Abstract:
Background:measuring the complex needs of care home residents is crucial for resource allocation. Hospital patient administration systems (PAS) may not accurately identify admissions from care homes. Objective:to develop and validate an accurate, practical method of identifying care home resident hospital admission using routinely collected PAS data. Method:admissions data between 2011 and 2012 (n = 103,105) to an acute Trust were modelled to develop an automated tool which compared the hospital PAS address details with the Care Quality Commission's (CQC) database, producing a likelihood of care home residency. This tool and the Nuffield method (CQC postcode match only) were validated against a manual check of a random sample of admissions (n = 2,000). A dataset from a separate Trust was analysed to assess generalisability. Results:the hospital PAS was inaccurate; none of the admissions from a care home identified on manual check had a care home source of admission recorded on the PAS. Both methods performed well; the automated tool had a higher positive predictive value than the Nuffield method (100% 95% confidence interval (CI) 98.23-100% versus 87.10% 95%CI 82.28-91.00%), meaning those coded as care home residents were more likely to actually be from a care home. Our automated tool had a high level of agreement 99.2% with the second Trust's data (Kappa 0.86 P < 0.001). Conclusions:care home status is not routinely or accurately captured. Automated matching offers an accurate, repeatable, scalable method to identify care home residency and could be used as a tool to benchmark how care home residents use acute hospital resources across the National Health Service.
journal_name
Age Ageingjournal_title
Age and ageingauthors
Housley G,Lewis S,Usman A,Gordon AL,Shaw DEdoi
10.1093/ageing/afx182subject
Has Abstractpub_date
2018-05-01 00:00:00pages
387-391issue
3eissn
0002-0729issn
1468-2834pii
4757114journal_volume
47pub_type
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