2024
Functional disability and receipt of informal care among Chinese adults living alone with cognitive impairment
Liu X, Li C, Jin S, Cao X, Hoogendijk E, Han L, Xu X, Allore H, Feng Q, Zhang Q, Liu Z. Functional disability and receipt of informal care among Chinese adults living alone with cognitive impairment. Experimental Gerontology 2024, 194: 112490. PMID: 38876449, DOI: 10.1016/j.exger.2024.112490.Peer-Reviewed Original ResearchActivities of daily livingBurden of functional disabilityInformal careFunctional disabilityActivities of daily living disabilityCognitive impairmentChinese adultsInstrumental Activities of Daily Living (IADLReceipt of informal careNormal cognitionLong-term care servicesIADL disabilityInstrumental activitiesMobility disabilityProvision of long-term care servicesChina HealthFunctional healthCare servicesDaily livingMatched comparatorsOdds ratioMonthly hoursVulnerable subpopulationsCareDisabilityLeveraging Electronic Health Records to Assess Residential Mobility Among Veterans in the Veterans Health Administration
Wang K, Hendrickson Z, Miller M, Abel E, Skanderson M, Erdos J, Womack J, Brandt C, Desai M, Han L. Leveraging Electronic Health Records to Assess Residential Mobility Among Veterans in the Veterans Health Administration. Medical Care 2024, 62: 458-463. PMID: 38848139, DOI: 10.1097/mlr.0000000000002017.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationElectronic health recordsResidential addressesHealth recordsHealth AdministrationLeveraging electronic health recordsInfluence health care utilizationVeterans Health Administration dataAssociations of sociodemographicsHealth care utilizationHealth care systemPatient's residential addressCross-sectional analysisGeneralized logistic regressionCare utilizationHealth systemResidential mobilitySubstance use disordersCare systemPatient's residenceLogistic regressionVeteransMultinomial outcomesHealthOddsVariation in Specialist Palliative Care Reach and Associated Factors Among People With Advanced Heart Failure in the Department of Veterans Affairs
Feder S, Han L, Zhan Y, Abel E, Akgün K, Fried T, Ersek M, Redeker N. Variation in Specialist Palliative Care Reach and Associated Factors Among People With Advanced Heart Failure in the Department of Veterans Affairs. Journal Of Pain And Symptom Management 2024, 68: 22-31.e1. PMID: 38561132, PMCID: PMC11168897, DOI: 10.1016/j.jpainsymman.2024.03.022.Peer-Reviewed Original ResearchOutpatient specialist palliative careSpecialist palliative careVeterans Affairs Medical CenterPalliative careSpecialist palliative care consultationRandom intercept multilevel logistic regressionDepartment of Veterans AffairsMultilevel logistic regressionAffairs Medical CenterClinical practice guidelinesICD-9/10 codesAdvanced heart failureRetrospective cohort studyVeterans AffairsOutpatient palliativeOutpatient deliveryPractice guidelinesCohort studyLogistic regressionCardiology involvementDelivery characteristicsAssociated factorsMedical CenterIdentified factorsICD-9/10
2023
PERSONALIZED AND TYPICAL CONCURRENT RISK: JOINT MODELS OF RECURRENT OUTCOMES AND MORTALITY BY RACE/ETHNICITY
Allore H, McAvay G, Vander Wyk B, Han L, Quiñones A. PERSONALIZED AND TYPICAL CONCURRENT RISK: JOINT MODELS OF RECURRENT OUTCOMES AND MORTALITY BY RACE/ETHNICITY. Innovation In Aging 2023, 7: 231-231. PMCID: PMC10736438, DOI: 10.1093/geroni/igad104.0759.Peer-Reviewed Original ResearchMultiple chronic conditionsChronic conditionsRisk factorsConcurrent riskSociodemographic risk factorsPoor health outcomesHuman Services initiativeHealthcare system policiesRace/ethnicityFunctional statusHigh riskHealth outcomesHealth statusHealth servicesAverage riskPatient trajectoriesPopulation subgroupsOutcomesRecurrent outcomesRiskCohort levelConcurrent outcomesRandom intercept termLongitudinal effectsMultiple outcomesChanges in Restricting Symptoms after Critical Illness among Community-Living Older Adults.
