Melanie M Wall1, Kurt D Stromberg, Sandra Pothoff, Robert L Kane. 1. Division of Biostatistics, University of Minnesota School of Public Health, Mail Code 303, 420 Delaware Street SE, Minneapolis, MN 55455, USA. melanie@biostat.umn.edu
Abstract
OBJECTIVE: We propose a method for defining and empirically validating episodes of alcoholism treatment from health care utilization records. STUDY DESIGN AND SETTING: The study includes utilization records from 86,207 patients enrolled in a large managed behavioral care company who had at least one alcoholism encounter between 1991 and 1998. Treatment episodes are defined as a minimum number of alcoholism treatment encounters with the behavioral care company prior to a "clear zone" of no encounters. Statistical procedures to select a subset of episode definitions from a number of candidate definitions and methods for assessing the convergent and criterion validity of the definitions are presented. RESULTS: The percentage of patients having at least one episode of alcoholism treatment varies from 43% to 77%, with the results being more sensitive to the minimum number of encounters required than the length of the clear zone. Criterion validity does not reveal any clear "winning" definitions; positive predictive ability increases most rapidly when going from 2 to 3 encounters required. CONCLUSION: The most robust definitions of an alcoholism treatment episode entail 3 to 4 encounters with a clear zone of 3 to 4 months.
OBJECTIVE: We propose a method for defining and empirically validating episodes of alcoholism treatment from health care utilization records. STUDY DESIGN AND SETTING: The study includes utilization records from 86,207 patients enrolled in a large managed behavioral care company who had at least one alcoholism encounter between 1991 and 1998. Treatment episodes are defined as a minimum number of alcoholism treatment encounters with the behavioral care company prior to a "clear zone" of no encounters. Statistical procedures to select a subset of episode definitions from a number of candidate definitions and methods for assessing the convergent and criterion validity of the definitions are presented. RESULTS: The percentage of patients having at least one episode of alcoholism treatment varies from 43% to 77%, with the results being more sensitive to the minimum number of encounters required than the length of the clear zone. Criterion validity does not reveal any clear "winning" definitions; positive predictive ability increases most rapidly when going from 2 to 3 encounters required. CONCLUSION: The most robust definitions of an alcoholism treatment episode entail 3 to 4 encounters with a clear zone of 3 to 4 months.
Authors: Jeremy W Bray; Keith L Davis; Linda Graver; Don Schroeder; Jeffrey A Buck; Joan Dilonardo; Rita Vandivort Journal: J Behav Health Serv Res Date: 2005 Jul-Sep Impact factor: 1.505