Abstract：
OBJECTIVE:To develop and test predictive models of housing instability and homelessness based on responses to a brief screening instrument administered throughout the Veterans Health Administration (VHA). DATA SOURCES/STUDY SETTING:Electronic medical record data from 5.8 million Veterans who responded to the VHA's Homelessness Screening Clinical Reminder (HSCR) between October 2012 and September 2015. STUDY DESIGN:We randomly selected 80% of Veterans in our sample to develop predictive models. We evaluated the performance of both logistic regression and random forests-a machine learning algorithm-using the remaining 20% of cases. DATA COLLECTION/EXTRACTION METHODS:Data were extracted from two sources: VHA's Corporate Data Warehouse and National Homeless Registry. PRINCIPAL FINDINGS:Performance for all models was acceptable or better. Random forests models were more sensitive in predicting housing instability and homelessness than logistic regression, but less specific in predicting housing instability. Rates of positive screens for both outcomes were highest among Veterans in the top strata of model-predicted risk. CONCLUSIONS:Predictive models based on medical record data can identify Veterans likely to report housing instability and homelessness, making the HSCR screening process more efficient and informing new engagement strategies. Our findings have implications for similar instruments in other health care systems.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Byrne T,Montgomery AE,Fargo JDdoi
10.1111/1475-6773.13050subject
Has Abstractpub_date
2019-02-01 00:00:00pages
75-85issue
1eissn
0017-9124issn
1475-6773journal_volume
54pub_type
杂志文章abstract：OBJECTIVE:To quantify the effects of informal caregiver availability and public funding on formal long-term care (LTC) expenditures in developed countries. DATA SOURCE/STUDY SETTING:Secondary data were acquired for 15 Organization for Economic Cooperation and Development (OECD) countries from 1970 to 2000. STUDY DESI...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00328.x
更新日期：2004-12-01 00:00:00
abstract：OBJECTIVES:To explore effects of disease prevalence adjustment on ambulatory care-sensitive hospitalization (ACSH) rates used for quality comparisons. DATA SOURCES/STUDY SETTING:County-level hospital administrative data on adults discharged from German hospitals in 2011 and prevalence estimates based on administrative...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12680
更新日期：2018-04-01 00:00:00
abstract：OBJECTIVE:To determine whether Medicare enrollment at age 65 has an effect on the health trajectory of the near-elderly uninsured. DATA SOURCES:Eight biennial waves (1992-2006) of the Health and Retirement Study, a nationally representative panel survey of noninstitutionalized 51-61 year olds and their spouses. STUDY...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2009.00964.x
更新日期：2009-06-01 00:00:00
abstract：OBJECTIVE:To examine the impact of pay for performance in Medicaid on the quality and utilization of care. DATA SOURCES:Medicaid claims and encounter data in three intervention states (Pennsylvania, Minnesota, and Alabama) and three comparison states. STUDY DESIGN:Difference-in-difference analysis with propensity sco...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12426
更新日期：2016-08-01 00:00:00
abstract：:This article reports an evaluation of the impact of three administrative technologies--Admission Scheduling (AS) Systems, Outpatient Surgery (OPS) Programs, and Preadmission Testing (PAT) Programs--on the number of acute care beds required by a hospital. The evaluation mechanism reported here is called the ADTECH Comp...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1985-04-01 00:00:00
abstract：OBJECTIVE:Diabetes is a highly prevalent condition that results in substantial morbidity and premature mortality. We investigated how diabetes-associated mortality, disability, early retirement, and work absenteeism impacts workforce participation. DATA SOURCE:We used the Health and Retirement Study (HRS), a national ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00311.x
更新日期：2004-12-01 00:00:00
abstract：:In late 1982, as an alternative to Medicaid, Arizona implemented a prepaid, competitively bid medical care program--the Arizona Health Care Cost Containment System (AHCCCS). Before its introduction, the poor had been cared for primarily by a network of county-supported centers. Impact of the AHCCCS initiative was exam...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1985-08-01 00:00:00