Jain S, Han L, Gahbauer E, Leo-Summers L, Feder S, Ferrante L, Gill T. Changes in Restricting Symptoms after Critical Illness among Community-Living Older Adults. American Journal Of Respiratory And Critical Care Medicine 2023, 208: 1206-1215. PMID: 37769149, PMCID: PMC10868351, DOI: 10.1164/rccm.202304-0693oc.Peer-Reviewed Original ResearchConceptsNeighborhood-level socioeconomic disadvantageCritical illnessIntensive care unitHospital dischargeCommunity-living older adultsOlder adultsOlder ICU survivorsPost-ICU careSocioeconomic disadvantageProspective longitudinal studyQuality of lifeICU admissionICU survivorsCare unitFunctional recoverySymptom managementMultiple symptomsThird monthThree monthsSymptomsIllnessRestricted activityVulnerable subgroupsFirst monthMonthsA Joint Model for Disability, Self-Rated Health, and Mortality Among Medicare Beneficiaries-Differences by Chronic Disease and Race/Ethnicity.
Quiñones A, McAvay G, Vander Wyk B, Han L, Nagel C, Allore H. A Joint Model for Disability, Self-Rated Health, and Mortality Among Medicare Beneficiaries-Differences by Chronic Disease and Race/Ethnicity. Journal Of Aging And Health 2023, 8982643231210027. PMID: 37879084, DOI: 10.1177/08982643231210027.Peer-Reviewed Original ResearchPoor self-rated healthSelf-rated healthHigher oddsADL disabilityHip fractureAging Trends Study dataOlder adultsConcurrent riskPatient-centered outcomesLongitudinal logistic regression modelsLogistic regression modelsRace/ethnicityKidney diseaseChronic diseasesNational HealthDaily livingMortalityHealth declineOddsDisabilityHispanic respondentsDementiaDiseaseRiskWide variabilityRelationship Between Distressing Symptoms and Changes in Disability After Major Surgery Among Community-living Older Persons
Gill T, Han L, Feder S, Gahbauer E, Leo-Summers L, Becher R. Relationship Between Distressing Symptoms and Changes in Disability After Major Surgery Among Community-living Older Persons. Annals Of Surgery 2023, 279: 65-70. PMID: 37389893, PMCID: PMC10761592, DOI: 10.1097/sla.0000000000005984.Peer-Reviewed Original ResearchConceptsMajor surgeryDistressing symptomsElective surgeryFunctional outcomeOlder personsCommunity-living older personsMultiple distressing symptomsSocioeconomic disadvantageCommunity-living personsTiming of surgerySerious health eventsNumber of disabilitiesSurgerySignificant associationSymptomsHealth eventsRate ratioPotential targetDisabilityUnit increaseDeleterious effectsOutcomesPersonsMultimorbidityAdmissionDistressing symptoms after major surgery among community‐living older persons
Gill T, Han L, Murphy T, Feder S, Gahbauer E, Leo‐Summers L, Becher R. Distressing symptoms after major surgery among community‐living older persons. Journal Of The American Geriatrics Society 2023, 71: 2430-2440. PMID: 37010784, PMCID: PMC10524276, DOI: 10.1111/jgs.18357.Peer-Reviewed Original ResearchConceptsCommunity-living older personsMajor surgeryDistressing symptomsArea Deprivation IndexOlder personsSocioeconomic disadvantageCommunity-living personsTiming of surgeryProspective longitudinal studyYears of ageQuality of lifeSymptom burdenNonelective surgeryPresurgery valuesElective surgeryMultivariable analysisFunctional outcomeNonelective proceduresChronic conditionsSurgerySymptomsProportional increaseMedicaid eligibilityDeprivation indexMonthsAntibiotic therapy is associated with adverse drug events among older adults with advanced cancer: A cohort study
