Joan M Teno
Biographic Data
| ID | 5533957 |
|---|---|
| NAME | Joan M Teno |
| GIVEN NAMES | Joan M |
| FAMILY NAME | Teno |
| SIGNATURE | TENO J M |
| AFFILIATIONS | Brown University |
| ORCID | 0000-0002-4360-8732 |
| VERIFIED | Yes |
| TOTAL WORKS | 23 |
| TOTAL CITATIONS | 11 |
| WORKS AS AUTHOR | 23 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 1991 |
| LATEST PUBLICATION YEAR | 2024 |
| H-INDEX | 1 |
Characteristics and End-of-Life Care Pathways of Decedents From a National Cohort of Assisted Living Residents
BACKGROUND: Assisted living (AL) is an increasingly common, place of care for dying persons. However, it remains unclear to what extent residents are able to age in place or if AL represents an additional transition before death. OBJECTIVES: Examine the sociodemographic characteristics, comorbidities, health care utilization, and end-of-life care pathways of AL residents before death. RESEARCH DESIGN: A national cohort study of fee-for-service Me…
Reforming the Medicare Hospice Benefit—Unintended Consequences
This JAMA Forum discusses the reasons for changing the Medicare hospice benefit program, the potential serious unintended consequences, and provides recommendations for the testing of new alternative payment models
Garbage in, Garbage out—Words of Caution on Big Data and Machine Learning in Medical Practice
This JAMA Forum discusses developments with machine learning and artificial intelligence and provides examples showing how humans are required in these processes to avoid errors in classification
Comparison of the Pathway to Hospice Enrollment Between Medicare Advantage and Traditional Medicare
Compared with TM beneficiaries, those in MA were more likely to enroll in hospice from community settings vs following inpatient stays. However, hospice length of stay was not substantially different between MA and TM. Further research is needed to understand how MA plans influence hospice use and the direct association with quality of end-of-life care as reported by older adults and their families
Hospice—The Time Is Now for Additional Integrity Oversight
This JAMA Forum discusses the concerning trend of for-profit hospice programs in the US, the current issues and problems with hospice care, and the need for increased oversight to ensure and improve quality for patients
Promoting Multifaceted Interventions for Care of the Seriously Ill and Dying
For the past 4 decades, research, payment policy, and quality measurement have focused on advance directives-and later, on single-focus interventions such as educational videos on advance care planning (ACP)-as neat, plausible, and easy solutions to improve decision-making about end-of-life care and address potentially "wasteful" spending at the end of life. Since 1998, I have written 4 commentaries 2-5 that have tried to make 3 points about this…
Seriously Ill Individuals—A Canary in the Coal Mine for Medicare’s Transition to Accountable Health Care
As fundamental changes to payment models for health care are underway, it is important to ensure that vulnerable populations such as the seriously ill and dying are protected. One of the strategic objectives of the Centers for Medicare & Medicaid Services (CMS) Innovation Center, which was authorized under the Affordable Care Act and tasked with designing, implementing, and testing new payment models, is to increase the number of Medicare benefic…
Association Between State Regulations Supportive of Third-party Services and Likelihood of Assisted Living Residents in the US Dying in Place
The findings of this cohort study suggest that a higher percentage of assisted living residents died in place in US states with regulations supportive of third-party services. In addition, assisted living residents in licensed settings with regulations supportive of hospice regulations were especially likely to die in place
The Lake Wobegon Effect—Where Every Medicare Advantage Plan Is “Above Average”
This JAMA Forum discusses the 5-star quality rating system for Medicare Advantage plans, the quality measures that are used to generate the ratings, and the increased payments disbursed as a result of the higher ratings
Hospice Acquisitions by Profit-Driven Private Equity Firms
Financing the Care of the Seriously Ill—“Hell No, I Won’t Go”
Carving in Hospice to Medicare Advantage—Potential Unintended Consequences
There is only one difference between a bad economist and a good one: the bad economist confines himself to the visible effect; the good economist takes into account both the effect that can be seen and those effects that must be foreseen. Frdric Bastiat, "What Is Seen and What Is Not Seen," 1850 Since the creation of the Medicare hospice benefit in 1982, Medicare Advantage has grown rapidly
