking program: protocol for a type III effectiveness-implementation hybrid trial.

Journal article Implement Sci Commun · January 12, 2024 BACKGROUND: STRIDE is a supervised walking program designed to address the negative consequences of immobility during hospitalization for older adults. In an 8-hospital stepped wedge randomized controlled trial, STRIDE was associated with reduced odds of h ... Full text Link to item Cite

Elevated Amyloid-β PET Scan and Cognitive and Functional Decline in Mild Cognitive Impairment and Dementia of Uncertain Etiology.

Journal article J Alzheimers Dis · 2024 BACKGROUND: Elevated amyloid-β (Aβ) on positron emission tomography (PET) scan is used to aid diagnosis of Alzheimer's disease (AD), but many prior studies have focused on patients with a typical AD phenotype such as amnestic mild cognitive impairment (MCI ... Full text Link to item Cite

Efficacy of BETTER transitional care intervention for diverse patients with traumatic brain injury and their families: Study protocol of a randomized controlled trial.

Journal article PLoS One · 2024 OBJECTIVE: The purpose of this study is to examine the efficacy of BETTER (Brain Injury, Education, Training, and Therapy to Enhance Recovery) vs. usual transitional care management among diverse adults with traumatic brain injury (TBI) discharged home fro ... Full text Open Access Link to item Cite

"I've been doing this for years": the COVID-19 pandemic and family caregiver isolation and loneliness.

Journal article Front Aging · 2024 BACKGROUND: Family caregivers are family members or friends of care recipients who assist with activities of daily living, medication management, transportation, and help with finances among other activities. As a result of their caregiving, family caregiv ... Full text Link to item Cite

Organizational Characteristics of Hospitals Meeting STRIDE Program Adoption Benchmarks to Support Mobility for Hospitalized Persons.

Journal article Inquiry · 2024 There are few validated contextual measures predicting adoption of evidence-based programs. Variation in context at clinical sites can hamper dissemination. We examined organizational characteristics of Veterans Affairs hospitals implementing STRIDE, a hos ... Full text Link to item Cite

Informing a home time measure reflective of quality of life: A data driven investigation of time frames and settings of health care utilization.

Journal article Health Serv Res · December 2023 OBJECTIVE: To evaluate short- and long-term measures of health care utilization-days in the emergency department (ED), inpatient (IP) care, and rehabilitation in a post-acute care (PAC) facility-to understand how home time (i.e., days alive and not in an a ... Full text Link to item Cite

Linking Medicare-Medicaid Claims for Patient-Centered Outcomes Research Among Dual-Eligible Beneficiaries.

Journal article Med Care · December 1, 2023 BACKGROUND: Evaluation of Medicare-Medicaid integration models' effects on patient-centered outcomes and costs requires multiple data sources and validated processes for linkage and reconciliation. OBJECTIVE: To describe the opportunities and limitations o ... Full text Link to item Cite

Mental health therapy for veterans with PTSD as a family affair: A qualitative inquiry into how family support and social norms influence veteran engagement in care.

Journal article Psychol Serv · November 2023 Social support is important for posttraumatic stress disorder (PTSD) recovery and emerging literature indicate that social support could increase engagement in PTSD therapy. However, there is a need to understand how and why family involvement can increase ... Full text Link to item Cite

Group physical therapy for knee osteoarthritis: protocol for a hybrid type III effectiveness-implementation trial.

Journal article Implement Sci Commun · October 12, 2023 BACKGROUND: Knee osteoarthritis (OA) is a leading cause of chronic pain and disability and one of the most common conditions treated in outpatient physical therapy (PT). Because of the high and growing prevalence of knee OA, there is a need for efficient a ... Full text Open Access Link to item Cite

The BETTER Traumatic Brain Injury Transitional Care Intervention: A Feasibility Study.

Journal article West J Nurs Res · October 2023 This study aimed to investigate the feasibility, acceptability, and clinical outcome measures of BETTER (Brain Injury Education, Training, and Therapy to Enhance Recovery), a culturally tailored traumatic brain injury (TBI) transitional care intervention, ... Full text Link to item Cite

Are Geriatrics-Focused Primary Care Clinics Better at Diagnosing Dementia Than Traditional Clinics? A Matched Cohort Study.

Journal article J Gen Intern Med · September 2023 BACKGROUND: Dementia and mild cognitive impairment (MCI) are prevalent but underdiagnosed. OBJECTIVE: To compare new dementia/MCI diagnosis rates in geriatrics-focused primary care clinics and traditional primary care clinics. DESIGN: Secondary analysis of ... Full text Link to item Cite

Implementation intensification to disseminate a skills-based caregiver training program: protocol for a type III effectiveness-implementation hybrid trial.

Journal article Implement Sci Commun · August 16, 2023 BACKGROUND: Family caregiver training decreases caregiver psychological burden and improves caregiver depressive symptoms and health-related quality of life. Caregivers FIRST is an evidence-based group skills training curriculum for family caregivers and w ... Full text Link to item Cite

Knowledge, goals, and misperceptions about palliative care in adults with chronic disease or cancer.

Journal article Palliat Support Care · August 10, 2023 OBJECTIVES: Limited evidence investigates how knowledge, misconceptions, and beliefs about palliative care vary across patients with cancerous versus non-cancerous chronic disease. We examined the knowledge of and misconceptions about palliative care among ... Full text Link to item Cite

Prevalence and incidence of depressive symptoms and diagnosis of depression as associated with elevated amyloid among Medicare beneficiaries with cognitive impairment.

Journal article J Affect Disord · August 1, 2023 BACKGROUND: Depression and cognitive impairment commonly co-occur, and it has been hypothesized that the two share pathological processes. Our objective for this study was to determine the relationship between elevated β-amyloid level and the prevalence an ... Full text Link to item Cite

The many "costs" of transportation: Examining what cancer caregivers experience as transportation obstacles.

Journal article Cancer Med · August 2023 BACKGROUND: Transportation has been identified as a specific source of burden for cancer caregivers. This study examined cancer caregivers' subjective experiences and objectives costs associated with transportation over a 6-month period of providing end-of ... Full text Link to item Cite

Family spillovers and long-term care insurance.

Journal article J Health Econ · July 2023 We examine how long-term care insurance (LTCI) affects informal care use and expectations among the insured individuals and co-residence and labor market outcomes of their adult children. We address the endogeneity of LTCI coverage by instrumenting for LTC ... Full text Link to item Cite

Ready, set, go! The role of organizational readiness to predict adoption of a family caregiver training program using the Rogers' diffusion of innovation theory.

Journal article Implement Sci Commun · June 19, 2023 BACKGROUND: Caregivers FIRST is an evidence-based program addressing gaps in caregivers' skills. In 2020, the Veterans Health Administration Caregiver Support Program (CSP) nationally endorsed Caregivers FIRST, offering credit in leadership performance pla ... Full text Open Access Link to item Cite

Effects of Implementation of a Supervised Walking Program in Veterans Affairs Hospitals : A Stepped-Wedge, Cluster Randomized Trial.

Journal article Ann Intern Med · June 2023 BACKGROUND: In trials, hospital walking programs have been shown to improve functional ability after discharge, but little evidence exists about their effectiveness under routine practice conditions. OBJECTIVE: To evaluate the effect of implementation of a ... Full text Link to item Cite

Exploring the importance of predisposing, enabling, and need factors for promoting Veteran engagement in mental health therapy for post-traumatic stress: a multiple methods study.

Journal article BMC Psychiatry · May 27, 2023 PURPOSE: This study explored Veteran and family member perspectives on factors that drive post-traumatic stress disorder (PTSD) therapy engagement within constructs of the Andersen model of behavioral health service utilization. Despite efforts by the Depa ... Full text Link to item Cite

Health Care Use and Spending Among Need-Based Subgroups of Medicare Beneficiaries With Full Medicaid Benefits.

Journal article JAMA Health Forum · May 5, 2023 IMPORTANCE: Beneficiaries dual eligible for Medicare and Medicaid account for a disproportionate share of expenditures due to their complex care needs. Lack of coordination between payment programs creates misaligned incentives, resulting in higher costs, ... Full text Link to item Cite

Improving Care Coordination Between Veterans Health Administration Primary Care Teams and Community Home Health Aide Providers: A Qualitative Study.

Journal article J Appl Gerontol · April 2023 Effective coordination between medical and long-term services is essential to high-quality primary care for older adults, but can be challenging. Our study assessed coordination and communication through semi-structured interviews with Veterans Health Admi ... Full text Link to item Cite

Racial inequality in functional trajectories between Black and White U.S. veterans.