Datta R, Han L, Doyle M, Allore H, Sanft T, Quagliarello V, Juthani-Mehta M. Antibiotic therapy is associated with adverse drug events among older adults with advanced cancer: A cohort study. Palliative Medicine 2023, 37: 793-798. PMID: 36999898, DOI: 10.1177/02692163231162889.Peer-Reviewed Original ResearchConceptsAdverse drug eventsAntibiotic therapyDrug eventsAdvanced cancerOlder adultsIndex admissionPalliative chemotherapyCohort studyTertiary care centerHospitalized older adultsPalliative care providersMultidrug-resistant organismsMean ageCommon tumorsCare centerCare providersRatio of daysSolid tumorsMultivariable testingPatientsTherapyStandardized criteriaCancerMean timeAdultsComplementary and Integrative Health Approaches and Pain Care Quality in the Veterans Health Administration Primary Care Setting: A Quasi-Experimental Analysis
Han L, Luther S, Finch D, Dobscha S, Skanderson M, Bathulapalli H, Fodeh S, Hahm B, Bouayad L, Lee A, Goulet J, Brandt C, Kerns R. Complementary and Integrative Health Approaches and Pain Care Quality in the Veterans Health Administration Primary Care Setting: A Quasi-Experimental Analysis. Journal Of Alternative And Complementary Medicine 2023, 29: 420-429. PMID: 36971840, PMCID: PMC10280173, DOI: 10.1089/jicm.2022.0686.Peer-Reviewed Original ResearchConceptsPain care qualityPrimary care settingCIH exposureIntegrative health approachesCare settingsPropensity scorePain managementCIH approachesPCQ scoresPrimary care clinic visitsHealth approachCare qualityInternational clinical guidelinesChronic pain managementPrimary care capacityDeclaration of AstanaVHA initiativesClinic visitsMusculoskeletal painBenefits patientsMassage therapyClinical guidelinesExposure groupCare capacityMusculoskeletal disordersRacial, Ethnic, and Rural Disparities in U.S. Veteran COVID-19 Vaccine Rates
Bernstein E, DeRycke E, Han L, Farmer M, Bastian L, Bean-Mayberry B, Bade B, Brandt C, Crothers K, Skanderson M, Ruser C, Spelman J, Bazan I, Justice A, Rentsch C, Akgün K. Racial, Ethnic, and Rural Disparities in U.S. Veteran COVID-19 Vaccine Rates. AJPM Focus 2023, 2: 100094. PMID: 37362395, PMCID: PMC10038675, DOI: 10.1016/j.focus.2023.100094.Peer-Reviewed Original ResearchRace/ethnicity groupsFirst vaccinationFirst COVID-19 vaccinationVeterans AffairsWhite veteransCharlson Comorbidity IndexRetrospective cohort studyPrimary care visitsEthnicity groupsCOVID-19 vaccinationLarge healthcare systemEquitable vaccine distributionAsian Americans/Pacific IslandersRace/ethnicityUnvaccinated patientsComorbidity indexInfluenza vaccinationSelf-reported categoriesBlack groupCare visitsCohort studyHazard ratioPrimary outcomeWhite patientsBlack patientsDissemination and implementation of age‐friendly care and geriatric emergency department accreditation at Veterans Affairs hospitals
Hwang U, Runels T, Han L, Gruber E, McQuown C, Ragsdale L, Jetter E, Rossomano N, Javier D. Dissemination and implementation of age‐friendly care and geriatric emergency department accreditation at Veterans Affairs hospitals. Academic Emergency Medicine 2023, 30: 270-277. PMID: 36653961, DOI: 10.1111/acem.14665.Peer-Reviewed Original ResearchConceptsVA emergency departmentEmergency departmentOlder veteransED visitsVA Corporate Data WarehouseAge-friendly careIndex ED visitVeterans Affairs hospitalYears of ageCorporate Data WarehouseScreening prevalencePoor outcomeStandardization of practiceMean ageVisit encountersPotential confoundingEmergency careGreater oddsExtended careDemographic dataOlder adultsLevel 1Observational evaluationCarePandemic year
2022
Post-9/11 deployment history and the incidence of breast cancer among women veterans
