See the Campus Alcohol Drug Addiction Treatment in Chelsea New York Call 24 Hours 18668315700 Monday Friday 322 8th Avenue 12th Floor New York City NY 10001 Outpatient Rehab for Drug and Alcohol Addiction in New York City The Hazelden Betty Ford Foundations Chelsea addiction treatment center is located on the bustling West Side of the borough of Manhattan in New York City New York offering convenient outpatient rehab options close to home and work With expert counselors daytime and evening outpatient program hours and easy access to New York Citys subway and bus lines our Chelsea treatment center provides the optimal addiction rehab program for busy professionals ready to start your path to recovery All outpatient drug and alcohol treatment services at Hazelden Betty Ford Foundations Chelsea New York center combine evidencebased therapeutic practices along with the latest scientific knowledge and research about addictionalways leading with the respect dignity and individualized attention that have set our care apart for decades We take a holistic and personalized approach in developing each patients rehab plan by providing Tailored outpatient addiction treatment planning to fit your specific situation challenges and needs Comprehensive care for your mind body and spirit Integrated care to address cooccurring mental health conditions such as anxiety or depression By working with you to understand your whole pictureyour physical and mental health family history the types of drugs you are using and many other influences and variablesour addiction experts are able to develop the best possible outpatient treatment plan to help you get well and stay well If you or a loved one are struggling with substance abuse contact us or call 18668315700 to learn more about outpatient alcohol and drug rehab programs and insurance options available at our Chelsea outpatient addiction treatment center Outpatient Treatment in New York Outpatient drug and alcohol rehab programs at our Chelsea New York addiction treatment center operate under the same evidencebased principles and practices as our inpatient addiction treatment programs We align timetested Twelve Step recovery wisdom with the latest applications of neuroscience mindfulness and other researchbased therapeutic approaches This means your comprehensive outpatient treatment sessions at Hazelden in Chelsea will involve Psychological social and substance abuse alcohol and other drugs assessments to ensure an accurate diagnosis and inform treatment planning An individualized addiction rehab plan to specifically address your condition and circumstances Continuing care recommendations to support and reinforce your development of healthy routines and behaviors posttreatment Our outpatient treatment program goals and expectations are designed to ensure that you have the best opportunity to learn change and healwith the ultimate goal of experiencing lasting freedom from addiction In developing your outpatient addiction treatment planand with your permissionour clinicians will also welcome the opportunity to collaborate with other professionals you may be working with in order to ensure continuity of care Outpatient addiction treatment at our Chelsea clinic in New York City is offered weekdays and weeknights with convenient afternoon and evening sessions available MondayThursday 14 pm MondayThursday 69 pm Extended Outpatient Treatment As you progress through outpatient drug or alcohol rehab at Hazelden and begin implementing newly gained recovery principles and practices into your daily life you will attend treatment sessions less frequently while transitioning into our extended outpatient level of care Extended care is designed to give you more opportunities to solidify your abstinence by building healthy new routines developing your recovery support network identifying relapse triggers and practicing relapse prevention skills In counselorfacilitated extended care group sessions you will continue to discover what it takes to restore your sense of trust community hope andmost of allbelief in yourself You will gradually develop independence from treatment programming as you appreciate the importance of prioritizing your recovery on a daily basis Our extended outpatient treatment groups meet conveniently on weeknights and afternoons as follows Monday 6730 pm Tuesday 1230 pm or 6730 pm Wednesday 6730 pm Thursday 2304 pm or 6730 pm Family Support Addiction affects everyone in the family And every family member needs help in their own right to understand the disease of addiction and to work through the chaos and pain it causes We know when families start to understand the disease of addiction they can start their own healing We offer a free weekly workshop for families at our Tribeca treatment center every Tuesday from 5457 pm The workshops are open to the public and people are welcome to attend as often as they would like These workshops provide a safe nonjudgmental place for families faced with addiction to Learn about the disease nature of addiction Understand the importance of taking responsibility for their own happiness and wellbeing Identify ways to open the lines of communication and set healthy boundaries Recovery Management Addiction is a chronic disease that has no cure but there are effective solutions and there is hope Most people who go to treatment programs not only stop using drugs they also improve their occupational social and psychological functioning Much like learning to manage other chronic conditions such as diabetes or heart disease recovery from addiction involves learning to live differentlyreplacing what had been a drugusing lifestyle with healthy new routines activities and interests Scientific research identifies ongoing involvement in recoveryrelated activities as the best predictor of longterm sobriety Active engagement is of utmost importance during the first 18 months of recovery when risk of relapse is most intense Participating in a Twelve Step or other mutualhelp program staying connected with your recovery community and pursuing new recreational and creative interests are all important ways to sustain and strengthen your sobriety The Hazelden Betty Ford Foundation offers a wide range of inperson online and mobile recovery support resources and services to help you thrive in recovery over the long haul These support options include webphonebased recovery coaching monitoring and accountability services family education and guidance Twelve Step recovery enrichment retreats and workshops and many more helpful resources In addition Hazelden hosts a number of Twelve Step meetings at our Chelsea New York treatment center Truly a gift from God so grateful for this experience Grateful Alumna Dont wait Call today to learn more about outpatient rehab options and insurance coverage for addiction treatment at our Chelsea New York clinic 18668315700 Meet the Treatment Team See More Close Learn more about the experience and expertise provided by the patient care team at Hazelden in Chelsea New York City Meet the team Insurance Coverage See More Close Find information on accepted insurance read FAQs and more Learn more FAQs See More Close Find answers to your questions regarding Hazelden Betty Ford Foundation programs and services Read FAQs