Defining Advance Care Planning for Adults
Place of death in the population dying from diseases indicative of palliative care need
BACKGROUND: Studying where people die across countries can serve as an evidence base for health policy on end-of-life care. This study describes the place of death of people who died from diseases indicative of palliative care need in 14 countries, the association of place of death with cause of death, sociodemographic and healthcare availability characteristics in each country and the extent to which these characteristics explain country differe…
An Examination of the First 30 Days After Patients are Discharged to the Community From Hip Fracture Postacute Care
BACKGROUND: Postacute care (PAC) rehabilitation aims to maximize independence and facilitate a safe community transition. Yet little is known about PAC patients' success in staying home after discharge or differences on this outcome across PAC providers. OBJECTIVES: Examine the percentage of PAC patients who remain in the community at least 30 days after discharge (ie, successful community discharge) after hip fracture rehabilitation and describe…
Driven to Tiers
Nursing home care is currently a two‐tiered system. The lower tier consists of facilities housing mainly Medicaid residents and, as a result, has very limited resources. The nearly 15 percent of U.S. nonhospital‐based nursing homes that serve predominantly Medicaid residents have fewer nurses, lower occupancy rates, and more health‐related deficiencies. They are more likely to be terminated from the Medicaid/Medicare program, are disproportionate…
Family Perspectives on End-of-Life Care at the Last Place of Care
CONTEXT: Over the past century, nursing homes and hospitals increasingly have become the site of death, yet no national studies have examined the adequacy or quality of end-of-life care in institutional settings compared with deaths at home. OBJECTIVE: To evaluate the US dying experience at home and in institutional settings. DESIGN, SETTING, AND PARTICIPANTS: Mortality follow-back survey of family members or other knowledgeable informants repres…
A Death Worth Dying for
From the *Department of Pulmonary, Critical Care and Sleep Medicine, Brown Medical School, Providence, Rhode Island; and the †Center for Gerontology and Health Care Research, Department of Community Health, Brown Medical School, Providence, Rhode Island. Reprints: Nicholas S. Ward, MD, Department of Pulmonary, Critical Care and Sleep Medicine, Brown Medical School, 593 Eddy St., Providence, RI 02903. E-mail: [email protected]
Factors Associated With Site of Death
Rapid physical decline during the last 5 months was associated with dying at home or in a nursing home, whereas earlier functional loss was associated with dying in a nursing home
Advance Care Planning Priorities for Ethical and Empirical Research
garding Life-Sustaining Treatmeant, Clinical Research 40, no. 2 (1992): 612A. 3. Theodore Geisel (Dr. Seuss), Green Eggs and Ham (New York: Beginner Books, 1960, 1988). 4. Ezekiel J. Emanuel and Linda L. Emanuel, Proxy Decision Making for Incompetent Patients: An Ethical and Empirical Analysis,JAMA 267, no. 15 (1992): 2067-71. 5. Robert Pearlman et al., Insights Pertaining to Patient Assessments of States Worse than Death,Journal of ClinicalEthic…
Priorities for Ethical and Empirical Research
After the Patient Self-Determination Act The Need for Empirical Research on Formal Advance Directives
Joanne Lynn, Joan M. Teno, After the Patient Self-Determination Act The Need for Empirical Research on Formal Advance Directives, The Hastings Center Report, Vol. 23, No. 1 (Jan. - Feb., 1993), pp. 20-24
Health Care Utilization and Functional Status in the Aged Following a Fall
Falls in the aged may lead to increases in health care utilization and declines in functional status. The Longitudinal Study of Aging was analyzed to test the hypotheses that use of the health care system is greater in elderly persons subsequent to a fall in the preceding year than in those who have not fallen and that fallers are more likely to decline in function than are nonfallers. One-time fallers and, especially repeated fallers, (2 or more…
Place of death in the population dying from diseases indicative of palliative care need