Gaffey A, Han L, Ramsey C, Skanderson M, Dziura J, Driscoll M, Burg M, Brandt C, Bastian L, Haskell S. Post-9/11 deployment history and the incidence of breast cancer among women veterans. Annals Of Epidemiology 2022, 77: 98-102. PMID: 36470323, DOI: 10.1016/j.annepidem.2022.11.010.Peer-Reviewed Original ResearchConceptsOEF/OIF deploymentBreast cancerWomen veteransHealthcare utilizationHormone replacement therapy useRetrospective cohort studyVeterans Affairs (VA) careHealthy soldier effectOEF/OIFCohort studyTherapy useBC incidenceHormonal contraceptivesLifestyle factorsPrimary careBC diagnosisLower incidenceOperations Enduring Freedom/Iraqi FreedomWomenIncidenceGreater likelihoodIraqi FreedomVeteransCancerCareCharacteristics Associated with Spirometry Guideline Adherence in VA Patients Hospitalized with Chronic Obstructive Pulmonary Disease
Rodwin BA, DeRycke EC, Han L, Bade BC, Brandt CA, Bastian LA, Akgün KM. Characteristics Associated with Spirometry Guideline Adherence in VA Patients Hospitalized with Chronic Obstructive Pulmonary Disease. Journal Of General Internal Medicine 2022, 38: 619-626. PMID: 36241942, PMCID: PMC9971396, DOI: 10.1007/s11606-022-07826-5.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseHigh-risk COPD patientsObstructive pulmonary diseaseAnnual spirometryCOPD patientsClinic visitsPulmonary diseaseChronic obstructive lung diseaseVeterans Health Administration facilitiesPost-hospitalization careGuideline-concordant careObstructive lung diseaseYear of hospitalizationCorporate Data WarehouseProvider-level dataPulmonary clinicGuideline adherencePatient demographicsConcordant careCOPD hospitalizationsPrimary outcomeVA patientsLung diseaseProvider variablesProvider ageMental Health Diagnoses are Not Associated With Indicators of Lower Quality Pain Care in Electronic Health Records of a National Sample of Veterans Treated in Veterans Health Administration Primary Care Settings
Dobscha SK, Luther SL, Kerns RD, Finch DK, Goulet JL, Brandt CA, Skanderson M, Bathulapalli H, Fodeh SJ, Hahm B, Bouayad L, Lee A, Han L. Mental Health Diagnoses are Not Associated With Indicators of Lower Quality Pain Care in Electronic Health Records of a National Sample of Veterans Treated in Veterans Health Administration Primary Care Settings. Journal Of Pain 2022, 24: 273-281. PMID: 36167230, PMCID: PMC9898089, DOI: 10.1016/j.jpain.2022.08.009.Peer-Reviewed Original ResearchConceptsPain care qualityQuality pain careMental health conditionsPrimary care cliniciansVeterans Health AdministrationPain carePCQ scoresHealth conditionsCare cliniciansUse disordersCare qualitySevere musculoskeletal painRetrospective cohort studyPrimary care visitsGeneral medical carePrimary care settingElectronic health record dataFinal adjusted modelMental health diagnosesEquation Poisson modelsHealth record dataBipolar disorder diagnosisSubstance use disordersAlcohol use disorderPost-traumatic stress disorderNational Cohort Study of Homebound Persons Living With Dementia: Antibiotic Prescribing Trends and Opportunities for Antibiotic Stewardship
Datta R, Fried T, O’Leary J, Zullo AR, Allore H, Han L, Juthani-Mehta M, Cohen A. National Cohort Study of Homebound Persons Living With Dementia: Antibiotic Prescribing Trends and Opportunities for Antibiotic Stewardship. Open Forum Infectious Diseases 2022, 9: ofac453. PMID: 36147594, PMCID: PMC9487603, DOI: 10.1093/ofid/ofac453.Peer-Reviewed Original ResearchHome-based primary careDays of therapyAntibiotic use ratesAntibiotic useHomebound personsOverall median lengthPhysician home visitsNational cohort studyAntibiotic prescribing trendsVeterans Health AdministrationUse ratesProvider visitsAntibiotic prescriptionsCohort studyPrescribing trendsTelephone visitsMedian agePrescription fillsMedian lengthAntibiotic stewardshipNational cohortPrimary careHome visitsHealth AdministrationPrescribed classMilitary sexual trauma and incident hypertension: a 16-year cohort study of young and middle-aged men and women