abstract：OBJECTIVE:To investigate factors affecting willingness to pay (WTP) for health insurance of older adults in a longitudinal setting in Germany. DATA SOURCES:Survey data from a cohort study in Saarland, Germany, from 2008-2010 and 2011-2014 (n1 = 3,124; n2 = 2,761) were used. STUDY DESIGN:Panel data were taken at two...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12522
更新日期：2017-06-01 00:00:00
abstract：OBJECTIVES:To compare different methods for defining screening mammograms with Medicare claims and their impact on estimates of breast cancer screening rates. METHODS:Medicare outpatient facility and physician claims for 61,962 women in 1993 and 59,652 women in 1998 were reviewed for evidence of receipt of screening m...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.10912
更新日期：2002-12-01 00:00:00
abstract：OBJECTIVE:To translate a set of evidence-based clinical standards designed to allow paramedics to forego unnecessary and potentially harmful resuscitation attempts into a feasible new policy. DATA SOURCES/SETTING:Policy documents, meeting minutes, and personal communications between a large urban Emergency Medical Ser...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01341.x
更新日期：2012-02-01 00:00:00
abstract：:The concept of validity as it applies to measures of health and health status is examined in the context of a set of standard, widely accepted definitions of validity. Criterion validity is shown to be irrelevant to health status measures because of the lack of a single specific, directly observable measure of health ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1976-01-01 00:00:00
abstract：OBJECTIVE:To utilize functional status (FS) outcomes to benchmark outpatient therapy clinics. DATA SOURCES:Outpatient therapy data from clinics using Focus on Therapeutic Outcomes (FOTO) assessments. STUDY DESIGN:Retrospective analysis of 538 clinics, involving 2,040 therapists and 90,392 patients admitted July 2006-...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12344
更新日期：2016-04-01 00:00:00
abstract：OBJECTIVE:To examine the association between bodyweight status and provision of population-based prevention services. DATA SOURCES:The National Association of City and County Health Officials 2005 Profile survey data, linked with two cross-sections of the Behavioral Risk Factor Surveillance System (BRFSS) survey in 20...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2012.01447.x
更新日期：2013-04-01 00:00:00
abstract：OBJECTIVES:(1) To identify resident and organizational factors associated with the use of advance care plans pre- and post-implementation of the Patient Self-Determination Act (PSDA), and (2) to identify changes (pre- and post-implementation of the PSDA) in the relationship between these factors and the use of advance ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1998-04-01 00:00:00
abstract：OBJECTIVES:To compare the ability of two diagnosis-based risk adjustment systems and health self-report to predict short- and long-term mortality. DATA SOURCES/STUDY SETTING:Data were obtained from the Department of Veterans Affairs (VA) administrative databases. The study population was 78,164 VA beneficiaries at eig...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00622.x
更新日期：2007-04-01 00:00:00
abstract：:Over a two-year interval, computerized tomography (CT) scans at an urban, 400-bed Department of Veterans Affairs medical center (VAMC) were obtained in three ways. First, an in-house low-efficiency machine was used. Then, scans were done at another area hospital, in effect duplicating some aspects of regionalizing ser...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1990-04-01 00:00:00
abstract：BACKGROUND:Many states have passed legislation mandating that health plans provide direct access to obstetricians/gynecologists (hereinafter "ob/gyns") for women, limiting the ability of plans to require referrals or otherwise restrict access. One benefit of these laws may be improved preventive screening rates, but no...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00646.x
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVE:To estimate the total hours of paid and unpaid personal assistance of daily living provided to adults living at home in the United States using nationally representative household survey data. DATA SOURCES:The Disability Followback Survey of the National Health Interview Survey on Disability (NHIS-D) conduct...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.029
更新日期：2002-04-01 00:00:00
abstract：:Uniform hospital discharge abstract data from Maryland were used to examine the homogeneity of trauma-related DRGs with respect to a well-established measure of injury severity, the Injury Severity Score (ISS). Thirty DRGs were identified as including trauma cases with a wide range of severity; for each of these DRGs,...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1991-04-01 00:00:00