O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O

alcohol & drug addiction
ford foundation 's


STATISTICAL

BRIEF

January

Trends

in

Hospital

Inpatient

Stays

by

Age

and

Payer

Ruirui

Sun

PhD

Zeynal

Karaca

PhD

and

Herbert

S

Wong

PhD

Introduction

The

utilization

of

hospital

care

is

related

to

and

affected

by

changes

in

population

characteristics

as

well

as

market

forces

In

terms

of

population

characteristics

growth

in

general

and

growth

of

the

older

adult

population

in

particular

may

contribute

to

hospital

visits

The

US

population

has

grown

in

the

past

decades

and

the

population

of

older

adults

has

grown

disproportionately

Projections

show

that

one

in

five

Americans

will

be

years

or

older

by

In

terms

of

market

forces

factors

such

as

efforts

to

reduce

unnecessary

hospitalization

and

adjustments

in

reimbursement

incentives

may

decrease

utilization

of

inpatient

care

Market

forces

also

may

vary

across

age

groups

and

eventually

shift

hospital

utilization

in

terms

of

payer

mix

for

those

who

seek

care

Examples

of

such

factors

include

employment

status

and

changes

in

health

care

policy

that

target

age

groups

differently

This

Healthcare

Cost

and

Utilization

Project

HCUP

Statistical

Brief

presents

data

on

hospital

inpatient

stays

from

through

by

age

group

and

primary

payer

First

trends

in

the

population

rate

of

inpatient

stays

by

age

group

are

presented

Second

trends

in

expected

primary

payer

among

inpatient

stays

by

age

group

are

examined

The

National

Inpatient

Sample

NIS

from

to

was

used

to

generate

national

estimates

of

inpatient

stays

The

total

number

of

inpatient

stays

related

to

maternal

and

neonatal

diagnoses

accounted

for

percent

of

all

inpatient

stays

and

for

percent

of

those

stays

Medicaid

was

Findings

National

rate

of

inpatient

stays

by

patient

age

Figure

presents

the

rate

of

nonneonatal

nonmaternal

inpatient

stays

per

population

from

to

Results

are

shown

by

four

age

groups

Highlights

Between

and

the

population

rate

of

nonneonatal

nonmaternal

inpatient

stays

dropped

for

all

age

groups

the

largest

percentage

decrease

percent

was

among

patients

aged

years

and

over

Between

and

for

all

age

groups

under

years

old

the

share

of

uninsured

stays

reached

its

low

in

From

to

Medicaid

was

the

top

primary

payer

for

patients

under

age

years

with

nonneonatal

nonmaternal

inpatient

stays

its

share

exceeded

percent

starting

in

From

to

the

share

of

Medicaid

among

nonneonatal

nonmaternal

inpatient

stays

for

those

aged

years

and

years

increased

by

percent

and

percent

respectively

Among

patients

aged

years

the

share

of

nonneonatal

nonmaternal

inpatient

stays

covered

by

Medicare

increased

by

percent

from

to

Among

patients

aged

years

the

share

of

nonneonatal

nonmaternal

stays

covered

by

Medicare

increased

by

percent

from

to

Among

patients

aged

years

and

over

Medicare

and

private

insurance

together

accounted

for

about

percent

of

inpatient

stays

each

year

Figure

Rate

of

nonneonatal

nonmaternal

inpatient

stays

per

population

by

age

group

Source

Agency

for

Healthcare

Research

and

Quality

AHRQ

Center

for

Delivery

Organization

and

Markets

Healthcare

Cost

and

Utilization

Project

HCUP

National

Nationwide

Inpatient

Sample

NIS

Line

graph

that

shows

the

rate

of

nonneonatal

nonmaternal

inpatient

stays

per

by

age

from

to

years

net

change

years

increased

steadily

from

in

to

in

decreased

to

in

increased

to

in

decreased

steadily

to

in

increased

to

in

decreased

steadily

to

in

increased

to

in

Older

age

groups

have

higher

rates

of

nonneonatal

and

nonmaternal

inpatient

rates

During

the

time

period

patients

aged

years

and

over

had

the

highest

rate

of

inpatient

stays

above

per

population

every

year

followed

by

those

aged

years

ranging

from

about

to

per

population

Patients

aged

years

and

under

were

the

most

infrequent

visitors

for

nonneonatal

and

nonmaternal

inpatient

stays

with

a

rate

below

per

population

every

year

The

rate

of

nonneonatal

and

nonmaternal

inpatient

stays

reached

the

lowest

levels

in

or

for

all

age

groups

Among

patients

aged

years

and

over

the

rate

of

inpatient

stays

was

per

population

in

The

rate

stayed

at

or

above

until

when

it

started

to

drop

By

the

rate

had

decreased

to

its

lowest

level

during

this

per

populationa

percent

reduction

compared

with

Among

patients

aged

years

the

rate

of

nonneonatal

nonmaternal

inpatient

stays

was

per

population

in

and

remained

above

through

after

which

it

began

to

drop

By

the

rate

has

decreased

to

per

population

a

percent

decrease

since

Among

patients

aged

years

the

rate

was

per

population

in

and

stayed

at

or

above

per

through

The

rate

began

to

drop

below

this

level

in

and

by

the

rate

had

decreased

to

a

percent

reduction

since

Among

patients

aged

years

and

under

the

rate

stayed

above

from

to

with

the

highest

rate

reached

in

per

population

In

the

rate

reached

its

lowest

level

in

years

at

per

population

a

decrease

of

percent

since

Trends

in

primary

payer

among

nonneonatal

nonmaternal

inpatient

stays

by

patient

age

Figures

to

present

national

trends

in

expected

primary

payer

for

nonneonatal

nonmaternal

inpatient

care

for

each

age

group

from

to

Figure

National

trends

in

primary

payer

among

nonneonatal

nonmaternal

inpatient

stays

for

patients

under

age

years

Note

Shares

of

Missing

and

Other

payers

are

not

presented

Source

Agency

for

Healthcare

Research

and

Quality

AHRQ

Center

for

Delivery

Organization

and

Markets

Healthcare

Cost

and

Utilization

Project

HCUP

National

Nationwide

Inpatient

Sample

NIS

Line

graph

that

shows

the

share

of

each

payer

among

neonatal

and

nonmaternal

inpatient

stays

for

patients

aged

years

from

to

Medicaid

increased

steadily

from

in

to

in

decreased

to

in

increased

steadily

to

in

decreased

to

in

increased

steadily

to

in

net

change

Private

insurance

increased

from

in

to

in

decreased

steadily

to

in

increased

to

in

decreased

steadily

to

in

increased

to

in

decreased

steadily

to

in

increased

Starting

in

Medicaid

replaced

private

insurance

as

the

most

common

primary

payer

for

nonneonatal

and

nonmaternal

inpatient

stays

among

those

under

age

years

In

the

most

common

payer

for

nonneonatal

and

nonmaternal

inpatient

stays

among

patients

under

age

years

was

private

insurance

percent

followed

by

Medicaid

percent

By

the

share

of

Medicaid

had

reached

percent

which

is

an

increase

of

percent

since

By

the

share

of

private

insurance

had

dropped

to

percent

its

lowest

level

in

yearsa

decrease

of

percent

since

The

share

of

uninsured

patients

within

this

age

group

fluctuated

between

and

percent

from

to

and

dropped

to

percent

or

below

thereafter

The

share

of

Medicare

within

this

age

group

stayed

below

percent

in

all

years

Figure

National

trends

in

primary

payer

among

nonneonatal

nonmaternal

inpatient

stays

for

patients

aged

years

Note

Shares

of

Missing

and

Other

payers

are

not

presented

Source

Agency

for

Healthcare

Research

and

Quality

AHRQ

Center

for

Delivery

Organization

and

Markets

Healthcare

Cost

and

Utilization

Project

HCUP

National

Nationwide

Inpatient

Sample

NIS

Line

graph

that

shows

the

share

of

each

payer

among

neonatal

and

nonmaternal

inpatient

stays

for

patients

aged

years

from

to

Medicaid

increased

steadily

from

in

to

in

decreased

steadily

to

in

increased

steadily

to

in

decreased

to

in

increased

steadily

to

in

net

change

Private

insurance

increased

from

in

to

in

decreased

steadily

to

in

increased

to

in

decreased

steadily

to

in

increased

to

in

decreased

steadily

to

in

Among

nonneonatal

nonmaternal

inpatient

stays

for

private

insurance

was

the

most

common

primary

payer

followed

by

Medicaid

The

most

common

primary

payer

for

nonneonatal

and

nonmaternal

inpatient

stays

among

patients

aged

years

was

private

insurance

which

accounted

for

percent

of

stays

in

and

dropped

to

percent

in

During

the

same

period

the

share

of

Medicaid

increased

from

percent

to

percent

the

share

of

uninsured

increased

from

percent

to

percent

and

the

share

of

Medicare

increased

from

percent

to

percent

From

to

the

share

of

Medicaid

within