Journal article J Am Geriatr Soc · April 2023 BACKGROUND: Racial inequality in functional trajectories has been well documented in the U.S. civilian population but has not been explored among Veterans. Our objectives were to: (1) assess how functional trajectories differed for Black and White Veterans ... Full text Link to item Cite

Intensification of Implementation Strategies: Developing a Model of Foundational and Enhanced Implementation Approaches to Support National Adoption and Scale-up.

Journal article Gerontologist · March 21, 2023 Implementation strategies are activities to support integration of evidence-based programs (EBPs) into routine care. Comprised of 170+ facilities, the Veterans Affairs Healthcare System is conducive to evaluating feasibility and scalability of implementati ... Full text Link to item Cite

Mandated Caregiver Training in the Veterans Health Administration: Caregiver Inquiry Informs National Dissemination.

Journal article Gerontologist · March 21, 2023 BACKGROUND AND OBJECTIVES: A minority of family caregivers receive training, with implications for their own and their recipient's outcomes. Federal policy has supported the implementation and expansion of caregiver training and support. The Department of ... Full text Open Access Link to item Cite

Short-term effects of comprehensive caregiver supports on caregiver outcomes.

Journal article Health Serv Res · February 2023 OBJECTIVE: To estimate the association of the Veterans Health Administration (VHA) Program of Comprehensive Assistance for Family Caregivers (PCAFC) implemented in 2011 with caregiver health and health care use. DATA SOURCES: VHA claims and electronic heal ... Full text Link to item Cite

Reactions to Amyloid PET Scan Results and Levels of Anxious and Depressive Symptoms: CARE IDEAS Study.

Journal article Gerontologist · January 24, 2023 BACKGROUND AND OBJECTIVES: Few studies have examined care partners' reactions to their loved ones receiving amyloid-β positron emission tomography (PET) scan results, which can be indicative of Alzheimer's disease. We explored care partners' reactions qual ... Full text Link to item Cite

Continuity of care (COC) and amyloid-β PET scan: the CARE-IDEAS study.

Journal article Alzheimers Res Ther · January 7, 2023 BACKGROUND: High continuity of care (COC) is associated with better clinical outcomes among older adults. The impact of amyloid-β PET scan on COC among adults with mild cognitive impairment (MCI) or dementia of uncertain etiology is unknown. METHODS: We li ... Full text Link to item Cite

Development of a Home-Based Stress Management Toolkit for Dementia Caring Dyads: Protocol for a Pilot Intervention Development and Feasibility Study.

Journal article JMIR Res Protoc · December 14, 2022 BACKGROUND: People living with dementia (PLWD) and their care partners (dementia caring dyads) are at a heightened risk of experiencing stress-related symptoms and conditions. Yet, many dyadic stress management interventions have had limited uptake by heal ... Full text Link to item Cite

Self-Organization of Interprofessional Staff to Improve Mobility of Hospitalized Patients with STRIDE: a Complexity Science-Informed Qualitative Study.

Journal article J Gen Intern Med · December 2022 BACKGROUND: Inpatient mobility programs can help older adults maintain function during hospitalization. Changing hospital practice can be complex and require engagement of various staff levels and disciplines; however, we know little about how interprofess ... Full text Link to item Cite

Adapting a family-involved intervention to increase initiation and completion of evidenced-based psychotherapy for posttraumatic stress disorder.

Journal article SSM Ment Health · December 2022 Posttraumatic stress disorder (PTSD) is disabling condition among United States Veterans. Training programs for evidenced-based therapies have been rolled out nationally in the Veterans Health Administration (VHA), but provider adoption of these treatments ... Full text Link to item Cite

Determinants of inter-organizational implementation success: A mixed-methods evaluation of Veteran Directed Care.

Journal article Healthc (Amst) · December 2022 BACKGROUND: Veteran Directed Care (VDC) aims to keep Veterans at risk for nursing home placement in their communities. VA medical centers (VAMCs) purchase VDC from third-party organizational providers who then partner with them during implementation. Exper ... Full text Link to item Cite

Advance directives among cognitively impaired persons who had an amyloid PET scan and their care partners: a mixed-methods study.

Journal article BMC Palliat Care · November 6, 2022 BACKGROUND: Little research exists on the role of β-amyloid PET scans as part of Alzheimer's diagnostic tests and documentation of end-of-life preferences for persons with cognitive impairment. The study objectives were to examine the association of amyloi ... Full text Link to item Cite

Improving Prediction of Long-Term Care Utilization Through Patient-Reported Measures: Cross-Sectional Analysis of High-Need U.S. Veterans Affairs Patients.

Journal article Med Care Res Rev · October 2022 This article examines the relative merit of augmenting an electronic health record (EHR)-derived predictive model of institutional long-term care (LTC) use with patient-reported measures not commonly found in EHRs. We used survey and administrative data fr ... Full text Link to item Cite

"Now at least we have something to call it": Patient and care partner experiences receiving an amyloid PET scan.

Journal article J Am Geriatr Soc · October 2022 BACKGROUND: The primary objective of this paper was to examine perspectives and experiences of individuals with cognitive impairment who received an amyloid PET scan and their care partners, with regard to the process, logistics, and decision-making associ ... Full text Link to item Cite

Standing Up For My Sister.

Journal article Health Aff (Millwood) · October 2022 Integrating family caregivers into the health care team is particularly important for patients with intellectual disabilities. ... Full text Link to item Cite

The Landscape of State Policies Supporting Family Caregivers as Aligned With the National Academy of Medicine Recommendations.

Journal article Milbank Q · September 2022 UNLABELLED: Policy Points In the absence of federal policy, states adopted policies to support family caregivers, but availability and level of support varies. We describe, compare, and rank state policies to support family caregivers as aligned with Natio ... Full text Link to item Cite

Using a home time measure to differentiate ACO performance for seriously ill populations.

Journal article J Am Geriatr Soc · September 2022 BACKGROUND: Alternative Payment Models (APMs) piloted by the Centers for Medicare and Medicaid Services (CMS) such as ACO Realizing Equity, Access and Community Health (REACH) seek to improve care and quality of life among seriously ill populations (SIP). ... Full text Link to item Cite

Individual and program Characteristics May Drive Variability in Outcomes After Caregivers Participate in a Tailored Support Intervention.

Journal article J Appl Gerontol · August 2022 Critically needed programs designed to support family caregivers have shown inconsistent reductions in stress and burden. To explore drivers of improvement in caregiver outcomes after participation in a support intervention we analyzed data from a one-on-o ... Full text Open Access Link to item Cite

Predictors of discharge from the VA Caregiver Support Program.

Journal article Am J Manag Care · August 1, 2022 OBJECTIVES: The Department of Veterans Affairs (VA) Program of Comprehensive Assistance for Family Caregivers (PCAFC) is a clinical program providing training, a monthly stipend, and other services to caregivers of qualifying post-9/11 veterans with servic ... Full text Link to item Cite

Preappointment surveys and reminder calls to improve show rate.

Journal article Am J Manag Care · August 1, 2022 OBJECTIVES: To assess the impact of preappointment surveys and reminder phone calls on show rate and time spent in new patient appointments at a multidisciplinary pediatric chronic pain clinic. STUDY DESIGN: We examined show rates and appointment length du ... Full text Link to item Cite

Adapting to CONNECT: modifying a nursing home-based team-building intervention to improve hospital care team interactions, functioning, and implementation readiness.

Journal article BMC Health Serv Res · July 29, 2022 BACKGROUND: Clinical interventions often need to be adapted from their original design when they are applied to new settings. There is a growing literature describing frameworks and approaches to deploying and documenting adaptations of evidence-based prac ... Full text Open Access Link to item Cite

Identifying Family and Unpaid Caregivers in Electronic Health Records: Descriptive Analysis.

Journal article JMIR Form Res · July 18, 2022 BACKGROUND: Most efforts to identify caregivers for research use passive approaches such as self-nomination. We describe an approach in which electronic health records (EHRs) can help identify, recruit, and increase diverse representations of family and ot ... Full text Open Access Link to item Cite

Making the Informal Formal: Discussing and Completing Advance Care Plans in Care Dyads with Cognitive Impairment.

Journal article J Palliat Care · July 2022 Background: Discussing advance care planning (ACP) with care partners may be a steppingstone to the completion of advance directives (ADs) for persons with cognitive impairment (PwCIs). Objectives: To examine whether PwCI-reported occurrence of and PwCI-ca ... Full text Link to item Cite

Family Caregivers of Veterans Experience Clinically Significant Levels of Distress Prepandemic and During Pandemic: Implications for Caregiver Support Services.

Journal article Med Care · July 1, 2022 BACKGROUND: Of the 26.4 million family caregivers in the United States, nearly 40% report high levels of emotional strain and subjective burden. However, for the 5 million caregivers of Veterans, little is known about the experiences of caregivers of Veter ... Full text Link to item Cite

Needs of care partners of older Veterans with serious illness.