Gaffey AE, Rosman L, Sico JJ, Haskell SG, Brandt CA, Bathulapalli H, Han L, Dziura J, Skanderson M, Burg MM. Military sexual trauma and incident hypertension: a 16-year cohort study of young and middle-aged men and women. Journal Of Hypertension 2022, 40: 2307-2315. PMID: 35983872, DOI: 10.1097/hjh.0000000000003267.Peer-Reviewed Original ResearchConceptsIncident hypertensionRisk factorsPsychiatric disordersMultivariate Cox proportional hazards modelVeterans Health Administration dataGreater riskCox proportional hazards modelTrauma-related psychiatric disordersMiddle-aged veteransCardiovascular risk factorsBaseline blood pressureElevated cardiovascular riskLarge prospective cohortHealth Administration dataMiddle-aged menProportional hazards modelSex-specific analysesPosttraumatic stress disorderMilitary sexual traumaCardiovascular riskCohort studyProspective cohortBlood pressureTreatment attenuatesCardiovascular impactCatastrophic health expenditure among Chinese adults living alone with cognitive impairment: findings from the CHARLS
Li C, Jin S, Cao X, Han L, Sun N, Allore H, Hoogendijk EO, Xu X, Feng Q, Liu X, Liu Z. Catastrophic health expenditure among Chinese adults living alone with cognitive impairment: findings from the CHARLS. BMC Geriatrics 2022, 22: 640. PMID: 35922775, PMCID: PMC9351200, DOI: 10.1186/s12877-022-03341-8.Peer-Reviewed Original ResearchTrends in the prevalence of vision impairment among the oldest-old Chinese population from 1998 to 2018.
Luo Y, Zhang Q, Han L, Shen Z, Chen Y, Wang K, Huang Z, De Fries CM, Cao G, Su H, Xu H, Chen Z, Ren Z, Hu Y, Xu B. Trends in the prevalence of vision impairment among the oldest-old Chinese population from 1998 to 2018. Journal Of Global Health 2022, 12: 11006. PMID: 35862489, DOI: 10.7189/jogh.12.11006.Peer-Reviewed Original ResearchConceptsOldest-old Chinese populationImpairment prevalenceVision impairmentChinese populationChronic conditionsHealth behaviorsHearing impairmentChinese Longitudinal Healthy Longevity SurveyProminent public health issueSociodemographic variablesRetrospective longitudinal studyPublic health issueLandolt C chartStudy entryChronic diseasesPrevalence trendsChinese adultsLongevity SurveyCognitive impairmentPrevalence changesPrevalenceUrban residenceOlder peopleHealth issuesImpairmentFactors Associated With Days Away From Home in the Year After Major Surgery Among Community-living Older Persons
Gill TM, Becher RD, Murphy TE, Gahbauer EA, Leo-Summers L, Han L. Factors Associated With Days Away From Home in the Year After Major Surgery Among Community-living Older Persons. Annals Of Surgery 2022, 278: e13-e19. PMID: 35837967, PMCID: PMC9840715, DOI: 10.1097/sla.0000000000005528.Peer-Reviewed Original ResearchConceptsHealth care facilitiesMajor surgeryAge 85 yearsCare facilitiesOlder personsRisk factorsNumber of daysLower peak expiratory flowCommunity-living older personsShort Physical Performance BatteryIndependent risk factorCommunity-living personsPhysical Performance BatteryPeak expiratory flowCandidate risk factorsQuality of lifeHospital dischargeMultivariable analysisExpiratory flowMedian numberPerformance BatteryMusculoskeletal surgerySurgeryMean differenceHospital