this

age

group

increased

and

the

share

of

uninsured

decreased

The

share

of

Medicaid

in

was

percent

which

is

an

increase

of

percent

since

The

share

of

uninsured

in

dropped

to

percent

its

lowest

level

during

these

years

The

share

of

private

insurance

dropped

to

percent

in

and

remained

as

the

most

common

payer

within

this

age

group

The

share

of

Medicare

in

was

an

increase

of

percent

since

Figure

National

trends

in

primary

payer

among

nonneonatal

nonmaternal

inpatient

stays

for

patients

aged

years

Note

Shares

of

Missing

and

Other

payers

are

not

presented

Source

Agency

for

Healthcare

Research

and

Quality

AHRQ

Center

for

Delivery

Organization

and

Markets

Healthcare

Cost

and

Utilization

Project

HCUP

National

Nationwide

Inpatient

Sample

NIS

Line

graph

that

shows

the

share

of

each

payer

among

neonatal

and

nonmaternal

inpatient

stays

for

patients

aged

years

from

to

Medicaid

fluctuated

between

and

from

to

increased

steadily

in

decreased

to

in

and

increased

steadily

to

in

decreased

to

in

increased

steadily

to

in

net

change

Private

insurance

increased

from

in

to

in

decreased

steadily

to

in

increased

to

in

decreased

steadily

to

in

increased

to

in

net

Among

nonneonatal

nonmaternal

inpatient

stays

for

patients

aged

years

private

insurance

was

the

most

common

primary

payer

followed

by

Medicare

The

share

of

private

insurance

among

inpatient

stays

for

patients

aged

years

dropped

from

percent

in

to

percent

in

During

the

same

period

the

share

of

Medicare

increased

from

percent

to

percent

the

share

of

Medicaid

increased

from

percent

to

percent

and

the

share

of

uninsured

increased

from

percent

to

percent

which

remained

the

lowest

among

all

payers

for

this

age

group

From

to

the

share

of

inpatient

stays

covered

by

Medicaid

increased

and

the

share

that

were

uninsured

decreased

By

the

share

of

inpatient

stays

covered

by

Medicaid

in

this

age

group

had

increased

to

percent

an

increase

of

percent

since

The

share

of

stays

that

were

uninsured

had

dropped

to

percent

its

lowest

level

during

this

period

The

share

of

inpatient

stays

covered

by

private

insurance

in

and

was

at

about

the

same

level

as

it

had

been

in

From

to

the

share

of

stays

covered

by

private

insurance

decreased

by

percent

but

private

insurance

remained

the

most

common

primary

payer

The

share

of

stays

covered

by

Medicare

reached

percent

in

an

increase

of

percent

since

Figure

National

trends

in

primary

payer

among

nonneonatal

nonmaternal

inpatient

stays

for

patients

aged

years

and

over

Note

Shares

of

Missing

and

Other

payers

are

not

presented

Source

Agency

for

Healthcare

Research

and

Quality

AHRQ

Center

for

Delivery

Organization

and

Markets

Healthcare

Cost

and

Utilization

Project

HCUP

National

Nationwide

Inpatient

Sample

NIS

Line

graph

that

shows

the

share

of

each

payer

among

stays

for

patients

aged

years

and

over

from

to

Medicaid

fluctuated

between

and

between

and

starting

at

in

and

ending

at

in

net

change

Private

insurance

decreased

from

in

and

to

in

increased

to

in

decreased

to

in

increased

steadily

to

in

decreased

steadily

to

in

increased

steadily

to

in

decreased

to

in

net

change

Uninsured

fluctuated

between

and

Medicare

and

private

insurance

accounted

for

about

percent

of

nonneonatal

and

nonmaternal

inpatient

stays

among

patients

aged

years

and

over

Among

patients

aged

years

and

over

the

share

of

inpatient

stays

covered

by

Medicare

fluctuated

between

and

percent

during

the

period

at

the

same

time

the

share

of

stays

covered

by

private

insurance

fluctuated

between

and

percent

These

two

payers

together

consistently

covered

about

percent

of

the

inpatient

stays

within

this

age

group

during

the

period

Within

this

age

group

the

share

of

stays

covered

by

Medicaid

remained

under

percent

and

the

share

of

stays

that

were

uninsured

remained

under

percent

To

summarize

across

age

groups

from

to

for

patients

aged

years

or

younger

the

share

of

inpatient

stays

with

an

expected

primary

payer

of

private

insurance

decreased

and

the

share

of

stays

with

Medicaid

increased

The

share

of

uninsured

stays

reached

its

low

in

For

patients

aged

years

the

share

of

stays

with

Medicare

increased

during

the

period

About

Statistical

Briefs

HCUP

Statistical

Briefs

provide

basic

descriptive

statistics

on

a

variety

of

topics

using

HCUP

administrative

health

care

data

Topics

include

hospital

inpatient

ambulatory

surgery

and

emergency

department

use

and

costs

quality

of

care

access

to

care

medical

conditions

procedures

and

patient

populations

among

other

topics

The

reports

are

intended

to

generate

hypotheses

that

can

be

further

explored

in

other

research

the

reports

are

not

designed

to

answer

indepth

research

questions

using

multivariate

methods

Data

Source

The

estimates

in

this

Statistical

Brief

are

based

upon

data

from

the

Healthcare

Cost

and

Utilization

Project

HCUP

National

Nationwide

Inpatient

Sample

NIS

Supplemental

sources

included

population

denominator

data

for

use

with

HCUP

databases

derived

from

information

available

from

the

Bureau

of

the

Census

Definitions

Unit

of

analysis

The

unit

of

analysis

is

the

hospital

discharge

ie

the

hospital

stay

not

a

person

or

patient

This

means

that

a

person

who

is

admitted

to

the

hospital

multiple

times

in

year

will

be

counted

each

time

as

a

separate

discharge

from

the

hospital

Payer

Payer

is

the

expected

primary

payer

for

the

hospital

stay

To

make

coding

uniform

across

all

HCUP

data

sources

payer

combines

detailed

categories

into

general

groups

Medicare

includes

patients

covered

by

feeforservice

and

managed

care

Medicare

Medicaid

includes

patients

covered

by

feeforservice

and

managed

care

Medicaid

Private

Insurance

includes

Blue

Cross

commercial

carriers

and

private

health

maintenance

organizations

HMOs

and

preferred

provider

organizations

PPOs

Uninsured

includes

an

insurance

status

of

selfpay

and

no

charge

Other

includes

Workers

Compensation

TRICARECHAMPUS

CHAMPVA

Title

V

and

other

government

programs

Hospital

stays

billed

to

the

State

Childrens

Health

Insurance

Program

SCHIP

may

be

classified

as

Medicaid

Private

Insurance

or

Other

depending

on

the

structure

of

the

State

program

Because

most

State

data

do

not

identify

patients

in

SCHIP

specifically

it

is

not

possible

to

present

this

information

separately

Diagnosisrelated

groups

DRGs

and

major

diagnostic

categories

MDCs

DRGs

comprise

a

patient

classification

system

that

categorizes

patients

into

groups

that

are

clinically

coherent

and

homogeneous

with

respect

to

resource

use

DRGs

group

patients

according

to

diagnosis

type

of

treatment

procedures

age

and

other

relevant

criteria

Each

hospital

stay

has

one

assigned

DRG

Coding

criteria

for

the

types

of

hospitalization

are

based

on

MDCs

MDCs

are

broad

groups

of

DRGs

that

relate

to

an

organ

or

a

body

system

eg

digestive

system

and

not

to

an

etiology

For

example

MDC

Diseases

and

Disorders

of

the

Nervous

System

and

MDC

Diseases

and

Disorders

of

the

Eye

Each

hospital

stay

has

one

DRG

and

one

MDC

assigned

to

it

In

this

Statistical

Brief

nonneonatal

and

nonmaternal

hospitalizations

are

identified

using

the

MDCs

that

are

not

equal

to

Pregnancy

Childbirth

and

the

Puerperium

or

Newborns

and

Other

Neonates

with

Conditions

Originating

in

Types

of

hospitals

included

in

the

HCUP

National

Nationwide

Inpatient

Sample

The

National

Nationwide

Inpatient

Sample

NIS

is

based

on

data

from

community

hospitals

which

are

defined

as

shortterm

nonFederal

general

and

other

hospitals

excluding

hospital

units

of

other

institutions

eg

prisons

The

NIS

includes

obstetrics

and

gynecology

otolaryngology

orthopedic

cancer

pediatric

public

and

academic

medical

hospitals

Excluded

are

longterm

care

facilities

such

as

rehabilitation

psychiatric

and

alcoholism

and

chemical

dependency

hospitals

Beginning

in

longterm

acute

care

hospitals

are

also

excluded

However

if

a

patient

received

longterm

care

rehabilitation

or

treatment

for

a

psychiatric

or

chemical

dependency

condition

in

a

community

hospital

the

discharge

record

for

that

