Vicki A Freedman1, Judith D Kasper2, Alan Jette3. 1. Institute for Social Research, University of Michigan, Ann Arbor, MI. Electronic address: vfreedma@umich.edu. 2. Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD. 3. Center for Interprofessional Studies & Innovation, MGH Institute of Health Professions, Boston, MA.
Abstract
OBJECTIVE: To explore the accuracy of rehabilitation service use reports by older adults as well as variation in accuracy by demographic characteristics, time since use, duration, and setting (inpatient, outpatient, home). DESIGN: Longitudinal observational study. SETTING: Participants' homes. PARTICIPANTS: Community-dwelling adults ages 65 and older (N=4228) in the 2015 National Health and Aging Trends Study who were enrolled in Medicare Parts A and B for 12 months before their interview. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Respondents were asked whether they received rehabilitation services in the past year and the duration and location of services. Healthcare Common Procedure Coding System codes and Revenue Center codes were used to identify Medicare-eligible rehabilitation service. RESULTS: Survey-based reports and Medicare claims yielded similar estimates of rehabilitation use over the past year. Self-reported measures had high sensitivity (77%) and positive predictive value (80%) and even higher specificity and negative predictive value (approaching 95%). However, in adjusted models, sensitivity was lower for black enrollees, the very old, and those with lower education levels. CONCLUSIONS: Survey-based measures of rehabilitation accurately captured use over the past year, but differential reporting should be considered when characterizing rehabilitation use in certain subgroups of older Americans.
OBJECTIVE: To explore the accuracy of rehabilitation service use reports by older adults as well as variation in accuracy by demographic characteristics, time since use, duration, and setting (inpatient, outpatient, home). DESIGN: Longitudinal observational study. SETTING:Participants' homes. PARTICIPANTS: Community-dwelling adults ages 65 and older (N=4228) in the 2015 National Health and Aging Trends Study who were enrolled in Medicare Parts A and B for 12 months before their interview. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Respondents were asked whether they received rehabilitation services in the past year and the duration and location of services. Healthcare Common Procedure Coding System codes and Revenue Center codes were used to identify Medicare-eligible rehabilitation service. RESULTS: Survey-based reports and Medicare claims yielded similar estimates of rehabilitation use over the past year. Self-reported measures had high sensitivity (77%) and positive predictive value (80%) and even higher specificity and negative predictive value (approaching 95%). However, in adjusted models, sensitivity was lower for black enrollees, the very old, and those with lower education levels. CONCLUSIONS: Survey-based measures of rehabilitation accurately captured use over the past year, but differential reporting should be considered when characterizing rehabilitation use in certain subgroups of older Americans.
Authors: Carl V Granger; Timothy A Reistetter; James E Graham; Anne Deutsch; Samuel J Markello; Paulette Niewczyk; Kenneth J Ottenbacher Journal: Am J Phys Med Rehabil Date: 2011-03 Impact factor: 2.159
Authors: Bruce E Landon; Alan M Zaslavsky; Robert C Saunders; L Gregory Pawlson; Joseph P Newhouse; John Z Ayanian Journal: Health Aff (Millwood) Date: 2012-12 Impact factor: 6.301
Authors: Laura E Leggett; Rachel G Khadaroo; Jayna Holroyd-Leduc; Diane L Lorenzetti; Heather Hanson; Adrian Wagg; Raj Padwal; Fiona Clement Journal: Medicine (Baltimore) Date: 2016-03 Impact factor: 1.889
Authors: Adam Simning; Thomas V Caprio; Sarah L Szanton; Helena Temkin-Greener; Yeates Conwell Journal: Geriatr Nurs Date: 2019-07-09 Impact factor: 2.361