Journal article J Am Geriatr Soc · June 2022 BACKGROUND: The quality of life of care partners and care recipients may be improved by programs that address unmet needs. The aim of this qualitative study was to identify care partners' social and practical needs as they care for Veterans (65 yo+) with s ... Full text Link to item Cite

The Impact of Care Intensity and Work on the Mental Health of Family Caregivers: Losses and Gains.

Journal article J Gerontol B Psychol Sci Soc Sci · May 20, 2022 OBJECTIVES: We estimate the causal impact of intensive caregiving, defined as providing at least 80 h of care per month, and work on the mental health of caregivers while considering possible sources of endogeneity in these relationships. METHODS: We use 2 ... Full text Link to item Cite

Psychological distress among medically complex veterans with a recent emergency department visit.

Journal article Psychol Serv · May 2022 Medical complexity and psychological distress are associated with frequent emergency department (ED) use. Despite this known association, our understanding is limited about which patients are at risk for persistent psychological distress and what patterns ... Full text Link to item Cite

Fewer potentially avoidable health care events in rural veterans with self-directed care versus other personal care services.

Journal article J Am Geriatr Soc · May 2022 BACKGROUND: Rural residents face more barriers to healthcare access, including challenges in receiving home- and community-based long-term services, compared to urban residents. Self-directed services provide flexibility and choice in care options and may ... Full text Link to item Cite

Design, methods, and baseline characteristics of the Brain Injury Education, Training, and Therapy to Enhance Recovery (BETTER) feasibility study: a transitional care intervention for younger adult patients with traumatic brain injury and caregivers.

Journal article Curr Med Res Opin · May 2022 OBJECTIVES: We developed a patient- and family-centered traumatic brain injury (TBI) transitional care intervention, called BETTER (Brain Injury Education, Training, and Therapy to Enhance Recovery), to improve quality of life (via SF-36) of younger TBI pa ... Full text Link to item Cite

Informal Caregiver Support Policies Change Use of Vocational Assistance Services for Individuals With Disabilities.

Journal article Med Care Res Rev · April 2022 Support policies for caregivers improves care-recipient access to care and effects may generalize to nonhealth services. Using administrative data from the U.S. Department of Veterans Affairs (VA) for veterans <55 years, we assessed the association between ... Full text Link to item Cite

Cost and Quality of Life Outcomes of the STepped Exercise Program for Patients With Knee OsteoArthritis Trial.

Journal article Value Health · April 2022 OBJECTIVES: This study aimed to evaluate the cost-effectiveness of the randomized clinical trial STEP-KOA (STepped Exercise Program for patients with Knee OsteoArthritis). METHODS: The trial included 230 intervention and 115 control participants from 2 Vet ... Full text Link to item Cite

Use of motivational techniques to enhance unpaid caregiver engagement in a tailored skills training intervention.

Journal article Aging Ment Health · February 2022 OBJECTIVES: The Helping Invested Families Improve Veterans' Experiences Study (HI-FIVES) evaluated a skills training program to support family caregivers of cognitively or functionally impaired persons. HI-FIVES demonstrated sustained improvements in careg ... Full text Link to item Cite

Risk Recognition Policies for the Long-Term Care Workforce during the First Year of the COVID-19 Pandemic: A Multi-Country Study

Journal article Journal of Long Term Care · January 1, 2022 Context: The precarious work arrangements experienced by many long-term care workers have led to the creation of a “shared” workforce across residential, home, and community aging care sectors. This shared workforce was identified as a contributor to the s ... Full text Cite

Amyloid-β PET Scan Results Disclosure and Care-Partner Emotional Well-Being Over Time.

Journal article J Alzheimers Dis · 2022 BACKGROUND: Diagnostic tests, such as amyloid-β positron emission tomography (PET) scans, can increase appropriate therapeutic management for the underlying causes of cognitive decline. To evaluate the full utility of this diagnostic tool, information is n ... Full text Link to item Cite

Long-term care service mix in the Veterans Health Administration after home care expansion.

Journal article Health Serv Res · December 2021 OBJECTIVE: To determine whether the Veterans Health Administration's (VHA) efforts to expand access to home- and community-based services (HCBS) after the 2001 Millennium Act significantly changed Veterans' utilization of institutional, paid home, and unpa ... Full text Link to item Cite

Developing a person-centered, population based measure of "home time": Perspectives of older patients and unpaid caregivers.

Journal article Healthc (Amst) · December 2021 Measuring "home time," number of days not in facility-based care, with medical claims is a promising approach to assess person-centered outcomes on a population level. Generally, spending more time at home matches long-term care preferences and improves qu ... Full text Link to item Cite

Walking All over COVID-19: The Rapid Development of STRIDE in Your Room, an Innovative Approach to Enhance a Hospital-Based Walking Program during the Pandemic.

Journal article Geriatrics (Basel) · November 10, 2021 Hospitalization is common among older adults. Prolonged time in bed during hospitalization can lead to deconditioning and functional impairments. Our team is currently working with Department of Veterans Affairs (VA) medical centers across the United State ... Full text Open Access Link to item Cite

Inclusion of Caregivers in Veterans' Care: A Critical Literature Review.

Journal article Med Care Res Rev · October 2021 More direct inclusion of informal caregivers (i.e., family, friends) in patients' care will make care more patient- and family-centered and has the potential to improve overall quality of care for patients. We need to understand what potentially comprises ... Full text Link to item Cite

Evaluation of a geriatrics primary care model using prospective matching to guide enrollment.

Journal article BMC Med Res Methodol · August 16, 2021 BACKGROUND: Few definitive guidelines exist for rigorous large-scale prospective evaluation of nonrandomized programs and policies that require longitudinal primary data collection. In Veterans Affairs (VA) we identified a need to understand the impact of ... Full text Open Access Link to item Cite

'The face of the programme': How local clinicians shape decisions about eligibility for a national caregiver support programme in the USA.

Journal article J Health Serv Res Policy · July 2021 OBJECTIVE: To examine the causes of variation for determining clinical eligibility for a national caregiver programme in the US Veterans Health Administration (VHA) and so help inform standardization of clinical eligibility assessment for support and estab ... Full text Link to item Cite

Drivers of Long-Term Care Considerations by Persons With Cognitive Impairment.

Journal article J Appl Gerontol · June 2021 Consideration of place of care is the first step in long-term care (LTC) planning and is critical for patients diagnosed with Alzheimer's disease; yet, drivers of consideration of place of care are unknown. We apply machine learning algorithms to cross-sec ... Full text Link to item Cite

Experiences of VA vocational and education training and assistance services: Facilitators and barriers reported by veterans with disabilities.

Journal article Psychiatr Rehabil J · June 2021 OBJECTIVE: To understand the experiences of veterans with disabilities and caregiving needs who use Department of Veterans Affairs (VA) vocational and education services, including Supported Employment, the Post-9/11 GI Bill, and Vocational Rehabilitation ... Full text Link to item Cite

COVID-19: The Time for Collaboration Between Long-Term Services and Supports, Health Care Systems, and Public Health Is Now.

Journal article Milbank Q · June 2021 UNLABELLED: Policy Points To address systemic problems amplified by COVID-19, we need to restructure US long-term services and supports (LTSS) as they relate to both the health care systems and public health systems. We present both near-term and long-term ... Full text Open Access Link to item Cite

Inequities in access to VA'S aid and attendance enhanced pension benefit to help Veterans pay for long-term care.

Journal article Health Serv Res · June 2021 OBJECTIVE: To examine characteristics that are associated with receipt of Aid and Attendance (A&A), an enhanced pension benefit for Veterans who qualify on the basis of needing daily assistance, among Veterans who receive pensions. DATA SOURCES: Secondary ... Full text Link to item Cite

Replicating an effective VA program to train and support family caregivers: a hybrid type III effectiveness-implementation design.

Journal article BMC Health Serv Res · May 6, 2021 BACKGROUND: Caring for a growing aging population using existing long-term care resources while simultaneously supporting and educating family caregivers, is a public health challenge. We describe the application of the Replicating Effective Programs (REP) ... Full text Open Access Link to item Cite

Selection Bias in Observational Studies of Palliative Care: Lessons Learned.

Journal article J Pain Symptom Manage · May 2021 CONTEXT: Palliative care (PC) programs are typically evaluated using observational data, raising concerns about selection bias. OBJECTIVES: To quantify selection bias because of observed and unobserved characteristics in a PC demonstration program. METHODS ... Full text Link to item Cite

The Metrics Matter: Improving Comparisons of COVID-19 Outbreaks in Nursing Homes.