stay

will

be

About

HCUP

The

Healthcare

Cost

and

Utilization

Project

HCUP

pronounced

HCup

is

a

family

of

health

care

databases

and

related

software

tools

and

products

developed

through

a

FederalStateIndustry

partnership

and

sponsored

by

the

Agency

for

Healthcare

Research

and

Quality

AHRQ

HCUP

databases

bring

together

the

data

collection

efforts

of

State

data

organizations

hospital

associations

and

private

data

organizations

HCUP

Partners

and

the

Federal

government

to

create

a

national

information

resource

of

encounterlevel

health

care

data

HCUP

includes

the

largest

collection

of

longitudinal

hospital

care

data

in

the

United

States

with

allpayer

encounterlevel

information

beginning

in

These

databases

enable

research

on

a

HCUP

would

not

be

possible

without

the

contributions

of

the

following

data

collection

Partners

from

across

the

United

States

Alaska

Department

of

Health

and

Social

Services

Alaska

State

Hospital

and

Nursing

Home

Association

Arizona

Department

of

Health

Services

Arkansas

Department

of

Health

California

Office

of

Statewide

Health

Planning

and

Development

Colorado

Hospital

Association

Connecticut

Hospital

Association

District

of

Columbia

Hospital

Association

Florida

Agency

for

Health

Care

Administration

Georgia

Hospital

Association

Hawaii

Health

Information

Corporation

Illinois

Department

of

Public

Health

Indiana

Hospital

Association

Iowa

Hospital

Association

Kansas

Hospital

Association

Kentucky

Cabinet

for

Health

and

Family

Services

Louisiana

Department

of

Health

Maine

Health

Data

Organization

Maryland

Health

Services

Cost

Review

Commission

Massachusetts

Center

for

Health

Information

and

Analysis

Michigan

Health

Hospital

Association

Minnesota

Hospital

Association

Mississippi

State

Department

of

Health

Missouri

Hospital

Industry

Data

Institute

Montana

Hospital

Association

Nebraska

Hospital

Association

Nevada

Department

of

Health

and

Human

Services

New

Hampshire

Department

of

Health

Human

Services

New

Jersey

Department

of

Health

New

Mexico

Department

of

Health

New

York

State

Department

of

Health

North

Carolina

Department

of

Health

and

Human

Services

North

Dakota

data

provided

by

the

Minnesota

Hospital

Association

Ohio

Hospital

Association

Oklahoma

State

Department

of

Health

Oregon

Association

of

Hospitals

and

Health

Systems

Oregon

Office

of

Health

Analytics

Pennsylvania

Health

Care

Cost

Containment

Council

Rhode

Island

Department

of

Health

South

Carolina

Revenue

and

Fiscal

Affairs

Office

South

Dakota

Association

of

Healthcare

Organizations

Tennessee

Hospital

Association

Texas

Department

of

State

Health

Services

Utah

Department

of

Health

Vermont

Association

of

Hospitals

and

Health

Systems

Virginia

Health

Information

Washington

State

Department

of

Health

West

Virginia

Department

of

Health

and

Human

Resources

West

Virginia

Health

Care

Authority

Wisconsin

Department

of

Health

Services

Wyoming

Hospital

Association

About

the

NIS

The

HCUP

National

Nationwide

Inpatient

Sample

NIS

is

a

nationwide

database

of

hospital

inpatient

stays

The

NIS

is

nationally

representative

of

all

community

hospitals

ie

shortterm

nonFederal

nonrehabilitation

hospitals

The

NIS

includes

all

payers

It

is

drawn

from

a

sampling

frame

that

contains

hospitals

comprising

more

than

percent

of

all

discharges

in

the

United

States

The

vast

size

of

the

NIS

allows

the

study

of

topics

at

the

national

and

regional

levels

for

specific

subgroups

of

patients

In

addition

NIS

data

are

standardized

across

years

to

facilitate

ease

of

use

Over

time

the

sampling

frame

for

the

NIS

has

The

NIS

was

redesigned

to

optimize

national

estimates

The

redesign

incorporates

two

critical

changes

Revisions

to

the

sample

designstarting

with

the

NIS

is

now

a

sample

of

discharge

records

from

all

HCUPparticipating

hospitals

rather

than

a

sample

of

hospitals

from

which

all

discharges

were

retained

as

is

the

case

for

NIS

years

before

Revisions

to

how

hospitals

are

definedthe

NIS

now

uses

the

definition

of

hospitals

and

discharges

supplied

by

the

statewide

data

organizations

that

contribute

to

HCUP

rather

than

the

definitions

used

by

the

American

Hospital

Association

AHA

Annual

Survey

of

Hospitals

The

new

sampling

strategy

is

expected

to

result

in

more

precise

estimates

than

those

that

resulted

from

the

previous

NIS

design

by

reducing

sampling

error

for

many

estimates

confidence

intervals

under

the

new

design

are

about

half

the

length

of

confidence

intervals

under

the

previous

design

The

change

in

sample

design

for

necessitates

recomputation

of

prior

years

NIS

data

to

enable

analyses

of

trends

that

use

the

same

definitions

of

discharges

and

hospitals

For

More

Information

For

other

information

on

hospitalizations

in

the

United

States

refer

to

the

HCUP

Statistical

Briefs

located

at

wwwhcupusahrqgovreportsstatbriefssb_hospoverviewjsp

For

additional

HCUP

statistics

visit

HCUP

Fast

Stats

at

wwwhcupusahrqgovfaststatslandingjsp

for

easy

access

to

the

latest

HCUPbased

statistics

for

health

information

topics

HCUPnet

HCUPs

interactive

query

system

at

wwwhcupnetahrqgov

For

more

information

about

HCUP

visit

wwwhcupusahrqgov

For

a

detailed

description

of

HCUP

and

more

information

on

the

design

of

the

National

Nationwide

Inpatient

Sample

NIS

please

refer

to

the

following

database

documentation

Agency

for

Healthcare

Research

and

Quality

Overview

of

the

National

Nationwide

Inpatient

Sample

NIS

Healthcare

Cost

and

Utilization

Project

HCUP

Rockville

MD

Agency

for

Healthcare

Research

and

Quality

Updated

December

wwwhcupusahrqgovnisoverviewjsp

Accessed

January

Suggested

Citation

Sun

R

AHRQ

Karaca

Z

AHRQ

Wong

HS

AHRQ

Trends

in

Hospital

Inpatients

Stays

by

Age

and

Payer

HCUP

Statistical

Brief

January

Agency

for

Healthcare

Research

and

Quality

Rockville

MD

AHRQ

welcomes

questions

and

comments

from

readers

of

this

publication

who

are

interested

in

obtaining

more

information

about

access

cost

use

financing

and

quality

of

health

care

in

the

United

States

We

also

invite

you

to

tell

us

how

you

are

using

this

Statistical

Brief

and

other

HCUP

data

and

tools

and

to

share

suggestions

on

how

HCUP

products

might

be

enhanced

to

further

meet

your

needs

Please

email

us

at

hcupahrqgov

or

send

a

letter

to

the

address

below

Sharon

B

Arnold

PhD

Acting

Director

Center

for

Delivery

Organization

and

Markets

Agency

for

Healthcare

Research

and

Quality

Fishers

Lane

Rockville

MD

This

Statistical

Brief

was

posted

online

on

January

Bernstein

AB

Hing

E

Moss

AJ

Allen

KF

Siller

AB

Tiggle

RB

Health

Care

in

America

Trends

in

Utilization

National

Center

for

Health

Statistics

wwwcdcgovnchsdatamischealthcarepdf

Accessed

December

Howden

LM

Meyer

JA

Age

and

Sex

Composition

Census

Briefs

May

US

Census

Bureau

Accessed

December

Colby

SL

Ortman

JM

Projections

of

the

Size

and

Composition

of

the

US

population

to

Current

Population

Reports

March

US

Census

Bureau

Accessed

December

Leslie

DL

Rosenheck

R

Shifting

to

outpatient

care

mental

health

care

use

and

cost

under

private

insurance

American

Journal

of

Psychiatry

Bernstein

et

al

Op

cit

Maeda

JL

Henke

RM

Marder

WD

Karaca

Z

Friedman

BS

Wong

HS

Association

between

the

unemployment

rate

and

inpatient

cost

per

discharge

by

payer

in

the

United

States

BMC

Health

Services

Research

Barrett

M

Coffey

R

Levit

K

Population

Denominator

Data

for

Use

With

the

HCUP

Databases

Updated

With

Population

Data

HCUP

Methods

Series

Report

ONLINE

October

US

Agency

for

Healthcare

Research

and

Quality

wwwhcupusahrqgovreportsmethodsmethodsjsp

Accessed

November

O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I I I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I I I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I I I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I I I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I I I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I I I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I I I I O O O O O O O O O O O O O O O O B I I I I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I I I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I I I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I I I I I O O O O O

