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Supplementary Material for Feasibility of a Modified Otago Exercise Program for Older Adults With Cognitive Vulnerability by Kathleen K. Mangione, Hope Darreff, McKenna Welsh, Weihong Ni, Edward Wolff, Julie T. Booth, Susan S. Glenney, and Richard H. Fortinsky in Journal of Applied Gerontology.

Supplemental Material for The Risk for Loneliness and Major Depression among Solo Agers by Kathryn Betts Adams, Rupal Parekh, Rebecca L. Mauldin, Richard H. Fortinsky, and David C. Steffens in Journal of Applied Gerontology

Supplemental Material, sj-pdf-1-jag-10.1177_07334648211051867 for Continuity of Care and Successful Hospital Discharge of Older Veterans With Dementia by Lianlian Lei, Shubing Cai, Yeates Conwell, Richard H. Fortinsky and Orna Intrator in Journal of Applied Gerontology

Supplemental Material, sj-pdf-1-jag-10.1177_07334648211051867 for Continuity of Care and Successful Hospital Discharge of Older Veterans With Dementia by Lianlian Lei, Shubing Cai, Yeates Conwell, Richard H. Fortinsky and Orna Intrator in Journal of Applied Gerontology

To examine the cost structure of home health agencies by estimating an empirical cost function for those that are Medicare-certified, ten years following the implementation of prospective payment.2010 national Medicare cost report data for certified home health agencies were merged with case-mix information from the Outcome and Assessment Information Set (OASIS). We estimated a fully interacted (by tax status) hybrid cost function for 7,064 agencies and calculated marginal costs as percent of total costs for all variables.The home health industry is dominated by for-profit agencies, which tend to be newer than the non-profit agencies and to have higher average costs per patient but lower costs per visit. For-profit agencies tend to have smaller scale operations and different cost structures, and are less likely to be affiliated with chains. Our estimates suggest diseconomies of scale, zero marginal cost for contracting with therapy workers, and a positive marginal cost for contracting with nurses, when controlling for quality.Our findings suggest that efficiencies may be achieved by promoting non-profit, smaller agencies, with fewer contract nursing staff. This conclusion should be tested further in future studies that address some of the limitations of our study.

ObjectivesTo determine the relationship between depressive symptoms after hospitalization and survival and functional outcomes.DesignSecondary analysis of a prospective cohort study.SettingGeneral medical service of two urban, teaching hospitals in Ohio.ParticipantsHospitalized individuals aged 70 and older.MeasurementsTen depressive symptoms, instrumental activities of daily living (IADLs), and basic activities of daily living (ADLs) were measured at hospital discharge and 1, 3, 6, and 12 months later. Participant-specific changes in depressive symptoms (slopes) were determined using all data points. Four groups were also defined according to number of depressive symptoms (≤3 symptoms, low; 4-10 symptoms, high) at discharge and follow-up: low-low, low-high, high-low, and high-high. Mortality was measured 3, 6, and 12 months after hospital discharge.ResultsParticipant-specific discharge depressive symptoms and change in depressive symptoms over time (slopes) were associated (P < .05) with functional and mortality outcomes. At 1 year, more participants in the low-low depressive symptom group (49%) were alive and independent in IADLs and ADLs than in the low-high group (37%, P = .02), and more participants in the high-low group (39%) were alive and independent in IADLs and ADLs than in the high-high group (19%, P < .001).ConclusionNumber of depressive symptoms and change in number of depressive symptoms during the year after discharge were associated with functional and mortality outcomes in hospitalized older adults. Fewer participants with persistently high or increasing depressive symptoms after hospitalization were alive and functionally independent 1 year later than participants with decreasing or persistently low symptoms, respectively.