Journal article J Am Med Dir Assoc · May 2021 OBJECTIVES: In the United States, nursing facility residents comprise fewer than 1% of the population but more than 40% of deaths due to Coronavirus Disease 2019 (COVID-19). Mitigating the enormous risk of COVID-19 to nursing home residents requires adequa ... Full text Open Access Link to item Cite

The Effects of Home Care Provider Mix on the Care Recipient: An International, Systematic Review of Articles from 2000 to 2020.

Journal article Annu Rev Public Health · April 1, 2021 In this systematic review, we examine the literature from 2000 to 2020 to ascertain whether we can make strong conclusions about the relative benefit of adding informal care or formal care providers to the care mix among individuals receiving care in the h ... Full text Link to item Cite

Older Adults Post-Incarceration: Restructuring Long-term Services and Supports in the Time of COVID-19.

Journal article J Am Med Dir Assoc · March 2021 OBJECTIVES: To describe long-term care services and supports (LTSS) in the United States, note their limitations in serving older adults post-incarceration, and offer potential solutions, with special consideration for the Coronavirus Disease 2019 pandemic ... Full text Open Access Link to item Cite

Stepped Exercise Program for Patients With Knee Osteoarthritis : A Randomized Controlled Trial.

Journal article Ann Intern Med · March 2021 BACKGROUND: Evidence-based models are needed to deliver exercise-related services for knee osteoarthritis efficiently and according to patient needs. OBJECTIVE: To examine a stepped exercise program for patients with knee osteoarthritis (STEP-KOA). DESIGN: ... Full text Link to item Cite

Video-Enhanced Care Management for Medically Complex Older Adults with Cognitive Impairment.

Journal article J Am Geriatr Soc · January 2021 OBJECTIVE: This pilot study assessed feasibility of video-enhanced care management for complex older veterans with suspected mild cognitive impairment (CI) and their care partners, compared with telephone delivery. DESIGN: Pilot randomized controlled trial ... Full text Link to item Cite

State Policy Responses to COVID-19 in Nursing Homes

Journal article Journal of Long Term Care · January 1, 2021 Context: COVID-19 has a high case fatality rate in high-risk populations and can cause severe morbidity and high healthcare resource use. Nursing home residents are a high-risk population; they live in congregate settings, often with shared rooms, and requ ... Full text Cite

Advancing the science of population-based measures of home-time.

Journal article Healthc (Amst) · December 2020 The "home time" measure is gaining appeal in evaluating outcomes for multiple patient populations including post-surgery or intervention and the last 6 months of life. Advancing the science of home time measures will require obtaining the perspectives of p ... Full text Link to item Cite

Prospective or retrospective ACO attribution matters for seriously ill patients.

Journal article Am J Manag Care · December 2020 OBJECTIVES: Since 2019, the Medicare Shared Savings Program (MSSP) has allowed accountable care organizations (ACOs) to choose either retrospectively or prospectively attributed ACO populations. To understand how ACOs' choice of attribution method affects ... Full text Link to item Cite

Family Caregivers of Veterans Experience High Levels of Burden, Distress, and Financial Strain.

Journal article J Am Geriatr Soc · November 2020 BACKGROUND/OBJECTIVES: To describe the caregiving experiences and physical and emotional needs of family members and friends who provide care to veterans with mental, physical, and cognitive comorbidities. DESIGN: Cross-sectional study. SETTING: National t ... Full text Link to item Cite

Implementation of a stepped wedge cluster randomized trial to evaluate a hospital mobility program.

Journal article Trials · October 16, 2020 BACKGROUND: Stepped wedge cluster randomized trials (SW-CRT) are increasingly used to evaluate new clinical programs, yet there is limited guidance on practical aspects of applying this design. We report our early experiences conducting a SW-CRT to examine ... Full text Open Access Link to item Cite

Comprehensive support of family caregivers: Are there health system cost offsets?

Journal article Health Serv Res · October 2020 OBJECTIVES: To examine the effect of the Department of Veterans Affairs' (VA) Program of Comprehensive Assistance for Caregivers (PCAFC) on total VA health care costs for Veterans. DATA SOURCES: VA claims. STUDY DESIGN: Using a pre-post cohort design with ... Full text Link to item Cite

Caring for Caregivers During COVID-19.

Journal article J Am Geriatr Soc · October 2020 Full text Open Access Link to item Cite

Mechanisms Through Which a Family Caregiver Coaching Intervention Might Reduce Anxiety Among Children in Military Households.

Journal article Matern Child Health J · October 2020 OBJECTIVES: Children of injured or disabled veterans and service members may be at risk for mental health and adjustment problems due to household stress. Yet, there are few widely available interventions to address the needs of this population. Reducing d ... Full text Link to item Cite

Association of Medicaid Expansion Under the Patient Protection and Affordable Care Act With Use of Long-term Care.

Journal article JAMA Netw Open · October 1, 2020 IMPORTANCE: Medicaid expansion is associated with increased access to health services, increased quality of medical care delivered, and reduced mortality, but little is known about its association with use of long-term care. OBJECTIVE: To examine the assoc ... Full text Link to item Cite

Cardiovascular disease, risk factors, and health behaviors among cancer survivors and spouses: A MEPS Study.

Journal article Cancer Med · September 2020 PURPOSE: The purpose of this study was to examine the prevalences of CVD, CVD risk factors. and health behaviors among cancer survivor-spouse dyads, assess how these prevalences differ by role (survivor vs spouse) and gender, and report congruences in heal ... Full text Open Access Link to item Cite

Measurement Properties of the CAPACITY Instrument to Assess Perceived Communication With the Health Care Team Among Care Partners of Patients With Cognitive Impairment.

Journal article Med Care · September 2020 BACKGROUND: The CAregiver Perceptions About CommunIcaTion with Clinical Team members (CAPACITY) instrument measures how care partners perceive themselves to be supported by the patient's health care team and their experiences communicating with the team. O ... Full text Link to item Cite

Utilization and Costs by Primary Care Provider Type: Are There Differences Among Diabetic Patients of Physicians, Nurse Practitioners, and Physician Assistants?

Journal article Med Care · August 2020 OBJECTIVE: The objective of this study was to compare health care utilization and costs among diabetes patients with physician, nurse practitioner (NP), or physician assistant (PA) primary care providers (PCPs). RESEARCH DESIGN AND METHODS: Cohort study us ... Full text Link to item Cite

Essential Long-Term Care Workers Commonly Hold Second Jobs and Double- or Triple-Duty Caregiving Roles.

Journal article J Am Geriatr Soc · August 2020 OBJECTIVES: Long-term care (LTC) facilities are particularly dangerous places for the spread of COVID-19 given that they house vulnerable high-risk populations. Transmission-based precautions to protect residents, employees, and families alike must account ... Full text Open Access Link to item Cite

Informal And Formal Home Care For Older Adults With Disabilities Increased, 2004-16.

Journal article Health Aff (Millwood) · August 2020 Rates of informal home care use among older adults with disabilities increased from 2004 to 2016, such that in 2016 almost three-quarters of these adults received informal home care. Informal care remains the most common source of home care, even though fo ... Full text Link to item Cite

Connecting Caregivers to Support: Lessons Learned From the VA Caregiver Support Program.

Journal article J Appl Gerontol · April 2020 Development and evaluation of supportive caregiver interventions has become a national priority. This study's aim was to evaluate how caregivers participating in the Department of Veterans Affairs (VA) Caregiver Support Program (CSP) use and value supporti ... Full text Link to item Cite

The effect of rural hospital closures on emergency medical service response and transport times.

Journal article Health Serv Res · April 2020 OBJECTIVE: To examine the effect of rural hospital closures on EMS response time (minutes between dispatch notifying unit and arriving at scene); transport time (minutes between unit leaving the scene and arriving at destination); and total activation time ... Full text Link to item Cite

Identifying treatment effects of an informal caregiver education intervention to increase days in the community and decrease caregiver distress: a machine-learning secondary analysis of subgroup effects in the HI-FIVES randomized clinical trial.

Journal article Trials · February 14, 2020 BACKGROUND: Informal caregivers report substantial burden and depressive symptoms which predict higher rates of patient institutionalization. While caregiver education interventions may reduce caregiver distress and decrease the use of long-term institutio ... Full text Open Access Link to item Cite

Implementation of a group physical therapy program for Veterans with knee osteoarthritis.

Journal article BMC Musculoskelet Disord · February 3, 2020 BACKGROUND: A previous randomized clinical trial found that a Group Physical Therapy (PT) program for knee osteoarthritis yielded similar improvements in pain and function compared with traditional individual PT. Based on these findings the Group PT progra ... Full text Open Access Link to item Cite

Willingness to Undergo a Risky Treatment to Improve Cognition Among Persons With Cognitive Impairment Who Received an Amyloid PET Scan.