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Home Beauty 6 AntiAging Foundations That Erase Years Instantly These dermatologistrecommended foundations smooth wrinkles add moisture and deliver potent skinperfecting ingredients By Kristin Canning November 02 2017 Your skin has totally different needs in your 30s and 40s than it does in your 20s and buying makeup that doubles as skincare is great way to keep skin looking and feeling young Thats where antiaging foundations come in According to Jessica Wu MD a dermatologist in Los Angeles a lot of women will start to see their oil glands shrink in their mid30s leading to dryer skin Choosing liquid or cream foundations with key ingredients like hyaluronic acid or glycerin will help keep skin moisturized Dr Wu says and prevent the foundation from settling into fine lines and Read on to find out favorite dermrecommended antiaging foundations which restore moisture and reduce wrinkle appearance Smooth these on after your skincare routine and a primer for flawless youthful skin 1 Neutrogena Healthy Skin AntiAging Perfector This dewy moisturizing foundation contains retinol Its a vitamin A derivative that stimulates your skins collagen production says Dr Wu which makes skin appear smoother and fuller Plus it contains SPF 20 to protect skin from sun damage And if you arent yet using a retinol what are you waiting for Here are the best retinol creams you can buy without a prescription according to dermatologists available at targetcom 10 Advertisement 2 Juice Beauty Phyto Pigments Flawless Serum Foundation This organic foundation has grapeseed oil and vitamins C and E which are antioxidants that protect your skins collagen says Dr Wu It also provides a radiant finish Dr Wu recommends looking for words like radiant luminous and glowy on your foundations which usually means they contain lightreflecting particles that help blur imperfections available at dermstorecom 42 3 Bobbi Brown Extra SPF 25 Tinted Moisturizing Balm This dewy oilandwater formula is super moisturizing and rich Plus it contains Argireline peptide which boosts collagen production says Dr Wu available at bluemercurycom 58 Advertisement 4 Yves Saint Laurent Touche Eclat Le Teint Radiance Awakening Foundation SPF 22 This light yet moisturizing formula contains vitamin E which protects against free radicals that damage skin says Debra Jaliman MD a dermatologist in New York City SPF protects against the suns harmful rays and helps keep skin looking young available at sephoracom 58 Advertisement 5 Hourglass Veil Fluid Makeup This foundation contains SPF 15 and matrixyl pentapeptide which helps stimulate collagen production says Dr Jaliman available at bluemercurycom 60 Advertisement 6 Le Metier de Beaute Peau Vierge AntiAging Complexe With SPF This foundation contains hyaluronic acid which is highly moisturizing says Dr Jaliman It also has vitamins A C and E to protect skin from free radicals available at neimanmarcuscom 125

O O O O O O B I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O


Home News Researchers Identify 8 Signs of Impending Death By Health Editor February 09 2015 FB By Alan Mozes HealthDay Reporter MONDAY Feb 9 2015 HealthDay News Researchers say they have identified eight specific physical signs that strongly indicate that someone with advanced cancer is entering the last days of life The investigators focused on telltale signs that a patient has at most just three days to live The hope is that this information will help family members and other caregivers better handle an impending death as well as be more prepared for choices that may have to be made during endoflife care I think the bottom line is that our study identified several classical signs that can be observed by the bedside by doctors nurses and even family caregivers which may help them to determine with confidence that the patient has entered the final days of life said study lead author Dr David Hui He is an assistant professor in the department of palliative care and rehabilitation medicine at the University of Texas MD Anderson Cancer Center in Houston He also said that we believe these signs may apply to both cancer and even noncancer patients because these signs occur as part of the natural process of dying Hui and his colleagues reported their findings in the Feb 9 online edition of Cancer To compile their list the researchers monitored physical changes that occurred just prior to death among more than 350 advancedstage cancer patients They were being treated at one of two cancer centers one in the United States and one in Brazil All of the patients were in an acute palliative endoflife care unit Physical changes were noted twice daily according to the study During the study time frame more than half 57 percent of the patients died And in the end the authors settled on eight indicators that seemed to most accurately predict imminent death Those included an inability to close the eyelids diminishing ability to react to visual stimulation a reduced ability to react to sounds and words facial drooping nonreactive pupils hyperextension of the neck this causes the head to tilt further back when lying down vocal cord grunting and bleeding in the upper digestive tract It is important to point out that only a small proportion of patients may have each of the signs before death said Hui although a majority would have at least one of the signs in the last three days of life The presence of these signs strongly suggests that death will occur in the next three days However absence of these signs does not suggest that death will not occur Some signs seemed to be more common than others with some occurring among just 5 percent of the patients while others were seen among nearly 80 percent during the last three days of life according to the study Hui also cautioned that there will always be exceptions to the rule and his teams list will not cover all situations Exceptions he said would include cases of sudden death or when intensive care unit patients are breathing by means of mechanical ventilation Dr R Sean Morrison is director of the Lilian and Benjamin Hertzberg Palliative Care Institute at the Mount Sinai Icahn School of Medicine in New York City He said that while doctors are already very familiar with signs of impending death the list could be very helpful for families struggling to come to grips with a disorienting set of circumstances Within the palliative care community this is very well understood Morrison noted And this is certainly not just about cancer This would apply to anyone dying of heart disease lung disease or even dementia because the symptoms that are identified in this cancer population are almost universal for anyone approaching the end of life But from a clinical perspective as physicians I dont think this list will prove terribly helpful he added Because what were talking about here is really people hours from death who really cant respond or are not interactive or are essentially in a coma approaching death So I would hope and expect that by this point a discussion of patient goals and family needs would have already taken place long before along with any decisions about blood tests and treatments Still Morrison said the list could be helpful for the family and for helping us guide families Because one of the things that families wrestle with is how long do I have with my loved one And were not always that good at predicting that So this may help give families a time frame for knowing how long the vigil is going to be Theres more on palliative care for cancer patients at the US National Cancer Institute

O O O O O O O B I O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O

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Harvard Health Letter 5 tips to build muscle strength Published March 2014 Proper sleep balanced diet and strengthening exercises can boost endurance and ensure independence Muscle building isnt just for those who are into fitness as a hobby Muscle strength is crucial for good health especially as we age Muscle strength is important to help reduce injuries most notably falls says Ashley Wiater a physical therapist at Harvardaffiliated Massachusetts General Hospital To continue reading this article you must login Subscribe to Harvard Health Online for immediate access to health news and information from Harvard Medical School Research health conditions Check your symptoms Prepare for a doctors visit or test Find the best treatments and procedures for you Explore options for better nutrition and exercise Learn more about the many benefits and features of joining Harvard Health Online Sign Up Now For HEALTH beat Our FREE ENewsletter Get health information and advice from the experts at Harvard Medical School Email Address First Name Optional Daily Health Tip Dont sit so much Sitting for long stretches of time increases the odds of illness and untimely death Here are some simple tricks to get yourself out of your chair While youre on the phone stand up and walk around When watching TV stand and pace during commercials Instead of sitting at your makeup table stand up In general try to get on your feet every 30 minutes

O O O O O O O B I O O O B I B I O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O

