Siddharth Jain1,2, Paul R Rosenbaum2,3, Joseph G Reiter1, Geoffrey Hoffman4,5, Dylan S Small2,3, Jinkyung Ha6, Alexander S Hill1, David A Wolk7, Timothy Gaulton2,8,9, Mark D Neuman2,8,9, Roderic G Eckenhoff8,9, Lee A Fleisher2,8,9, Jeffrey H Silber1,2,8,9,10,11. 1. Center for Outcomes Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. 2. The Leonard Davis Institute of Health Economics, The University of Pennsylvania, Philadelphia, Pennsylvania, USA. 3. Department of Statistics, The Wharton School, The University of Pennsylvania, Philadelphia, Pennsylvania, USA. 4. Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan, USA. 5. University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan, USA. 6. Division of Geriatric and Palliative Medicine, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA. 7. Department of Neurology, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA. 8. Center for Perioperative Outcomes Research and Transformation, The University of Pennsylvania, Philadelphia, Pennsylvania, USA. 9. Department of Anesthesiology and Critical Care, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA. 10. The Departments of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA. 11. Department of Health Care Management, The Wharton School, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Abstract
INTRODUCTION: This study develops a measure of Alzheimer's disease and related dementias (ADRD) using Medicare claims. METHODS: Validation resembles the approach of the American Psychological Association, including (1) content validity, (2) construct validity, and (3) predictive validity. RESULTS: We found that four items-a Medicare claim recording ADRD 1 year ago, 2 years ago, 3 years ago, and a total stay of 6 months in a nursing home-exhibit a pattern of association consistent with a single underlying ADRD construct, and presence of any two of these four items predict a direct measure of cognitive function and also future claims for ADRD. DISCUSSION: Our four items are internally consistent with the measurement of a single quantity. The presence of any two items do a better job than a single claim when predicting both a direct measure of cognitive function and future ADRD claims.
INTRODUCTION: This study develops a measure of Alzheimer's disease and related dementias (ADRD) using Medicare claims. METHODS: Validation resembles the approach of the American Psychological Association, including (1) content validity, (2) construct validity, and (3) predictive validity. RESULTS: We found that four items-a Medicare claim recording ADRD 1 year ago, 2 years ago, 3 years ago, and a total stay of 6 months in a nursing home-exhibit a pattern of association consistent with a single underlying ADRD construct, and presence of any two of these four items predict a direct measure of cognitive function and also future claims for ADRD. DISCUSSION: Our four items are internally consistent with the measurement of a single quantity. The presence of any two items do a better job than a single claim when predicting both a direct measure of cognitive function and future ADRD claims.
Keywords:
Alzheimer's disease; Alzheimer's disease and related dementias; Medicare; Medicare claims; administrative data; cognitive impairment; dementia; health and retirement study
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