Journal article Alzheimer Dis Assoc Disord · 2020 OBJECTIVE: To evaluate determinants of willingness to accept a treatment to return memory to normal among persons with cognitive impairment who received an amyloid positron emission tomography (PET) scan and their care partner and discordance in risk takin ... Full text Open Access Link to item Cite

Adaptation and Implementation of a Family Caregiver Skills Training Program: From Single Site RCT to Multisite Pragmatic Intervention.

Journal article J Nurs Scholarsh · January 2020 PURPOSE: We describe an approach to rapidly adapt and implement an education and skills improvement intervention to address the needs of family caregivers of functionally impaired veterans-Helping Invested Families Improve Veterans' Experience Study (HI-FI ... Full text Link to item Cite

Discharge Information and Support for Patients Discharged from the Emergency Department: Results from a Randomized Controlled Trial.

Journal article J Gen Intern Med · January 2020 BACKGROUND: Little research has been done on primary care-based models to improve health care use after an emergency department (ED) visit. OBJECTIVE: To examine the effectiveness of a primary care-based, nurse telephone support intervention for Veterans t ... Full text Link to item Cite

Leveraging institutional support for family caregivers to meet the health and vocational needs of persons with disabilities.

Journal article Nurs Outlook · 2020 BACKGROUND: Family caregivers might enhance veteran engagement in health and nonhealth services (i.e., vocational/educational assistance). PURPOSE: To describe how veterans with disabilities perceive their recovery needs, identify types of social support f ... Full text Link to item Cite

How Accurately Do Patients and Their Care Partners Report Results of Amyloid-β PET Scans for Alzheimer's Disease Assessment?

Journal article J Alzheimers Dis · 2020 BACKGROUND: Amyloid-β PET scans will likely become an integral part of the diagnostic evaluation for Alzheimer's disease if Medicare approves reimbursement for the scans. However, little is known about patients' and their care partners' interpretation of s ... Full text Open Access Link to item Cite

Interorganizational Context When Implementing Multisector Partnered Programs: A Qualitative Analysis of Veteran Directed Care.

Journal article J Gerontol Soc Work · 2020 As the number of Veterans enrolled in the Veterans Health Administration (VHA) and at risk for needing Long Term Services and Supports increases, VHA is shifting from institutional to Home and Community Based Services, such as the Veteran-Directed Care (VD ... Full text Link to item Cite

Development and Initial Validation of the Caregiver Perceptions About Communication With Clinical Team Members (CAPACITY) Measure.

Journal article Med Care Res Rev · December 2019 Despite the important role that family caregivers play managing the care of persons with complex health needs, little is known about how caregivers perceive themselves to be recognized and valued by health care professionals. Our objective was to develop a ... Full text Link to item Cite

Glycemic Control and Insulin Treatment Alter Fracture Risk in Older Men With Type 2 Diabetes Mellitus.

Journal article J Bone Miner Res · November 2019 Diabetes mellitus among older men has been associated with increased bone mineral density but paradoxically increased fracture risk. Given the interactions among medication treatment, glycemic control, and diabetes-associated comorbidities, the relative ef ... Full text Link to item Cite

Association Between Dual Use of Department of Veterans Affairs and Medicare Part D Drug Benefits and Potentially Unsafe Prescribing.

Journal article JAMA Intern Med · November 1, 2019 This observational study evaluates the association of dual prescribing for Veterans Affairs and Medicare Part D benefits with unsafe prescription exposure in a national cohort of older veterans. ... Full text Link to item Cite

Family Caregiver Skills Training to Improve Experiences of Care: a Randomized Clinical Trial.

Journal article J Gen Intern Med · October 2019 OBJECTIVE: To evaluate the effectiveness of Helping Invested Families Improve Veterans' Experiences Study (HI-FIVES), a skills training program for caregivers of persons with functional or cognitive impairments. DESIGN: A two-arm RCT. SETTING: Single Veter ... Full text Link to item Cite

Prevalence of cardiovascular disease and risk factors, quality of life, and health behaviors of cancer survivors and their spouses: findings from MEPS.

Journal article J Cancer Surviv · October 2019 PURPOSE: Few population-based studies have examined the prevalence of cardiovascular disease (CVD) and risk factors, quality of life (QOL), and health behaviors of cancer survivors and their spouses. This case-control study aimed to fill this gap using the ... Full text Link to item Cite

Association of Sensory and Cognitive Impairment With Healthcare Utilization and Cost in Older Adults.

Journal article J Am Geriatr Soc · August 2019 OBJECTIVES: To examine the association between self-reported vision impairment (VI), hearing impairment (HI), and dual-sensory impairment (DSI), stratified by dementia status, on hospital admissions, hospice use, and healthcare costs. DESIGN: Retrospective ... Full text Link to item Cite

Characteristics of dual drug benefit use among veterans with dementia enrolled in the Veterans Health Administration and Medicare Part D.

Journal article Res Social Adm Pharm · June 2019 BACKGROUND: Obtaining prescription medications from multiple health systems may complicate coordination of care. Older Veterans who obtain medications concurrently through Veterans Affairs (VA) benefits and Medicare Part D benefits (dual users) are at high ... Full text Link to item Cite

Impact Of Physicians, Nurse Practitioners, And Physician Assistants On Utilization And Costs For Complex Patients.

Journal article Health Aff (Millwood) · June 2019 Because of workforce needs and demographic and chronic disease trends, nurse practitioners (NPs) and physician assistants (PAs) are taking a larger role in the primary care of medically complex patients with chronic conditions. Research shows good quality ... Full text Link to item Cite

Including Family Caregivers In Seriously Ill Veterans' Care: A Mixed-Methods Study.

Journal article Health Aff (Millwood) · June 2019 Family caregivers often serve as unpaid members of the home and community-based care workforce for people with serious illness; as key partners in the home-clinic continuum, they should be included in health care teams. The Campaign for Inclusive Care is a ... Full text Link to item Cite

A Path To High-Quality Team-Based Care For People With Serious Illness.

Journal article Health Aff (Millwood) · June 2019 Although most care for people with serious illness is delivered by multiple providers and agencies, there is no gold standard for how to assemble, train, unify, and sustain strong teams. Using lessons from complexity science, a way of studying complex syst ... Full text Link to item Cite

STepped exercise program for patients with knee OsteoArthritis (STEP-KOA): protocol for a randomized controlled trial.

Journal article BMC Musculoskelet Disord · May 28, 2019 BACKGROUND: Physical therapy (PT) and other exercise-based interventions are core components of care for knee osteoarthritis (OA), but both are underutilized, and some patients have limited access to PT services. This clinical trial is examining a STepped ... Full text Open Access Link to item Cite

What is the marginal benefit of payment-induced family care? Impact on Medicaid spending and health of care recipients.

Journal article Health Econ · May 2019 Research on home-based long-term care has centered almost solely on the costs; there has been very little, if any, attention paid to the relative benefits. This study exploits the randomization built into the Cash and Counseling Demonstration and Evaluatio ... Full text Link to item Cite

An Interdisciplinary Academic Detailing Approach to Decrease Inappropriate Medication Prescribing by Physician Residents for Older Veterans Treated in the Emergency Department.

Journal article J Pharm Pract · April 2019 OBJECTIVE: To evaluate the impact of an academic detailing intervention delivered as part of a quality improvement project by a physician-pharmacist pair on (1) self-reported confidence in prescribing for older adults and (2) rates of potentially inappropr ... Full text Link to item Cite

Economic Spillover Effects of Intensive Unpaid Caregiving.

Journal article Pharmacoeconomics · April 2019 BACKGROUND: Growing evidence has documented economic spillover effects experienced by intensive caregivers across the lifecycle. These spillover effects are rarely incorporated in economic analyses of health interventions. When these costs are captured, it ... Full text Link to item Cite

Invisible partners in care: Snapshot of well-being among caregivers receiving comprehensive support from Veterans Affairs.

Journal article Health Sci Rep · March 2019 BACKGROUND AND AIMS: Since May 2011, over 23 000 caregivers of Veterans seriously injured on or after September 11, 2001 have enrolled in the Program of Comprehensive Assistance for Family Caregivers (PCAFC). PCAFC provides caregivers training, a stipend, ... Full text Open Access Link to item Cite

Comprehensive Support for Family Caregivers: Impact on Veteran Health Care Utilization and Costs.

Journal article Med Care Res Rev · February 2019 This study aimed to examine the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) on Veteran health care utilization and costs. A pre-post cohort design including a nonequivalent control group was used to understand how ... Full text Link to item Cite

Hospital Readmission and Costs of Total Knee Replacement Surgery in 2009 and 2014: Potential Implications for Health Care Managers.

