Decreasing use of percutaneous endoscopic gastrostomy tube feeding for veterans with dementia - Racial differences remain

Research output: Contribution to journalArticle

Ursula K. Braun, Linda Rabeneck, Laurence B. McCullough, Diana L. Urbauer, Nelda Wray, David R. Lairson, Rebecca J. Beyth

OBJECTIVES: Percutaneous endoscopic gastrostomy (PEG) tube placement is a widely used method for long-term enteral feeding of demented patients unable to take sufficient food by mouth. National time trends in PEG tube use over the last decade have not been previously reported. The objective of this study was to determine whether use of PEG tubes for patients with dementia has changed over time and by race. DESIGN: Retrospective cohort study. SETTING: All Veterans Affairs hospitals. PARTICIPANTS: Using an administrative database of the Veterans Health Administration, all veterans with dementia and all veterans who received a PEG tube were identified between fiscal years 1990-2001. MEASUREMENTS: Proportion of PEG tube placement for dementia patients over time and by race. RESULTS: Four hundred thirteen thousand six hundred twenty-seven dementia patients aged 60 and older were identified, of whom 6,464 (1.6%) received a PEG tube. Use of PEG tubes for dementia patients increased during the first half of the decade but subsequently decreased almost to baseline after peaking in 1996 (1990: 1.2%, 1996: 1.8%, 2001: 1.3%). Time trends in the use of PEG tube feeding for dementia patients varied by race. Specifically, the relative risk for PEG tube placement in African-American dementia patients increased from 1.65 (95% confidence interval (CI) = 1.25-2.17, FY 1990) to 1.97 (95% CI = 1.62-2.4, FY 2001). CONCLUSION: Although the overall use of PEG tube feeding for dementia patients decreased over time, rates in use and changes in use over time varied significantly by race. Reasons for the differential use of this procedure should be explored.

Original languageEnglish (US)
Pages (from-to)242-248
Number of pages7
JournalJournal of the American Geriatrics Society
Volume53
Issue number2
DOIs
StatePublished - Feb 1 2005

PMID: 15673347

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Decreasing use of percutaneous endoscopic gastrostomy tube feeding for veterans with dementia - Racial differences remain. / Braun, Ursula K.; Rabeneck, Linda; McCullough, Laurence B.; Urbauer, Diana L.; Wray, Nelda; Lairson, David R.; Beyth, Rebecca J.

In: Journal of the American Geriatrics Society, Vol. 53, No. 2, 01.02.2005, p. 242-248.

Research output: Contribution to journalArticle

Harvard

Braun, UK, Rabeneck, L, McCullough, LB, Urbauer, DL, Wray, N, Lairson, DR & Beyth, RJ 2005, 'Decreasing use of percutaneous endoscopic gastrostomy tube feeding for veterans with dementia - Racial differences remain' Journal of the American Geriatrics Society, vol. 53, no. 2, pp. 242-248. https://doi.org/10.1111/j.1532-5415.2005.53109.x

APA

Braun, U. K., Rabeneck, L., McCullough, L. B., Urbauer, D. L., Wray, N., Lairson, D. R., & Beyth, R. J. (2005). Decreasing use of percutaneous endoscopic gastrostomy tube feeding for veterans with dementia - Racial differences remain. Journal of the American Geriatrics Society, 53(2), 242-248. https://doi.org/10.1111/j.1532-5415.2005.53109.x

Vancouver

Braun UK, Rabeneck L, McCullough LB, Urbauer DL, Wray N, Lairson DR et al. Decreasing use of percutaneous endoscopic gastrostomy tube feeding for veterans with dementia - Racial differences remain. Journal of the American Geriatrics Society. 2005 Feb 1;53(2):242-248. https://doi.org/10.1111/j.1532-5415.2005.53109.x

Author

Braun, Ursula K. ; Rabeneck, Linda ; McCullough, Laurence B. ; Urbauer, Diana L. ; Wray, Nelda ; Lairson, David R. ; Beyth, Rebecca J. / Decreasing use of percutaneous endoscopic gastrostomy tube feeding for veterans with dementia - Racial differences remain. In: Journal of the American Geriatrics Society. 2005 ; Vol. 53, No. 2. pp. 242-248.

