OBJECTIVE: To understand dental service utilization by frail older adults residing in a long-term care (LTC) setting in the last two years of their life. To understand the types of dental services utilized by this demographic, the frequency of utilization and determine the characteristics that may be predictors of ‘higher dental service utilization’. METHODS: A retrospective cohort study was conducted by an electronic chart review of all LTC patients at two sites who died between 11/1/2014 - 12/30/2016 and had a dental visit in the two-year period prior to death, resulting in a sample of 369 patients. Based on the number of dental appointments attended prior to death, the patients were categorized into five groups: 0,1-2,3-5,6-9 and10 or more appointments. A multivariate logistic regression model was created to identify the factors associated with higher dental service utilization. RESULT: The study found that 84% of patients who died in the study period, utilized on-site dental services in the last two years of their life. Approximately 66% had 3 or more dental appointments. Diagnostic and preventive procedures were most commonly utilized (utilized by 81% and 73% of patients respectively). Multivariate analysis suggested that dentate patients and patients wearing removable dental prosthesis were about 7 and 12 times more likely respectively to have a higher utilization of dental services (OR=6.5 and OR=11.7). Medicaid beneficiaries were more likely (OR=1.9) to have a higher utilization of dental services than the others. CONCLUSIONS: This study showed that a large percentage of frail older adults utilized dental services even in the last years of their lives when given access to these services. As people are living longer and retaining their teeth longer, there is a rising need and subsequent demand for end-of-life dental services. Certain administrative and policy implementation strategies need to be developed to provide dental services to LTC patients in the last years of their lives.

Darbo tikslas - įvertinti Kauno Raudonojo Kryžiaus slaugos ir palaikomojo gydymo ligoninės darbo organizavimo ypatumus ir jo gerinimo galimybes. Tyrimo metodika. Kauno Raudonojo Kryžiaus slaugos ir palaikomojo gydymo ligoninės 2005-2007 metų veiklos statistinių rodiklių analizė, anketinė pacientų (n = 102) ir personalo (n = 82) apklausa, bei jų vertinimų palyginimas. Duomenų analizė atlikta naudojant statistinę programą SPSS for Windows 12,0. Rezultatai. Palaikomojo gydymo ir slaugos ligoninių poreikis auga: 2007 metais Raudonojo Kryžiaus slaugos ir palaikomojo gydymo ligoninėje gydyta 18 proc. pacientų daugiau nei 2005 metais. Ligoninėje slaugomų ligonių daugumą sudaro asmenys sergantys širdies ir smegenų kraujotakos sutrikimais (70 proc.), po traumų (11 proc.) ir sergantys onkologiniais susirgimais (8 proc.). Lovos funkcionavimo rodiklis ir vidutinė ligonio gulėjimo ligoninėje trukmė aukšti (364,9 ir 74,9 dienos), lyginant su kitomis Lietuvos slaugos ligoninėmis (atitinkamai 345,2 ir 51,7), galimai dėl nemažo skaičiaus savivaldybės finansuojamų ligonių, laukiančių eilėje į globos įstaigas (2007 m. 1,2 proc. gydytų ligonių pateko į globos namus, 2008 m.sausio 1 d. - 34 laukiantys eilėje). Patekti į ligoninę galima greitai – 70 proc. pacientų pateko iš karto arba laukė eilėje iki 7 d. Didelė problema ligoninėje yra slaugos personalo kaita: per tris metus įsidarbino 82, o atleista 57 slaugytojų padėjėjos, priimta 11 ir atleista 8 bendrosios praktikos slaugytojos. Tiriant... [toliau žr. visą tekstą] / Aim of the study – to evaluate the management and potential for improvement at Kaunas Red Cross long-term care hospital. Material and methods. The study included analysis of statistical performance indicators at hospital setting during 2005–2007, the questionnaires for patients (n = 102) and staff (n = 82). Data analysis was conducted using statistical package „SPSS for Windows 12.0“. Results. The demand of long-term care institutions is increasing: in 2007 the number of patients was increased by more then 18% compare to 2005. The majority of patients had cardiovascular disorders (70%), post-traumatic conditions (11%), or cancer (8%). The bed occupancy and average length of stay were relatively high (364.9 and 74.9 days, respectively), compared to other hospital care settings in Lithuania (345.2 and 51.7, respectively), probably due to high number of patients waiting for municipality-financed nursing homes (in 2007 only 1.2% of patients got to nursing home, while on 1st January 2008 the waiting list contained 34 persons). On the other hand, the acceptance to long-term care is quite fast – 70% of patients were hospitalized immediately or were on the waiting list up to 7 days. However, a significant issue is the changing of staff: during 3 years, 82 nurse assistants were employed and 57 dismissed, while general practice nurses 11 and 8, respectively. Analysis of quality of care revealed, that lowest scores were for hospital signalization system (average scores 3.0 by staff and... [to full text]