Journal article Health Care Manag (Frederick) · 2019 The purpose of this article is to describe changes in hospital readmissions and costs for US hospital patients who underwent total knee replacement (TKR) in 2009 and 2014. Data came from the Healthcare Cost and Utilization Project net-Nationwide Readmissio ... Full text Link to item Cite

Family caregiver satisfaction with inpatient rehabilitation care.

Journal article PLoS One · 2019 INTRODUCTION: Informal family caregivers play an increasingly important role in healthcare. Despite their role in ongoing management and coordination of care, caregiver satisfaction with the healthcare services care recipients receive has been understudied ... Full text Open Access Link to item Cite

Comprehensive Family Caregiver Support and Caregiver Well-Being: Preliminary Evidence From a Pre-post-survey Study With a Non-equivalent Control Group.

Journal article Front Public Health · 2019 Introduction: In May 2010, the Caregivers and Veterans Omnibus Health Services Act of 2010, was signed into law in the United States, establishing the Program of Comprehensive Assistance for Family Caregivers (PCAFC) provided through the VA Caregiver Suppo ... Full text Open Access Link to item Cite

Implementing a Mandated Program Across a Regional Health Care System: A Rapid Qualitative Assessment to Evaluate Early Implementation Strategies.

Journal article Qual Manag Health Care · 2019 BACKGROUND: Rapid qualitative assessment was used to describe early strategies to implement an evidence-based walking program for hospitalized older adults, assiSTed eaRly mobIlity for hospitalizeD older vEterans (STRIDE), mandated by a regional Department ... Full text Link to item Cite

Effect of Dual Use of Veterans Affairs and Medicare Part D Drug Benefits on Antihypertensive Medication Supply in a National Cohort of Veterans with Dementia.

Journal article Health Serv Res · December 2018 OBJECTIVE: To evaluate the effect of dual use of VA/Medicare Part D drug benefits on antihypertensive medication supply in older Veterans with dementia. DATA SOURCES/STUDY SETTING: National, linked 2007-2010 Veterans Affairs (VA) and Medicare utilization a ... Full text Link to item Cite

Limited Osteoporosis Screening Effectiveness Due to Low Treatment Rates in a National Sample of Older Men.

Journal article Mayo Clin Proc · December 2018 OBJECTIVE: To determine the association between dual-energy x-ray absorptiometry (DXA) testing for osteoporosis and subsequent fractures in US male veterans without a previous fracture. PATIENTS AND METHODS: This is a propensity score-matched observational ... Full text Link to item Cite

Early Mobility in the Hospital: Lessons Learned from the STRIDE Program.

Journal article Geriatrics (Basel) · December 2018 Immobility during hospitalization is widely recognized as a contributor to deconditioning, functional loss, and increased need for institutional post-acute care. Several studies have demonstrated that inpatient walking programs can mitigate some of these n ... Full text Open Access Link to item Cite

The Impact of Stigma on Community Reintegration of Veterans With Traumatic Brain Injury and the Well-Being of Their Caregivers.

Journal article Arch Phys Med Rehabil · November 2018 OBJECTIVE: To assess the association between perceived stigma and discrimination and caregiver strain, caregiver well-being, and patient community reintegration. DESIGN: A cross-sectional survey study of 564 informal caregivers of U.S. military service vet ... Full text Link to item Cite

Internet Use and Technology-Related Attitudes of Veterans and Informal Caregivers of Veterans.

Journal article Telemed J E Health · July 2018 BACKGROUND: Healthcare systems are interested in technology-enhanced interventions to improve patient access and outcomes. However, there is uncertainty about feasibility and acceptability for groups who may benefit but are at risk for disparities in techn ... Full text Link to item Cite

The Effect of Support and Training for Family Members on Access to Outpatient Services for Veterans with Posttraumatic Stress Disorder (PTSD).

Journal article Adm Policy Ment Health · July 2018 The VA Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides landmark support for family caregivers of post-9/11 veterans. This study examines PCAFC support for veterans with and without PTSD and assesses whether program effect differs ... Full text Link to item Cite

Interventions That Support or Involve Caregivers or Families of Patients with Traumatic Injury: a Systematic Review.

Journal article J Gen Intern Med · July 2018 BACKGROUND: Almost 40 million family caregivers care for a loved one with severe physical or cognitive impairments. The purpose of this review is to summarize evidence about the benefits of interventions to support or involve family members/caregivers of p ... Full text Link to item Cite

Impact of Postdischarge Follow-Up Care on Medicare Expenditures: Does Rural Make a Difference?

Journal article Med Care Res Rev · June 2018 Reducing postdischarge Medicare expenditures is a key focus for hospitals. Early follow-up care is an important piece of this focus, but it is unclear whether there are rural-urban differences in the impact of follow-up care on Medicare expenditures. To as ... Full text Link to item Cite

Supporting teams to optimize function and independence in Veterans: a multi-study program and mixed methods protocol.

Journal article Implement Sci · April 20, 2018 BACKGROUND: Successful implementation of new clinical programs depends on effectively establishing, reorganizing, or enhancing team structures and processes to coordinate the work of individuals who are interdependent in their tasks, manage relationships, ... Full text Open Access Link to item Cite

Medicare utilization, screening, and costs among participants in the Southeastern Diabetes Initiative: A population-based evaluation.

Journal article Prim Care Diabetes · April 2018 AIMS: Type 2 diabetes mellitus imposes significant burdens on patients and health care systems. Population-level interventions are being implemented to reach large numbers of patients at risk of or diagnosed with diabetes. We describe a population-based ev ... Full text Link to item Cite

Competing Risks of Fracture and Death in Older Adults with Chronic Kidney Disease.

Journal article J Am Geriatr Soc · March 2018 OBJECTIVES: To examine whether chronic kidney disease (CKD) at any stage is associated with fracture risk after adjusting for competing mortality and to determine whether age or race modify the relationship between CKD and fracture risk. DESIGN: Prospectiv ... Full text Link to item Cite

Clinical Fractures Among Older Men With Diabetes Are Mediated by Diabetic Complications.

Journal article J Clin Endocrinol Metab · January 1, 2018 INTRODUCTION: Type 2 diabetes mellitus among older women has been associated with increased bone mineral density, but paradoxically with increased fracture risk. Findings among older men have varied, and potential mechanisms have not been fully elucidated. ... Full text Link to item Cite

Comprehensive Support for Family Caregivers of Post-9/11 Veterans Increases Veteran Utilization of Long-term Services and Supports: A Propensity Score Analysis.

Journal article Inquiry · 2018 Family caregivers are an important component of the long-term services and supports (LTSS) system. However, caregiving may have negative consequences for caregiver physical and emotional health. Connecting caregivers to formal short-term home- and communit ... Full text Open Access Link to item Cite

Family caregiver use and value of support services in the VA Program of Comprehensive Assistance for Family Caregivers

Journal article Journal of Long Term Care · January 1, 2018 Context: The US Congress in 2010 established the Program of Comprehensive Assistance for Family Caregivers (PCAFC) in the Department of Veterans Affairs’ (VA) healthcare system, expanding services for family caregivers of eligible veterans with injuries su ... Full text Cite

Innovation in a Learning Health Care System: Veteran-Directed Home- and Community-Based Services.

Journal article J Am Geriatr Soc · November 2017 A path-breaking example of the interplay between geriatrics and learning healthcare systems is the Veterans Health Administration's (VHA's) planned roll-out of a program for providing participant-directed home- and community-based services to veterans with ... Full text Link to item Cite

Paternal history of mental illness associated with posttraumatic stress disorder among veterans.

Journal article Psychiatry Res · October 2017 This study examined the association between parent and family reported history of non-PTSD mental illness (MI), PTSD specifically, and substance use problems, and participant clinical diagnosis of PTSD. Participants were drawn from the US Department of Vet ... Full text Link to item Cite

Rural-Urban Differences in the Effect of Follow-Up Care on Postdischarge Outcomes.

Journal article Health services research · August 2017 ObjectiveTo assess rural-urban differences in quality of postdischarge care among Medicare beneficiaries, controlling for selection bias of postdischarge services.Data sourcesThe Medicare Current Beneficiary Survey (MCBS), Cost and Use Fi ... Full text Cite

Risk stratification for return emergency department visits among high-risk patients.

Journal article Am J Manag Care · August 1, 2017 OBJECTIVES: To compare 2 methods of identifying patients at high-risk of repeat emergency department (ED) use: high Care Assessment Need (CAN) score (≥90), derived from a model using Veterans Health Administration (VHA) data, and "Super User" status, defin ... Link to item Cite

How Can Adult Children Influence Parents' Long-Term Care Insurance Purchase Decisions?

