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Comparison of methods to identify long term care nursing home residence with administrative data
- Source :
- BMC Health Services Research, Vol 17, Iss 1, Pp 1-8 (2017), BMC Health Services Research
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- Background To compare different methods for identifying a long term care (LTC) nursing home stay, distinct from stays in skilled nursing facilities (SNFs), to the method currently used by the Center for Medicare and Medicaid Services (CMS). We used national and Texas Medicare claims, Minimum Data Set (MDS), and Texas Medicaid data from 2011-2013. Methods We used Medicare Part A and B and MDS data either alone or in combination to identify LTC nursing home stays by three methods. One method used Medicare Part A and B data; one method used Medicare Part A and MDS data; and the current CMS method used MDS data alone. We validated each method against Texas 2011 Medicare-Medicaid linked data for those with dual eligibility. Results Using Medicaid data as a gold standard, all three methods had sensitivities > 92% to identify LTC nursing home stays of more than 100 days in duration. The positive predictive value (PPV) of the method that used both MDS and Medicare Part A data was 84.65% compared to 78.71% for the CMS method and 66.45% for the method using Part A and B Medicare. When the patient population was limited to those who also had a SNF stay, the PPV for identifying LTC nursing home was highest for the method using Medicare plus MDS data (88.1%). Conclusions Using both Medicare and MDS data to identify LTC stays will lead to more accurate attribution of CMS nursing home quality indicators. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2318-9) contains supplementary material, which is available to authorized users.
- Subjects :
- Adult
Male
medicine.medical_specialty
Minimum Data Set
Eligibility Determination
Skilled Nursing
Medicare
Health administration
03 medical and health sciences
0302 clinical medicine
medicine
Humans
030212 general & internal medicine
Long term care
health care economics and organizations
Aged
Skilled Nursing Facilities
Aged, 80 and over
Medicaid
Nursing home
business.industry
lcsh:Public aspects of medicine
030503 health policy & services
Health Policy
Gold standard
Long-Term Care Nursing
lcsh:RA1-1270
Length of Stay
Middle Aged
Long-Term Care
Texas
United States
Nursing Homes
3. Good health
Long-term care
Knowledge Management
Family medicine
Female
Residence
0305 other medical science
business
Research Article
Subjects
Details
- ISSN :
- 14726963
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....8bb391a9c0c79338467077d2a40d2286