abstract：OBJECTIVE:To examine the relationship of services for post-acute care (PAC) to stroke patient outcomes. DATA SOURCES/STUDY SETTING:Veterans Health Administration (VHA) hospitals from two facility-level surveys and extant data files. STUDY DESIGN:Cross-sectional study of veterans hospitalized with acute stroke during ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2001-02-01 00:00:00
abstract：OBJECTIVE:To compare the estimated effects of dialysis center profit status on patient survival using alternative estimation strategies with retrospective data. DATA SOURCES/STUDY SETTING:Patient and provider-level retrospective data from the United States Renal Data System (USRDS), 1996-1999. STUDY DESIGN:Observatio...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00581.x
更新日期：2006-12-01 00:00:00
abstract：OBJECTIVE:To assess the value of a novel composite measure for identifying the best hospitals for major procedures. DATA SOURCE:We used national Medicare data for patients undergoing five high-risk surgical procedures between 2005 and 2008. STUDY DESIGN:For each procedure, we used empirical Bayes techniques to create...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2012.01407.x
更新日期：2012-10-01 00:00:00
abstract：OBJECTIVE:This study examines the degree to which a married individual's health habits and use of preventive medical care are influenced by his or her spouse's behaviors. STUDY DESIGN:Using longitudinal data on individuals and their spouses, we examine changes over time in the health habits of each person as a functio...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00754.x
更新日期：2008-02-01 00:00:00
abstract：OBJECTIVE:To describe the landscape of state antitrust activity and review related research and policy issues. In particular, to examine state laws that attempt to immunize mergers among healthcare providers from state and federal antitrust prosecution and consent decrees issued by state attorneys general permitting he...
journal_title：Health services research
pub_type： 杂志文章,评审
doi：
更新日期：1998-12-01 00:00:00
abstract：OBJECTIVE:To evaluate whether community-based health insurance (CBHI) protects household assets in rural Burkina Faso, Africa. DATA SOURCES:Data were used from a household panel survey that collected primary data from randomly selected households, covering 41 villages and one town, during 2004-2007(n = 890). STUDY DE...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01321.x
更新日期：2012-04-01 00:00:00
abstract：OBJECTIVE:To determine whether Medicaid home care spending reduces the proportion of the disabled elderly population who do not get help with personal care. DATA SOURCES:Data on Medicaid home care spending per poor elderly person in each state is merged with data from the Medicare Current Beneficiary Survey for 1992, ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00762.x
更新日期：2008-02-01 00:00:00
abstract：OBJECTIVE:. To examine the effect of premiums and benefits on the health plan choices of older enrollees who choose Federal Employees Health Benefits Program (FEHBP) health plans as their primary payer. DATA SOURCES:Administrative enrollment data from the Office of Personnel Management (OPM) and plan premiums and bene...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00580.x
更新日期：2006-10-01 00:00:00
abstract：OBJECTIVES:To assess the relative abilities of clinical and administrative data to predict mortality and to assess hospital quality of care for CABG surgery patients. DATA SOURCES/STUDY SETTING:1991-1992 data from New York's Cardiac Surgery Reporting System (clinical data) and HCFA's MEDPAR (administrative data). STUD...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1997-02-01 00:00:00
abstract：OBJECTIVE:To determine whether difficulty walking and the strategies persons use to compensate for this deficit influenced downstream Medicare expenditures. DATA SOURCE:Secondary data analysis of Medicare claims data (1999-2000) for age-eligible Medicare beneficiaries (N=4,997) responding to the community portion of t...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00509.x
更新日期：2006-06-01 00:00:00
abstract：OBJECTIVE:To examine the effect of post-hospital Medicare home health and informal care on the functional status of 755 Medicare beneficiaries six weeks after hospital discharge for treatment of stroke, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), hip procedures, and hip fractures. STU...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1998-08-01 00:00:00