Journal article Gerontologist · April 1, 2017 PURPOSE OF THE STUDY: Long-term care (LTC) poses a significant strain on public health insurance financing. In response, there is policy interest in bolstering the private long-term care insurance (LTCI) market. Although families are central to LTC provisi ... Full text Link to item Cite

Dual Health Care System Use and High-Risk Prescribing in Patients With Dementia: A National Cohort Study.

Journal article Ann Intern Med · February 7, 2017 BACKGROUND: Recent federal policy changes attempt to expand veterans' access to providers outside the Department of Veterans Affairs (VA). Receipt of prescription medications across unconnected systems of care may increase the risk for unsafe prescribing, ... Full text Link to item Cite

Control beliefs and risk for 4-year mortality in older adults: a prospective cohort study.

Journal article BMC Geriatr · January 11, 2017 BACKGROUND: Control beliefs are important psychological factors that likely contribute to heterogeneity in health outcomes for older adults. We evaluated whether control beliefs are associated with risk for 4-year mortality, after accounting for establishe ... Full text Open Access Link to item Cite

Burden and mental health among caregivers of veterans with traumatic brain injury/polytrauma.

Journal article Am J Orthopsychiatry · 2017 Veterans who survive multiple traumatic injuries, including traumatic brain injuries (TBI), must often rely on family caregivers for ongoing care and support with reintegration. Understanding factors associated with caregiving that help or harm caregivers' ... Full text Link to item Cite

Do Maternity Care Coordination Services Encourage Use of Behavioral Health Treatment among Pregnant Women on Medicaid?

Journal article Womens Health Issues · 2017 OBJECTIVE: Maternity care coordination (MCC) may provide an opportunity to enhance access to behavioral health treatment services. However, this relationship has not been examined extensively in the empirical literature. This study examines the effect of M ... Full text Link to item Cite

Impact of TBI on caregivers of veterans with TBI: Burden and interventions.

Journal article Brain Inj · 2017 OBJECTIVES: Describe State-of-the-Art in practice and research in caregiving with individuals, specifically, Veterans with traumatic brain injury (TBI) and the implications for current practice and future research. SOURCES: Professional literature and pers ... Full text Link to item Cite

Open-label randomized trial of titrated disease management for patients with hypertension: Study design and baseline sample characteristics.

Journal article Contemp Clin Trials · September 2016 Despite the availability of efficacious treatments, only half of patients with hypertension achieve adequate blood pressure (BP) control. This paper describes the protocol and baseline subject characteristics of a 2-arm, 18-month randomized clinical trial ... Full text Open Access Link to item Cite

Understanding the Context for Long-Term Care Planning.

Journal article Med Care Res Rev · June 2016 Evolving family structure and economic conditions may affect individuals' ability and willingness to plan for future long-term care (LTC) needs. We applied life course constructs to analyze focus group data from a study of family decision making about LTC ... Full text Open Access Link to item Cite

Impact of Clinical Pharmacy Specialists on the Design and Implementation of a Quality Improvement Initiative to Decrease Inappropriate Medications in a Veterans Affairs Emergency Department.

Journal article J Manag Care Spec Pharm · January 2016 BACKGROUND: As the proportion of older adult patients who interface with the health care system grows, clinical pharmacy specialists (CPS) have a pivotal role in reducing potentially inappropriate medication (PIM) use in this population. OBJECTIVES: To (a) ... Full text Link to item Cite

Correlation of hip fracture with other fracture types: Toward a rational composite hip fracture endpoint.

Journal article Bone · December 2015 PURPOSE: With ethical requirements to the enrollment of lower risk subjects, osteoporosis trials are underpowered to detect reduction in hip fractures. Different skeletal sites have different levels of fracture risk and response to treatment. We sought to ... Full text Link to item Cite

Baby Boomer caregivers in the workforce: Do they fare better or worse than their predecessors?

Journal article Journal of the Economics of Ageing · December 1, 2015 Objective: Since the 1960's there have been substantial increases in women's labor force attachment. Meanwhile, a shifting focus to care in community settings has implied an increasingly important role for informal caregivers. In light of these changes and ... Full text Cite

Informal Caregiver Disability and Access to Preventive Care in Care Recipients.

Journal article Am J Prev Med · September 2015 INTRODUCTION: Many informal caregivers of dependent midlife and older adults suffer from their own functional limitations. The impact of caregiver functional limitations on care recipient receipt of preventive services is unknown. The purpose of this study ... Full text Link to item Cite

Rural Medicare Beneficiaries Have Fewer Follow-up Visits and Greater Emergency Department Use Postdischarge.

Journal article Med Care · September 2015 BACKGROUND: Hospitals are focused on improving postdischarge services for older adults, such as early follow-up care after hospitalization to reduce readmissions and unnecessary emergency department (ED) use. Rural Medicare beneficiaries face many barriers ... Full text Link to item Cite

Control Beliefs and Risk for Death, Stroke and Myocardial Infarction in Middle-aged and Older Adults: An Observational Study.

Journal article J Gen Intern Med · August 2015 BACKGROUND: Chronic health conditions account for the largest proportion of illness-related mortality and morbidity as well as most of healthcare spending in the USA. Control beliefs may be important for outcomes in individuals with chronic illness. OBJECT ... Full text Link to item Cite

Long-term care insurance: Does experience matter?

Journal article J Health Econ · March 2015 We examine whether long-term care (LTC) experience helps explain the low demand for long-term care insurance (LTCI). We test if expectations about future informal care receipt, expectations about inheritance receipt, and LTCI purchase decisions vary betwee ... Full text Link to item Cite

Family structure and long-term care insurance purchase.

Journal article Health Econ · March 2015 While it has long been assumed that family structure and potential sources of informal care play a large role in the purchase decisions for long-term care insurance (LTCI), current empirical evidence is inconclusive. Our study examines the relationship bet ... Full text Link to item Cite

Informal care and caregiver's health.

Journal article Health Econ · February 2015 This study aims to measure the causal effect of informal caregiving on the health and health care use of women who are caregivers, using instrumental variables. We use data from South Korea, where daughters and daughters-in-law are the prevalent source of ... Full text Link to item Cite

The Relationship between Training and Mental Health among Caregivers of Individuals with Polytrauma.

Journal article Behav Neurol · 2015 This was a hypothesis-generating exploration of relationships between caregiver training during TBI/polytrauma rehabilitation and caregiver mental health. In this cross-sectional study, 507 informal caregivers to US service members with TBI who received in ... Full text Open Access Link to item Cite

Discharge information and support for veterans Receiving Outpatient Care in the Emergency Department: study design and methods.

Journal article Contemp Clin Trials · November 2014 BACKGROUND: An explicit goal of Patient Aligned Care Teams (PACTs) within the Veterans Health Administration is to promote continuity of care in primary care clinics and thereby reduce Emergency Department (ED) utilization; however, there has been little r ... Full text Link to item Cite

Helping Invested Families Improve Veterans' Experiences Study (HI-FIVES): study design and methodology.

Journal article Contemp Clin Trials · July 2014 Within the Veterans Health Administration (VHA), the largest integrated health care system in the US, approximately 8.5 million Veteran patients receive informal care. Despite a need for training, half of VHA caregivers report that they have not received t ... Full text Link to item Cite

Caregiving intensity and retirement status in Canada.

Journal article Soc Sci Med · February 2014 A number of OECD countries have implemented policies encouraging longer labour force participation in tandem with policies encouraging informal care provision in the community. To better understand how these policies may affect the available pool of caregi ... Full text Link to item Cite

Impact of caring for grandchildren on the health of grandparents in Taiwan.

Journal article J Gerontol B Psychol Sci Soc Sci · November 2013 OBJECTIVES: To understand how caring for grandchildren affects the physical and mental health of grandparents in Taiwan. METHOD: Grandparents aged 50 and older from 4 waves of the Taiwan Longitudinal Study on Aging (1993-2003, n = 3,711) were divided into ... Full text Link to item Cite

Do nurse-led skill training interventions affect informal caregivers' out-of-pocket expenditures?

Journal article Gerontologist · February 2013 PURPOSE OF THE STUDY: This paper is a report of a study of the Assistance, Support, and Self-health Initiated through Skill Training (ASSIST) randomized control trial. The aim of this paper is to understand whether participating in ASSIST significantly cha ... Full text Link to item Cite

The effect of informal care on work and wages.

Journal article J Health Econ · January 2013 Cross-sectional evidence in the United States finds that informal caregivers have less attachment to the labor force. The causal mechanism is unclear: do children who work less become informal caregivers, or are children who become caregivers working less? ... Full text Link to item Cite

The health effects of caregiving by grandparents in Taiwan: An instrumental variable estimation

Journal article Review of Economics of the Household · December 1, 2012 Previous research on the health effects of caring for grandchildren has had variable findings, including both positive and negative effects on the health of grandparents. The estimated effects of caregiving may be affected by selection, with the health of ... Full text Cite

Economic evaluation of telephone self-management interventions for blood pressure control.