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Health Tracking Health Affairs Vol 15 No 4 Trends Downsizing the Hospital Nursing Workforce Linda H Aiken Julie Sochalski and Gerard F Anderson Affiliations PUBLISHED Winter 1996 Free Access httpsdoiorg101377hlthaff15488 Sections Permissions TOPICS Nursing Hospital medical staff Case mix Hospital quality Hospital care Nursing homes Caregivers Markets Quality of care the hospital industry in the United States is undergoing widespread reorganization that includes restructuring of the workforce Surveys reveal that nurses now working in hospitals have serious concerns about the impact of such staffing changes on quality of care and the safety of patients 1 Media coverage of changes taking place in hospitals and hospital care echoes nurses warnings Congress expressed its concern by mandating the Institute of Medicine IOM to study the adequacy of nurse staffing in hospitals and nursing homes 2 The recently completed IOM study recommended greater involvement of nurses in restructuring initiatives and more research on the relationship between nurse staffing and patient outcomes because empirical evidence could not be found to support testimony and anecdotal reports by nurses and others that current staffing levels were adversely affecting patient care 3 Here we endeavor to reconcile nurses perceptions that hospitals are reducing nurse staffing to unsafe levels with the dominant hospital management view that major restructuring of the hospital workforce including nursing is warranted We bring together empirical data from various sources to examine the overall trends in hospital employment and to determine the implications for current hospital restructuring activities as well as nurses future job prospects Data and Methods Data on total hospital employment by labor category were abstracted from the American Hospital Associations AHAs Annual Survey data tapes for all shortterm general hospitals for each year between 1981 and 1993 and were aggregated at the state and national levels Hospital employees were grouped into five major categories nursing technicians nonprofessional nonnurse administration and other professional 4 Registered nurse RNspecific employment data were drawn from the AHA Hospital Statistics reports which also come from the Annual Survey These figures are reported in terms of fulltimeequivalent FTE employees We obtained the hospitalspecific casemix index from the Health Care Financing Administration HCFA for each hospital in each year we then divided each hospitals FTEs by its casemix index to compute casemixadjusted hospital personnel We derived data on the trends in overall RN employment from the Bureau of Health Professions Division of Nursing These data are based primarily on the National Sample Survey of Registered Nurses which is conducted every four years Hospital Employment Trends Total hospital employment grew steadily between 1981 and 1993 a trend that has motivated much of the recent attention to restructuring the hospital workforce When the increase in overall hospital employment is examined in more detailby taking into account the decline in inpatient days the increase in outpatient visits and the increasing level of patient acuitythere was still a net increase in employment of 113 percent Exhibit 1 Embedded in this trend are several significant points regarding nursing personnel RNs licensed practical nurses LPNs and nursesaides Exhibit 1 Percentage Change In FullTimeEquivalent Hospital Personnel Per 1000 Adjusted Patient Days Adjusted For CaseMix 19811993 Source American Hospital Association AHA Annual Survey data 1981 through 1993 NOTES Adjusted patient days is the AHA calculation that converts a hospitals inpatient and outpatient volume into one value Medicare casemix index values from the Federal Register are used as the proxy for overall casemix Most importantly nursing personnel declined by 73 percent nationally while all other categories of hospital personnel increasedincluding a 46 percent increase in nonnurse administrative personnel and a 50 percent increase in other professional staff The decline in nursing personnel was substantial in some states it reached 27 percent in Massachusetts 25 percent in New York and 20 percent in California Clearly in these states considerably fewer nursing caregivers are at the bedside which lends strong support to nurses claims of reduced staffing There are regional variations in employment patterns Maryland declined by only 1 percent and Texas increased by 25 The results of these changes in nurse staffing are a reduction in the number of nursing caregivers per patient at the bedside but also a richer skill mix in nursing personnel Between 1984 and 1994 the number of RN FTEs at shortterm community hospitals grew by 276 percent which translates into roughly 193000 additional RN FTEs The result was a 294 percent increase in the RNtopatient ratio Although this appears on its face to be a significant increase in RNs when the RNtopatient ratio is adjusted for casemix increases almost no change is seen in the ratio over the period The increased employment of RNs in hospitals although significant in absolute terms merely kept pace with the changing acuity levels of patients thus keeping the RNtopatient staffing ratios about constant in clinical terms over the period Exhibit 2 Growth In FullTimeEquivalent FTE Hospital Registered Nurses RNs Per 100 Adjusted Average Daily Census Adjusted For CaseMix 19841994 Hospital RN FTEs thousands Hospital RN FTEs per 100 AADC a Hospital RN FTEs per 100 AADC adjusted for casemix b 1984 698 85 8500 1994 891 110 8527 Percent change 276 294 03 SOURCE American Hospital Association Hospital Statistics 1985 through 199596 a Adjusted average daily census AADC is the average number of patients inpatients plus an equivalent figure for outpatients receiving care each day during the reporting period b The Medicare casemix index is used as the proxy for overall casemix It appears therefore that the loss of nonRN personnel has been the principal cause of the overall decrease in nursing personnel The result of these changes on nurse staffing steady growth in RNs commensurate with casemix increases and a decline in nonRN nursing personnelhas been an increase in RNs as a percentage of total nursing personnel or an enriched nursing skill mix Consequently fewer nursing caregivers per patient are available today than a decade ago to provide care to a more acutely ill patient population This substantiates nurses reports of reduced staffing levels and offers an explanation for RNs increased The net effect of overall changes in hospital employment has been an increase in nonclinical personnel relative to clinical staff 5 As hospital restructuring initiatives are implemented it would seem judicious to examine how savings may be achieved through productivity gains in the nonclinical workforce as well as through efficiency gains in nonlabor categories before focusing solely on clinical personnel where a relatively smaller investment has been made over the past decade As for nursing two objectives long advocated by hospital nurses have been achieved a richer nursing skill mix and higher wages Yet neither hospital nurses nor administrators are satisfied with the outcome for different reasons 6 We concur with the IOM report that nurses are in the best position to judge the clinical consequences of staffing patterns and thus should be charged by hospital administrators with evaluating the alternatives for organizing and staffing for clinical care Future Demand for Registered Nurses Hospitals share of the growing pool of RNs has changed little during the past decade from 68 percent to 665 percent when many believed that the dominance of hospital RN employment would diminish 7 This pattern has largely been a function of the inpatient demand for RNs Despite a substantial rise in hospital outpatient activity between 1988 and 1992 three new RNs were added for inpatient care for every new RN added for outpatient services 8 Although outofhospital settings offer new opportunities for RNs hospital employment more than kept pace For example between 1988 and 1992 the number of RNs employed in nursing homes grew almost 20 percent and the number of those employed in home care grew nearly 50 percent 9 Even with these high rates of increase however six new hospital RNs were hired for each new nursing home RN and five new hospital RNs were hired for every two new home care RNs Although hospitals will continue to generate new RN jobs it seems unlikely that they will continue to increase their employment of RNs at the same rate as they have over the past decade if hospital use falls significantly as some predict Current hospital workforce trends from the AHA National Hospital Panel Survey suggest that job growth is tapering off which could affect RNs in the future 10 A littlerecognized factor is that the rate of growth in RN supply is outstripping RN job growth Perceptions of RN Job Cuts It is possible that widespread reductions in the hospital RN workforce have taken place in 1995 and 1996 but are not yet reflected in available regional and national data However such perceptions were widely held in 1993 when the IOM study was commissioned and RN employment was continuing to grow We believe that perceptions of RN job reductions derive from several factors One cited earlier is the decline in the overall number of nursing personnel even though RN employment stayed constant through 1994 Another has to do with highly publicized actions at various institutions A third littlerecognized factor is that the rate of growth in RN supply is outstripping RN job growth particularly in certain geographic areas We found a strong negative relationship between RNtopopulation ratios and employment Census regions with a low RNtopopulation ratio in 1992 that is below the national average had higherthanaverage RN employment growth in the Future Employment The market for RNs has been reasonably selfcorrecting over time Although the demand for RNs still appears to be strong it is unclear whether graduating cohorts of 95000 the size of the class of 1994 will continue to be absorbed as hospital job growth is curtailed The RN supply likely will be tempered in the future if job availability is reduced In fact enrollment in RN programs dropped almost 1 percent in 1994 after seven consecutive years of growth perhaps in response to the tighter job market This reduction presaged a recommendation from the Pew Health Professions Commissions report in 11 The demand for nurses particularly in the hospital sector also is influenced by nurses relative wages which are at an alltime high 12 If nurses wages stagnate and fall relative to those of aides and LPNs the demand for nurses in hospitals could increase to the point of exhausting what may look like an oversupply resulting in the kinds of RN shortages experienced in the 1980s 13 Finally the average age of the nursing workforce is increasing suggesting that retirement could increase greatly over the long term thus providing more job opportunities for new graduates Estimates from the Bureau of Labor Statistics Occupational Outlook Handbook 199697 Edition rank RNs fifth among all job categories for the greatest predicted job growth between 1994 and 2005 14 Compared with many other categories especially those outside of health care that are growing more slowly nursing employment looks quite promising The biggest potential threat to nursing in the near term is not job availability It is the possibility that in the quest to reduce spending hospital management will implement poorly conceived reengineering plans that could undermine nursings best efforts to maintain the quality and safety of clinical care ACKNOWLEDGMENTS The research for this paper was supported by a grant from The Baxter Foundation NOTES 1 See for example ShindulRothschild J Berry D LongMiddleton E Whats Happening to Patient Care Final Results of the AJN Survey American Journal of Nursing forthcoming Google Scholar 2 Lumson K Faded Glory Will Nursing Ever Be the Same Hospitals 5 December 1995 30 32 34 35 Twedt S A Question of Skill Pittsburgh PostGazette 1114 February 1996 Institute of Medicine Nursing Staff in Hospitals and Nursing Homes Is It Adequate Washington National Academy Press 1996 92 127 Google Scholar 3 IOM Nursing Staff in Hospitals and Nursing Homes Google Scholar 4 Nursing includes total nursing personnel RNs LPNs and aides technicians includes clinical technical personnel such as pharmacy technicians nonprofessional includes nonclinical support personnel administration includes nonclinical administrative staff and other professional includes clinical professional staff such as dietitians physical therapists and social workers See Anderson GF Kohn LT Employment Trends in Hospitals 19811993 Inquiry Spring 11996 79 84 Google Scholar 5 Ibid Crossref Medline Also see Himmelstein DU Lewontin JP Woolhandler S Who Administers Who Cares Medical Administrative and Clinical Employment in the United States and Canada American Journal of Public Health 86 no 2 1996 172 178 Crossref Medline Google Scholar 6 Brannon RL Intensifying Care The Hospital Industry Professionalization and the Reorganization of the Nursing Labor Process New York Baywood Publishing 1994 125 168 Google Scholar 7 US Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions Division of Nursing The Registered Nurse Population Findings from the National Sample Survey of Registered Nurses March 1988 Rockville Md DHHS 1990 19 Division of Nursing The Registered Nurse Population Findings from the National Sample Survey of Registered Nurses March 1992 Rockville Md DHHS 1994 22 Google Scholar 8 Calculations from data provided in The Registered Nurse Population Findings from the National Sample Survey of Registered Nurses March 1988 Table 13 and March 1992 Table 14 Google Scholar 9 Calculations from data provided in The Registered Nurse Population Findings from the National Sample Survey of Registered Nurses March 1988 Table 12 and March 1992 Table 13 Google Scholar 10 A comparison of yearend cumulative figures for total hospital FTEs between 1992 and 1995 from the AHA National Hospital Panel Survey adjusted for average daily census shows a gradual decline in total FTE growth nursing personnel and all others from a 14 percent rise between 1992 and 1993 to a 05 percent decline between 1994 and 1995 Because occupationspecific employment is not available in the Panel Survey we do not know if the overall decline in employment also includes for the first time a drop in RN employment Google Scholar 11 Pew Health Professions Commission Critical Challenges Revitalizing the Health Professions for the Twentyfirst Century San Francisco University of California San Francisco Center for the Health Professions December 1995 ix Google Scholar 12 Calculations based on the anual weighted average salary from the National Survey of Hospital and Medical School Salaries Galveston Tex University of Texas Medical Branch at Galveston 1982 1994 Google Scholar 13 Aiken L Mullinix C The Nurse Shortage Myth or Reality The New Fngland Journal of Medicine 317 no 10 1987 641 646 Crossref Medline Google Scholar 14 Bureau of Labor Statistics US Department of Labor Occupational Outlook Handbook 199697 Edition Washington US Government Printing Office 1996 3 Google Scholar