BibTeX

@article{a5d7e1132c71492ca5876c5bf06080fa,
title = "Decreasing use of percutaneous endoscopic gastrostomy tube feeding for veterans with dementia - Racial differences remain",
abstract = "OBJECTIVES: Percutaneous endoscopic gastrostomy (PEG) tube placement is a widely used method for long-term enteral feeding of demented patients unable to take sufficient food by mouth. National time trends in PEG tube use over the last decade have not been previously reported. The objective of this study was to determine whether use of PEG tubes for patients with dementia has changed over time and by race. DESIGN: Retrospective cohort study. SETTING: All Veterans Affairs hospitals. PARTICIPANTS: Using an administrative database of the Veterans Health Administration, all veterans with dementia and all veterans who received a PEG tube were identified between fiscal years 1990-2001. MEASUREMENTS: Proportion of PEG tube placement for dementia patients over time and by race. RESULTS: Four hundred thirteen thousand six hundred twenty-seven dementia patients aged 60 and older were identified, of whom 6,464 (1.6{\%}) received a PEG tube. Use of PEG tubes for dementia patients increased during the first half of the decade but subsequently decreased almost to baseline after peaking in 1996 (1990: 1.2{\%}, 1996: 1.8{\%}, 2001: 1.3{\%}). Time trends in the use of PEG tube feeding for dementia patients varied by race. Specifically, the relative risk for PEG tube placement in African-American dementia patients increased from 1.65 (95{\%} confidence interval (CI) = 1.25-2.17, FY 1990) to 1.97 (95{\%} CI = 1.62-2.4, FY 2001). CONCLUSION: Although the overall use of PEG tube feeding for dementia patients decreased over time, rates in use and changes in use over time varied significantly by race. Reasons for the differential use of this procedure should be explored.",
keywords = "Dementia, End-of-life care, PEG tube, Time trends",
author = "Braun, {Ursula K.} and Linda Rabeneck and McCullough, {Laurence B.} and Urbauer, {Diana L.} and Nelda Wray and Lairson, {David R.} and Beyth, {Rebecca J.}",
year = "2005",
month = "2",
day = "1",
doi = "10.1111/j.1532-5415.2005.53109.x",
language = "English (US)",
volume = "53",
pages = "242--248",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley",
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}

RIS

TY - JOUR

T1 - Decreasing use of percutaneous endoscopic gastrostomy tube feeding for veterans with dementia - Racial differences remain

AU - Braun, Ursula K.

AU - Rabeneck, Linda

AU - McCullough, Laurence B.

AU - Urbauer, Diana L.

AU - Wray, Nelda

AU - Lairson, David R.

AU - Beyth, Rebecca J.

PY - 2005/2/1

Y1 - 2005/2/1

N2 - OBJECTIVES: Percutaneous endoscopic gastrostomy (PEG) tube placement is a widely used method for long-term enteral feeding of demented patients unable to take sufficient food by mouth. National time trends in PEG tube use over the last decade have not been previously reported. The objective of this study was to determine whether use of PEG tubes for patients with dementia has changed over time and by race. DESIGN: Retrospective cohort study. SETTING: All Veterans Affairs hospitals. PARTICIPANTS: Using an administrative database of the Veterans Health Administration, all veterans with dementia and all veterans who received a PEG tube were identified between fiscal years 1990-2001. MEASUREMENTS: Proportion of PEG tube placement for dementia patients over time and by race. RESULTS: Four hundred thirteen thousand six hundred twenty-seven dementia patients aged 60 and older were identified, of whom 6,464 (1.6%) received a PEG tube. Use of PEG tubes for dementia patients increased during the first half of the decade but subsequently decreased almost to baseline after peaking in 1996 (1990: 1.2%, 1996: 1.8%, 2001: 1.3%). Time trends in the use of PEG tube feeding for dementia patients varied by race. Specifically, the relative risk for PEG tube placement in African-American dementia patients increased from 1.65 (95% confidence interval (CI) = 1.25-2.17, FY 1990) to 1.97 (95% CI = 1.62-2.4, FY 2001). CONCLUSION: Although the overall use of PEG tube feeding for dementia patients decreased over time, rates in use and changes in use over time varied significantly by race. Reasons for the differential use of this procedure should be explored.

AB - OBJECTIVES: Percutaneous endoscopic gastrostomy (PEG) tube placement is a widely used method for long-term enteral feeding of demented patients unable to take sufficient food by mouth. National time trends in PEG tube use over the last decade have not been previously reported. The objective of this study was to determine whether use of PEG tubes for patients with dementia has changed over time and by race. DESIGN: Retrospective cohort study. SETTING: All Veterans Affairs hospitals. PARTICIPANTS: Using an administrative database of the Veterans Health Administration, all veterans with dementia and all veterans who received a PEG tube were identified between fiscal years 1990-2001. MEASUREMENTS: Proportion of PEG tube placement for dementia patients over time and by race. RESULTS: Four hundred thirteen thousand six hundred twenty-seven dementia patients aged 60 and older were identified, of whom 6,464 (1.6%) received a PEG tube. Use of PEG tubes for dementia patients increased during the first half of the decade but subsequently decreased almost to baseline after peaking in 1996 (1990: 1.2%, 1996: 1.8%, 2001: 1.3%). Time trends in the use of PEG tube feeding for dementia patients varied by race. Specifically, the relative risk for PEG tube placement in African-American dementia patients increased from 1.65 (95% confidence interval (CI) = 1.25-2.17, FY 1990) to 1.97 (95% CI = 1.62-2.4, FY 2001). CONCLUSION: Although the overall use of PEG tube feeding for dementia patients decreased over time, rates in use and changes in use over time varied significantly by race. Reasons for the differential use of this procedure should be explored.

KW - Dementia

KW - End-of-life care

KW - PEG tube

KW - Time trends

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UR - http://www.scopus.com/inward/citedby.url?scp=15044350008&partnerID=8YFLogxK

U2 - 10.1111/j.1532-5415.2005.53109.x

DO - 10.1111/j.1532-5415.2005.53109.x

M3 - Article

VL - 53

SP - 242

EP - 248

JO - Journal of the American Geriatrics Society

T2 - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 2

ER -

ID: 2604695