Journal article Am Heart J · June 2012 BACKGROUND: Half of patients with hypertension have poor blood pressure (BP) control. Recent models for treating hypertension have integrated disease monitoring and telephone-based interventions delivered in patients' homes. This study evaluated the costs ... Full text Open Access Link to item Cite

Informal care

Journal article · January 31, 2012 Cite

Is policy well-targeted to remedy financial strain among caregivers of severely injured U.S. service members?

Journal article Inquiry · 2012 U.S. military service members have sustained severe injuries since the start of the wars in Iraq and Afghanistan. This paper aims to determine the factors associated with financial strain of their caregivers and establish whether recent federal legislation ... Full text Link to item Cite

An organizing framework for informal caregiver interventions: detailing caregiving activities and caregiver and care recipient outcomes to optimize evaluation efforts.

Journal article BMC Geriatr · November 22, 2011 BACKGROUND: Caregiver interventions may help improve the quality of informal care. Yet the lack of a systematic framework specifying the targets and outcomes of caregiver interventions hampers our ability to understand what has been studied, to evaluate ex ... Full text Open Access Link to item Cite

Home blood pressure management and improved blood pressure control: results from a randomized controlled trial.

Journal article Arch Intern Med · July 11, 2011 BACKGROUND: To determine which of 3 interventions was most effective in improving blood pressure (BP) control, we performed a 4-arm randomized trial with 18-month follow-up at the primary care clinics at a Veterans Affairs Medical Center. METHODS: Eligible ... Full text Open Access Link to item Cite

Pilot study: individualized training for caregivers of hospitalized older veterans.

Journal article Nurs Res · 2011 BACKGROUND: : The hospital-to-home transition represents a vulnerable time for older veterans who are more medically and socioeconomically challenged than the general population of older adults. OBJECTIVES: : The aim of this study was examine the feasibili ... Full text Link to item Cite

Objective burden, resources, and other stressors among informal cancer caregivers: a hidden quality issue?

Journal article Psychooncology · January 2011 UNLABELLED: A great deal of clinical cancer care is delivered in the home by informal caregivers (e.g. family, friends), who are often untrained. Caregivers' context varies widely, with many providing care despite low levels of resources and high levels of ... Full text Link to item Cite

Spousal Health Shocks and the Timing of the Retirement Decision in the Face of Forward-Looking Financial Incentives

Journal article Boston College Center for Retirement Research Working Paper · June 1, 2010 Cite

Informal and formal care infrastructure and perceived need for caregiver training for frail US veterans referred to home and community-based services.

Journal article Chronic Illn · March 2010 Featured Publication OBJECTIVES: To describe the informal care network of US veterans referred to home and community-based services (Homemaker Home Health services, H/HHA, or Home-Based Primary Care, HBPC) at the Durham Veterans Affairs Medical Center (VAMC), including: quanti ... Full text Link to item Cite

Rural-urban differences in preventable hospitalizations among community-dwelling veterans with dementia.

Journal article J Rural Health · 2010 CONTEXT: Alzheimer's patients living in rural communities may face significant barriers to effective outpatient medical care. PURPOSE: We sought to examine rural-urban differences in risk for ambulatory care sensitive hospitalizations (ACSH), an indicator ... Full text Link to item Cite

Economic burden for informal caregivers of lung and colorectal cancer patients.

Journal article Oncologist · 2010 Featured Publication BACKGROUND: Informal care provides many benefits to cancer patients, but can be costly to caregivers. This study quantified the economic burden for informal caregivers of lung cancer (LC) and colorectal cancer (CRC) patients, examining differences by cance ... Full text Link to item Cite

Caring for mom and neglecting yourself? The health effects of caring for an elderly parent.

Journal article Health Econ · September 2009 Featured Publication We examine the physical and mental health effects of providing care to an elderly mother on the adult child caregiver. We address the endogeneity of the selection in and out of caregiving using an instrumental variable approach, using the death of the care ... Full text Link to item Cite

Is a home-care network necessary to access the Medicare hospice benefit?

Journal article J Palliat Med · August 2009 Featured Publication OBJECTIVE: To test whether the presence of an informal or formal care network in the home leads to different hospice utilization patterns near death. To examine how the informal care relationship affects hospice use patterns. DATA SOURCES: Medicare Current ... Full text Link to item Cite

Barriers to outpatient care in community-dwelling elderly with dementia: The role of caregiver life satisfaction

Journal article Journal of Applied Gerontology · August 1, 2009 The purpose of this study was to examine the relationship between informal caregiver life satisfaction and receipt of outpatient medical care in persons with dementia. We obtained data from the National Longitudinal Caregiver Survey (NLCS), a survey of 1,2 ... Full text Cite

Home health care and patterns of subsequent VA and medicare health care utilization for veterans.

Journal article Gerontologist · October 2008 Featured Publication PURPOSE: The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HHC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum ... Full text Link to item Cite

Characterizing hospice discharge patterns in a nationally representative sample of the elderly, 1993-2000.

Journal article Am J Hosp Palliat Care · 2008 The aim of this study is to identify the prevalence and correlates of individuals discharged alive from hospice in the Medicare program to determine whether the current hospice benefit matches the needs of dying patients. Using a nationally representative ... Full text Link to item Cite

Informal care and Medicare expenditures: testing for heterogeneous treatment effects.

Journal article J Health Econ · January 2008 Featured Publication We estimate the effect of informal care on Medicare expenditures not only for care provided by children but also by the source of informal care (sons versus daughters, children versus others) and recipient characteristics (marital status). Our conceptual f ... Full text Link to item Cite

Depression and missed work among informal caregivers of older individuals with dementia

Journal article Journal of Family and Economic Issues · December 1, 2007 Although providing informal care can negatively affect caregiver emotional health and lead to depression, the association between caregiver depression and missed work is unknown. We use data from the National Longitudinal Caregiver Survey to examine the re ... Full text Cite

What length of hospice use maximizes reduction in medical expenditures near death in the US Medicare program?

Journal article Soc Sci Med · October 2007 Featured Publication Hospices have been expected to reduce health expenditures since their addition to the US Medicare benefit package in the early-1980s, but the literature on their ability to do so is mixed. The contradictory findings noted in previous studies may be due to ... Full text Link to item Cite

Caregiver psychological distress as a barrier to influenza vaccination among community-dwelling elderly with dementia.

Journal article Med Care · August 2006 OBJECTIVE: This study examined whether informal caregiver psychologic distress decreases the likelihood of influenza vaccination for community-dwelling elderly with dementia. A secondary aim was to determine whether psychologic distress mediates the relati ... Full text Link to item Cite

Inter-vivos transfers and exchange

Journal article Southern Economic Journal · January 1, 2006 Most parents divide their bequests equally among their children, whereas inter-vivos transfers are usually unequal. We propose that exchange is better for inducing inter-vivos transfers than bequests. Inter-vivos transfers can be adjusted quickly to the am ... Full text Cite

Informal care intensity and caregiver drug utilization

Journal article Review of Economics of the Household · December 1, 2005 Providing informal care has negative health consequences for informal caregivers. If these health consequences increase drug utilization among caregivers, estimates of health care savings from informal care - mainly realized through reductions in utilizati ... Full text Cite

Perceived discrimination and reported delay of pharmacy prescriptions and medical tests.

Journal article J Gen Intern Med · July 2005 Featured Publication BACKGROUND: Access to health care varies according to a person's race and ethnicity. Delaying treatment is one measure of access with important health consequences. OBJECTIVE: Determine whether perceptions of unfair treatment because of race or ethnicity a ... Full text Link to item Cite

Home and community-based waivers for disabled adults: program versus selection effects.

Journal article Inquiry · 2005 Featured Publication This paper addresses whether changes in expenditures from participation in a Medicaid home and community-based waiver are due to selection effects or true program effects. We examined North Carolina Medicaid claims data (FY1998 to FY2000) for disabled or b ... Full text Link to item Cite

Informal care and health care use of older adults.

Journal article J Health Econ · November 2004 Featured Publication Informal care by adult children is a common form of long-term care for older adults and can reduce medical expenditures if it substitutes for formal care. We address how informal care by all children affects formal care, which is critically important given ... Full text Link to item Cite

Does prospective payment reduce inpatient length of stay?

Journal article Health Econ · July 2002 Featured Publication A change in payment mechanism for inpatient care from per diem to per episode creates two incentives - a marginal and an average price effect - to change length of stay. The decrease in marginal price per day to zero should reduce the length of stay, while ... Full text Link to item Cite