BACKGROUND: Studying where people die across countries can serve as an evidence base for health policy on end-of-life care. This study describes the place of death of people who died from diseases indicative of palliative care need in 14 countries, the association of place of death with cause of death, sociodemographic and healthcare availability characteristics in each country and the extent to which these characteristics explain country differe…
Health Care Utilization and Functional Status in the Aged Following a Fall
Falls in the aged may lead to increases in health care utilization and declines in functional status. The Longitudinal Study of Aging was analyzed to test the hypotheses that use of the health care system is greater in elderly persons subsequent to a fall in the preceding year than in those who have not fallen and that fallers are more likely to decline in function than are nonfallers. One-time fallers and, especially repeated fallers, (2 or more…
After the Patient Self-Determination Act The Need for Empirical Research on Formal Advance Directives
Joanne Lynn, Joan M. Teno, After the Patient Self-Determination Act The Need for Empirical Research on Formal Advance Directives, The Hastings Center Report, Vol. 23, No. 1 (Jan. - Feb., 1993), pp. 20-24
Advance Care Planning Priorities for Ethical and Empirical Research
garding Life-Sustaining Treatmeant, Clinical Research 40, no. 2 (1992): 612A. 3. Theodore Geisel (Dr. Seuss), Green Eggs and Ham (New York: Beginner Books, 1960, 1988). 4. Ezekiel J. Emanuel and Linda L. Emanuel, Proxy Decision Making for Incompetent Patients: An Ethical and Empirical Analysis,JAMA 267, no. 15 (1992): 2067-71. 5. Robert Pearlman et al., Insights Pertaining to Patient Assessments of States Worse than Death,Journal of ClinicalEthic…
Priorities for Ethical and Empirical Research
Factors Associated With Site of Death
Rapid physical decline during the last 5 months was associated with dying at home or in a nursing home, whereas earlier functional loss was associated with dying in a nursing home
Driven to Tiers
Nursing home care is currently a two‐tiered system. The lower tier consists of facilities housing mainly Medicaid residents and, as a result, has very limited resources. The nearly 15 percent of U.S. nonhospital‐based nursing homes that serve predominantly Medicaid residents have fewer nurses, lower occupancy rates, and more health‐related deficiencies. They are more likely to be terminated from the Medicaid/Medicare program, are disproportionate…
Family Perspectives on End-of-Life Care at the Last Place of Care
CONTEXT: Over the past century, nursing homes and hospitals increasingly have become the site of death, yet no national studies have examined the adequacy or quality of end-of-life care in institutional settings compared with deaths at home. OBJECTIVE: To evaluate the US dying experience at home and in institutional settings. DESIGN, SETTING, AND PARTICIPANTS: Mortality follow-back survey of family members or other knowledgeable informants repres…
A Death Worth Dying for
From the *Department of Pulmonary, Critical Care and Sleep Medicine, Brown Medical School, Providence, Rhode Island; and the †Center for Gerontology and Health Care Research, Department of Community Health, Brown Medical School, Providence, Rhode Island. Reprints: Nicholas S. Ward, MD, Department of Pulmonary, Critical Care and Sleep Medicine, Brown Medical School, 593 Eddy St., Providence, RI 02903. E-mail: [email protected]
An Examination of the First 30 Days After Patients are Discharged to the Community From Hip Fracture Postacute Care
BACKGROUND: Postacute care (PAC) rehabilitation aims to maximize independence and facilitate a safe community transition. Yet little is known about PAC patients' success in staying home after discharge or differences on this outcome across PAC providers. OBJECTIVES: Examine the percentage of PAC patients who remain in the community at least 30 days after discharge (ie, successful community discharge) after hip fracture rehabilitation and describe…
Place of death in the population dying from diseases indicative of palliative care need
BACKGROUND: Studying where people die across countries can serve as an evidence base for health policy on end-of-life care. This study describes the place of death of people who died from diseases indicative of palliative care need in 14 countries, the association of place of death with cause of death, sociodemographic and healthcare availability characteristics in each country and the extent to which these characteristics explain country differe…
Defining Advance Care Planning for Adults
Hospice Acquisitions by Profit-Driven Private Equity Firms
