Sensitivity and specificity of the Minimum Data Set 3.0 discharge data relative to Medicare claims.

Autor:	Rahman M; Department of Health Services, Policy, and Practice, Brown University, Providence, RI. Electronic address: Momotazur_Rahman@brown.edu., Tyler D; Department of Health Services, Policy, and Practice, Brown University, Providence, RI., Acquah JK; Department of Economics, Brown University, Providence, RI., Lima J; Department of Health Services, Policy, and Practice, Brown University, Providence, RI., Mor V; Department of Health Services, Policy, and Practice, Brown University, Providence, RI; Providence Veterans Administration Medical Center, Health Services Research Program, Providence, RI.
Jazyk:	angličtina
Zdroj:	Journal of the American Medical Directors Association [J Am Med Dir Assoc] 2014; Vol. 15 (11), pp. 819-24. Date of Electronic Publication: 2014 Aug 30.
DOI:	10.1016/j.jamda.2014.06.017
Abstrakt:	Objective: The objective of this study was to determine whether the Minimum Data Set (MDS) 3.0 discharge record accurately identifies hospitalizations and deaths of nursing home residents. Design: We merged date of death from Medicare enrollment data and hospital inpatient claims with MDS discharge records to check whether the same information can be verified from both the sources. We examined the association of 30-day rehospitalization rates from nursing homes calculated only from MDS and only from claims. We also examined how correspondence between these 2 data sources varies across nursing homes. Settings: All fee-for-service (FFS) Medicare beneficiaries admitted for Medicare-paid (with prospective payment system) skilled nursing facility (SNF) care in 2011. Results: Some 94% of hospitalization events in Medicare claims can be identified using MDS discharge records and 87% of hospitalization events detected in MDS data can be verified by Medicare hospital claims. Death can be identified almost perfectly from MDS discharge records. More than 99% of the variation in nursing home-level 30-day rehospitalization rate calculated using claims data can be explained by the same rates calculated using MDS. Nursing home structural characteristics explain only 5% of the variation in nursing home-level sensitivity and 3% of the variation in nursing home-level specificity. Conclusion: The new MDS 3.0 discharge record matches Medicare enrollment and hospitalization claims events with a high degree of accuracy, meaning that hospitalization rates calculated based on MDS offer a good proxy for the "gold standard" Medicare data.
Databáze:	MEDLINE
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