Abstract:
BACKGROUND:Currently there is no standard algorithm to identify whether a subject is residing in a nursing home from administrative claims. Our objective was to develop and validate an algorithm that identifies nursing home admissions at the resident-month level using the MarketScan Medicare Supplemental and Coordination of Benefit (COB) database. METHODS:The computer algorithms for identifying nursing home admissions were created by using provider type, place of service, and procedure codes from the 2000 - 2002 MarketScan Medicare COB database. After the algorithms were reviewed and refined, they were compared with a detailed claims review by an expert reviewer. A random sample of 150 subjects from the claims was selected and used for the validity analysis of the algorithms. Contingency table analysis, comparison of mean differences, correlations, and t-test analyses were performed. Percentage agreement, sensitivity, specificity, and Kappa statistics were analyzed. RESULTS:The computer algorithm showed strong agreement with the expert review (99.9%) for identification of the first month of nursing home residence, with high sensitivity (96.7%), specificity (100%) and a Kappa statistic of 0.97. Weighted Pearson correlation coefficient between the algorithm and the expert review was 0.97 (p < 0.0001). CONCLUSION:A reliable algorithm indicating evidence of nursing home admission was developed and validated from administrative claims data. Our algorithm can be a useful tool to identify patient transitions from and to nursing homes, as well as to screen and monitor for factors associated with nursing home admission and nursing home discharge.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Zuckerman IH,Sato M,Hsu VD,Hernandez JJdoi
10.1186/1472-6963-7-202subject
Has Abstractpub_date
2007-12-10 00:00:00pages
202issn
1472-6963pii
1472-6963-7-202journal_volume
7pub_type
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