Financing the Care of the Seriously Ill—“Hell No, I Won’t Go”
Carving in Hospice to Medicare Advantage—Potential Unintended Consequences
There is only one difference between a bad economist and a good one: the bad economist confines himself to the visible effect; the good economist takes into account both the effect that can be seen and those effects that must be foreseen. Frdric Bastiat, "What Is Seen and What Is Not Seen," 1850 Since the creation of the Medicare hospice benefit in 1982, Medicare Advantage has grown rapidly
Promoting Multifaceted Interventions for Care of the Seriously Ill and Dying
For the past 4 decades, research, payment policy, and quality measurement have focused on advance directives-and later, on single-focus interventions such as educational videos on advance care planning (ACP)-as neat, plausible, and easy solutions to improve decision-making about end-of-life care and address potentially "wasteful" spending at the end of life. Since 1998, I have written 4 commentaries 2-5 that have tried to make 3 points about this…
Seriously Ill Individuals—A Canary in the Coal Mine for Medicare’s Transition to Accountable Health Care
As fundamental changes to payment models for health care are underway, it is important to ensure that vulnerable populations such as the seriously ill and dying are protected. One of the strategic objectives of the Centers for Medicare & Medicaid Services (CMS) Innovation Center, which was authorized under the Affordable Care Act and tasked with designing, implementing, and testing new payment models, is to increase the number of Medicare benefic…
Association Between State Regulations Supportive of Third-party Services and Likelihood of Assisted Living Residents in the US Dying in Place
The findings of this cohort study suggest that a higher percentage of assisted living residents died in place in US states with regulations supportive of third-party services. In addition, assisted living residents in licensed settings with regulations supportive of hospice regulations were especially likely to die in place
The Lake Wobegon Effect—Where Every Medicare Advantage Plan Is “Above Average”
This JAMA Forum discusses the 5-star quality rating system for Medicare Advantage plans, the quality measures that are used to generate the ratings, and the increased payments disbursed as a result of the higher ratings
Reforming the Medicare Hospice Benefit—Unintended Consequences
This JAMA Forum discusses the reasons for changing the Medicare hospice benefit program, the potential serious unintended consequences, and provides recommendations for the testing of new alternative payment models
Garbage in, Garbage out—Words of Caution on Big Data and Machine Learning in Medical Practice
This JAMA Forum discusses developments with machine learning and artificial intelligence and provides examples showing how humans are required in these processes to avoid errors in classification
Comparison of the Pathway to Hospice Enrollment Between Medicare Advantage and Traditional Medicare
Compared with TM beneficiaries, those in MA were more likely to enroll in hospice from community settings vs following inpatient stays. However, hospice length of stay was not substantially different between MA and TM. Further research is needed to understand how MA plans influence hospice use and the direct association with quality of end-of-life care as reported by older adults and their families
Hospice—The Time Is Now for Additional Integrity Oversight
This JAMA Forum discusses the concerning trend of for-profit hospice programs in the US, the current issues and problems with hospice care, and the need for increased oversight to ensure and improve quality for patients
Characteristics and End-of-Life Care Pathways of Decedents From a National Cohort of Assisted Living Residents
BACKGROUND: Assisted living (AL) is an increasingly common, place of care for dying persons. However, it remains unclear to what extent residents are able to age in place or if AL represents an additional transition before death. OBJECTIVES: Examine the sociodemographic characteristics, comorbidities, health care utilization, and end-of-life care pathways of AL residents before death. RESEARCH DESIGN: A national cohort study of fee-for-service Me…
Medicine (15 works) · Palliative Care and End-of-Life Issues (12 works) · Nursing (11 works) · Health care (10 works) · Business (8 works) · Palliative care (8 works) · Environmental health (7 works) · Geriatric Care and Nursing Homes (7 works) · Political science (7 works) · Gerontology (6 works)