O O O O O O O O O O O B B I O O O O O O O O O O O O O O O O O O O O B O O O O B O B O O O O O O O O O B O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O B O O O O O O O O O O O O O O O O O O O B O O O O O O O O B O O O O O O O O O O O O O O O B O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O B O O O O O O O O O O O O O O O O O O O O B O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O B O O O B O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O B O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O B O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O


What Are the Best Meal Replacement Shakes for Men in 2019 Meal Replacement When you think of meal replacement shakes the first thing that comes to mind is probably those infomercials from the the 90s aimed at female chronic dieters That may have been the target audience two decades ago but things have changed in recent years Not only has the quality of meal replacement shakes dramatically improved men are beginning to get in on the action too and for good reason With shakes to slim down bulk up or just maintain the market is flooded with so many options for men In this article Ill answer some of the most common questions on the topic and help you choose the best meal replacement shakes for men Product Our 1 Rated Labrada Lean Body HiProtein Meal Replacement Shake 40 g of fast slow release proteins a sustained flow of vital amino acids with 6 g BCAAs Gluten free Check price MetRx Meal Replacement Whey Protein Powder Low fat meal replacement with generous 36 g of protein over 7 g of BCAAs Chocolate flavored powder Gluten free Check price N53 Lean 1 Cookies Cream Fat Burning Meal Replacement Fat burning formula with 20 g of protein to define muscles 27 minerals and vitamins added for nutritional support Check price Naturade Vegan Smart Plant Based Protein Powder 20 g protein using whole food complex Nine different fruits vegetables polyphenols antioxidants and flavonoids Check price ViSalus Vi Shape Weight Loss Protein Powder Mix tastes like a cake Low in fat sodium and sugar Lactose free and gluten free 12 g of protein per serving Check price What is a Meal Replacement Shake The main aim of a meal replacement shake as you can tell from the name is to replace a solid wellbalanced meal with a shake alternative When choosing a formula you have control over elements such as calories and nutrition Meal replacement shakes and protein shakes are very similar and the two are often confused The easiest way to distinguish between is by looking at their nutritional profile Meal replacement shakes should contain appropriate levels of protein fiber carbohydrates and essential nutrients such as vitamins and minerals This is to replicate what you would normally consume through solid whole foods On the other hand protein shakes usually focus on high protein low carbs and not much else What Can a Meal Replacement Shake Do for Me Weight Loss The general consensus when it comes to using meal replacement shakes for weight loss is to substitute two meals a day with a shake and eat one wellbalanced regular meal Most people prefer to save the real food for their evening meal because thats when they are least time pressured In one clinical trial volunteers were given either a meal replacement or a food based diet over a 40 week period Results indicated 62 of the meal replacement group lost more than 5 of their initial body weight proving that this can be an effective strategy in weight management source Calorie Control Made Simple Counting calories is an essential part of weight control With solid foods things are often not so straightforward Weighing measuring and even nowadays with mobile app technology tallying up calories still gets tiresome for most This is one reason meal replacements are particularly great for calorie control You know exactly what is in each serving therefore simplifying the counting process Your browser does not currently recognize any of the video formats available Click here to visit our frequently asked questions about HTML5 video Curbs Appetite Another important factor for weight loss is hunger When your goal is to shed a few pounds the last thing you should want is to feel your stomach grumbling way before lunchtime Protein and fiber have significant satiety factors due to the slower rate of digestion Therefore meal replacement shakes with sufficient levels of both are known to reduce hunger and make you feel fuller for longer sources 1 2 Workout Warrior With weight loss if you want to get lean you also need to think about combining exercise into your plan Muscle is the powerhouse of the body and to keep it in tiptop condition you need protein As meal replacements contain protein they could prove beneficial for your workouts When you hit it hard in the gym your muscles take a battering and start to break down Protein preserves muscle mass therefore allowing you to push yourself harder for longer to maximise gains and recover faster too source Weight Gain For all the hard gainers out there who struggle to put on weight meal replacement shakes could be an alternative way to raise your BMI without jeopardising your health If you find it hard to gain weight you need to up your calorie intake This is where the problem often lies as some men find it difficult to consume enough food especially if they are extremely active Whether your desired goal is gaining muscle or just pure pounds adding extra meals in the form of a shake to your regular diet is guaranteed to increase your calorie intake Nutritional Support How healthy is your diet Are you someone who skips breakfast Would you prefer to hit the fast food chain on the way home from work because you havent got time to cook If the answer is yes then you could be missing out on some very important nutrients Studies suggest the majority of the US population does not meet recommendations for all the nutrientrich food groups Significantly 80 of the population had intakes of over consumption of empty calories from fats added sugars and alcohol source A quality meal replacement should contain adequate levels of vitamins and minerals In these cases a meal replacement shake is a healthier alternative to processed convenience food What are the Best Meal Replacement Shakes for Men When looking for a meal replacement shake youll soon realise that there are a quite number out there to choose from It can often be difficult to work out which one is the best quality To help you make an informed choice Ive looked at the options available and chosen five top contenders for the best meal replacements shakes for men Quality Price Our rating Pros 290 calories 21 g carbs 35 g protein 6 g BCAAs 6 g glutamine 7 g fiber 21 vitamins and minerals 5 flavors Gluten free Cons Expensive Some find the taste too sweet Click for price Quality Price Our rating Pros 240 calories 2 g sugars 39 g protein 6 g BCAAs 3 g lglutamine 17 g carbs 25 vitamins and minerals 40 servings Individually packaged servings for convenience Aspartame free Gluten free Cons 3 g fiber Expensive Click for price Quality Price Our rating Pros 240 calories 11 g fiber 20 g protein 25 g carbs Gluten free 27 vitamins and minerals Green coffee bean extract Cons 9 g sugar Click for price Quality Price Our rating Pros 170 calories 14g carbs 20 g protein 6 g fiber 22 vitamins and minerals Dairy free Soy free Gluten free Whole food complex Made in the USA Cons 5 g sugar Click for price Quality Price Our rating Pros 90 calories 12 g protein 5 g fiber 1 g sugar 7 g carbs 26 vitamins and minerals Gluten free Vegetarian 24 servings Cons Expensive Too sweet for some Click for price My Pick for the Best Meal Replacement Shakes For Men I must admit it was a close call between MetRx and Labrada however Labrada Nutrition gets the top spot in my book because its truly a meal replacement shake that ticks all the boxes I believe it has a good allround balance of the most important nutritional bases protein carbohydrates and fiber I think their formula could be beneficial for men who are looking to get lean and shed pounds Labrada Nutritions shake has an adequate calorie content to keep energy levels sustained while managing to stay low fat This makes it an appealing option for those that are watching their weight The formula includes 21 vitamins and minerals in sufficient levels to ensure you are getting what you need to maintain your health Helen Sanders Helen started writing about health to document her own journey She fell into some very bad habits and knew things had to change Thats why she began this site More articles from Helen Sanders Picks for You What Are The Best Vegan Meal Replacement Shakes in 2019 Helen Sanders Meal Replacement What Are the Best Organic Meal Replacement Shakes in 2019 Helen Sanders Meal Replacement Best Meal Replacement Shakes for Weight Loss in 2019 Reviews Helen Sanders Meal Replacement What Are the Best Meal Replacement Shakes for Diabetics in 2019 Helen Sanders Diabetes Meal Replacement Popular Posts Apple Cider Vinegar for Blood Pressure Fluctuation Helen Sanders Home Remedies 12 Things That Will Happen If You Drink Apple Cider Vinegar Daily Helen Sanders Nutrition 12 Health Benefits of Drinking Lemon Water You Probably Didnt Know About Helen Sanders Nutrition 7 Negative Effects of Coffee The Healthy Drink You Should Replace it With Helen Sanders Foods Latest Posts Leesa Mattress Review Helen Sanders Health AZ Relieve Your Skin with the Top 5 Best Mattresses for Bedsores in 2019 Helen Sanders Sleep The Top 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O O O O B I O O O O O B I O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O B I O O O O O O O O O O O O O B I O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O B I O O O O O B I O O O O O B I O B I O O O O O O O O O B I O O O O B I O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O

