OASIS Alert

It's not your imagination that more patients have gait abnormalities as a primary diagnosis.

Agencies will continue to see an in-creasing number of patients recovering from hip and knee replacements in coming years, suggests a recent report by the federal Agency for Healthcare Research & Quality.

The report shows that HHAs are seeing an increase in post-acute, post-surgical patients in recent years, says the National Association for Home Care & Hospice -- a change that may help explain rising case-mix scores.

Note: The report, Statistical Brief No. 34, "Hospital Stays Involving Musculoskeletal Procedures, 1997-2005," is at www.hcupus.ahrq.go/reports/statbriefs/sb34.pdf.

• The Centers for Medicare & Med-icaid Services' post-acute cross-setting assessment tool (see OASIS Alert, Vol. 8, No. 8, p.72) needs your input.

• A New Jersey initiative to reduce pressure ulcers is getting dramatic results. A group of 150 hospitals, nursing homes and HHAs in NJ have reduced the number of patients who developed bedsores by 70 percent, thanks mostly to low-tech interventions, reports The New York Times.

The New Jersey Hospital Association planned and directed the initiative that ran from September 2005 to May 2007. Performing skin evaluations upon admission and specialized record-keeping to immediately detect skin deterioration were key, an NJHA official told the Times.

• It's not surprising you're struggling so hard with emergent care outcomes. A recent study found older adults have an emergency medical services utilization rate four times that of younger patients.

According to a study published in the journal Academic Emergency Medicine, re-searchers found: 38 percent of EMS responses were for senior patients (age 65 or older) between 1997 and 2000; 62.2 million older adults visited the emergency department during that same three-year period; and 167 older adults per 1,000 was the average rate of EMS utilization per year, compared to a rate of 39 per 1,000 for younger patients.

• Duke University studied illness and mortality rates in 33,772 Medicare beneficiaries with diabetes and in 25,563 similar people without diabetes over a 14-year period. Researchers found 92 percent of the diabetes group experienced an adverse health event compared with 72 percent of the control group.

The study, reported May 14 in the Archives of Internal Medicine, found that disorders affecting the legs and complications associated with surgery were higher among patients with diabetes. Furthermore, 58 percent of those with diabetes were diagnosed with heart failure, compared with 34 percent of the control group. While kidney disease and retinal eye disorders were less common, both increased markedly in the diabetic group.