labrada lean body hi - protein meal replacement shake


Athenahealth receives multiple acquisition bid offers report says The price is below what activist investor Elliott Management previously offered By Susan Morse September 27 2018 0131 PM Topics Cloud Computing Electronic Health Records EHR EMR Mergers Acquisitions

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Physical activity guidelines for older adults 4minute read How much physical activity do older adults aged 65 and over need to do to keep healthy The amount of physical activity you need to do each week depends on your age and level of health To stay healthy or to improve health older adults need to do two types of physical activity each week aerobic and musclestrengthening activity Why physical activity is important Physical activity has many benefits for older people It not only helps you to feel better physically and emotionally it helps to control weight blood pressure cholesterol diabetes and bone and joint problems like arthritis reduces the risk of heart disease stroke and some cancers helps to manage pain helps to maintain and increase joint movement Importantly it helps to reduce the risk of injury from falls a major concern with ageing How much physical activity do you need Adults aged 65 or older who are generally fit and have no health conditions that limit their mobility should try to be active daily Its recommended that adults aged 65 or older do at least 30 minutes of moderate intensity physical activity on most preferably all days Some activity however light is better for your health than none at all you should aim to do something no matter what your age weight health problems or abilities You should aim to active every day in as many ways as possible doing a range of physical activities that incorporate fitness strength balance and flexibility What counts as moderateintensity aerobic activity Moderateintensity aerobic activity means youre working hard enough to raise your heart rate and break a sweat One way to tell if youre working at a moderate intensity is if you can still talk but you cant sing the words to a song Examples of activities that require moderate effort for most people include walking fast doing water aerobics ballroom and line dancing riding a bike on level ground or with a few hills playing doubles tennis pushing a lawn mower canoeing volleyball Daily activities such as shopping cooking or housework dont count towards your daily 30 minutes of moderateintensity activity This is because the effort required isnt hard enough to increase your heart rate However its important to minimise the amount of time you spend sitting watching TV reading or listening to music Some activity however light is better for your health than none at all What counts as vigorousintensity aerobic activity Vigorousintensity aerobic activity means youre breathing hard and fast and your heart rate has gone up quite a bit If youre working at this level you wont be able to say more than a few words without pausing for a breath and you should stop if you feel unwell The Australian Physical Activity Guide for Older Australians doesnt recommend you exercise to this level but its OK if you do If you have enjoyed a lifetime of vigorous physical activity you should carry on doing it in a way that suits you now provided you stick to recommended safety procedures and guidelines What counts as musclestrengthening activity Musclestrengthening exercises are counted in repetitions and sets A repetition is 1 complete movement of an activity like lifting a weight or doing a situp A set is a group of repetitions For each activity try to do 8 to 12 repetitions in each set Try to do at least 1 set of each musclestrengthening activity Youll get even more benefits if you do 2 or 3 sets To gain health benefits from musclestrengthening activities you should do them to the point where you find it hard to complete another repetition There are many ways you can strengthen your muscles whether at home or in the gym Examples of musclestrengthening activities include carrying or moving heavy loads such as groceries activities that involve stepping and jumping such as dancing heavy gardening such as digging or shovelling exercises that use your body weight for resistance such as pushups or situps yoga lifting weights Make a time to do specific strength exercises 2 or 3 times a week and build some of them into your everyday activities Source s Department of Health Choose Health Be Active Australian Government Department of Health Australias Physical Activity and Sedentary Behaviour Guidelines Nutrition Australia Physical activity for older adults Last reviewed October 2018 Recommended links Get Healthy NSW gethealthynswcomau Was this article helpful Need more information These trusted information partners have more on this topic General search results Results for medical professionals

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Health Insurance California Covered California Income Limits Covered California Income Limits View Covered California Income Guidelines and See Chart to Calculate Your Health Care Options The Covered California income limits require consumers to have a household income that ranges from 0 to 400 of the Federal Poverty Level FPL in order to qualify for assistance on a government health insurance plan Based on your household income you may qualify for upfront tax credits when you enroll in health insurance in California through the Covered California Health Exchange Obamacare Income Guidelines Chart Based on the Federal Poverty Level According to Covered California income guidelines and salary restrictions if an individual makes less than 47520 per year or if a family of four earns wages less than 97200 per year then they qualify for government assistance based on their income If the family has a lower household net income then a greater amount of government assistance is available to the family Tax deductions can lower your income level View the Covered California income limits chart below Government Programs and Assistance Based on Income Ranges For adults the following Covered California income restrictions apply 0 138 of FPL You qualify for MediCal 138 400 of FPL You qualify for a subsidy on a Covered California plan 138 to 150 You also qualify for the Silver Enhanced 94 Plan 150 to 200 You also qualify for the Silver Enhanced 87 Plan 200 to 250 You qualify for the Silver Enhanced 73 Plan Parameters for Low Income Females Who Are Expecting a Baby Pregnant women may qualify for MAGI MediCal if you have household earnings of 138 to 213 according to Covered California income limits Also based on wages and the FPL women who are having a baby may be eligible for the MediCal Access Program MCAP if they have a household income of 213 to 322 Government Programs for Children Obamacare Information Guide and Wage Limits Adults qualify for MediCal with a household income of less than 138 of FPL However according to the Covered California income guide children who enroll on Obama Care California plans may qualify for MediCal when the family has a household income of 266 or less The children must be under 19 years of age to qualify Also CCHIP the County Childrens Health Initiative Program offers health care coverage for children when the family income is greater than 266 up to 322 of FPL Proof of Income Document proofs including pay stubs bank statements etc may be required to verify your household income threshold If you fail to provide proof of income you may lose your Obamacare subsidy or your health care coverage Reporting MidYear Changes in Household Earnings If your wagessalary increases during the year this may affect what levels of subsidies you qualify for according to Covered California income limits It also may affect whether or not you your spouse or your children qualify for certain government assistance programs If you have a significant income change midyear you may be required to report that to Covered California or to MediCal

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