干旱区生态环境知识资源中心(Arid): Crosswalk Algorithms for Cognitive and Functional Outcomes Among 2013-2018 Medicare Beneficiaries With Dementia

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DOI	10.1016/j.jamda.2024.105168
	Crosswalk Algorithms for Cognitive and Functional Outcomes Among 2013-2018 Medicare Beneficiaries With Dementia
	Pritchard, Kevin T.; Mahesri, Mufaddal; Chen, Qiaoxi; Yang, Chun-Ting; Brill, Gregory; Kim, Dae Hyun; Lin, Kueiyu Joshua
通讯作者	Lin, KJ
来源期刊	JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
ISSN	1525-8610
EISSN	1538-9375
出版年	2024
卷号	25 期号:10
英文摘要	Objective: Before 2019, the Minimum Data Set (MDS) and Outcome and Assessment Information Set (OASIS) had incongruent response categories for rating cognitive impairment and activities of daily living (ADLs), hindering direct comparisons between nursing facilities and home health. We devised rule-based algorithms to compare cognitive impairment and ADL limitations between these 2 care settings among people with Alzheimer's disease and Alzheimer's disease-related dementias (ADRD). Design: A retrospective cohort study. Setting and Participants: Included fee-for-service Medicare beneficiaries (2013-2018) transitioning from nursing facilities to home health, with 1-year of continuous enrollment, aged >65 years, diagnosed ADRD, and with complete MDS discharge and OASIS admission assessments (N = 398,496). Methods: We identified target phenotypes using the Cognitive Function Scale (CFS) and ADL items from the MDS discharge assessment as reference standards. We compared 6 OASIS-based algorithms for cognitive impairment and 1 for each ADL limitation by estimating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: The average age was 83.5 (SD = 7.5) years and 82.3% transitioned from nursing to home health within 3 days. In the MDS discharge assessment, 42.2% had moderate-to-severe cognitive impairment. ADL limitations ranged from 71.4% for feeding to 97.8% for bathing. Compared with the moderate-to- severe cognitive impairment (CFS >3) on the MDS, the OASIS cognitive assessment indicating considerable assistance to total dependence in routine situations had 24% sensitivity, 94% specificity, 75% PPV, and 63% NPV. The ADL limitation algorithms exhibited high sensitivities (>96%) and PPVs (>94%) except for feeding (Sensitivity: 82%; PPV: 74%). Despite the short time frame between the 2 assessments, the OASIS admission assessment showed a higher prevalence of ADL limitations than the MDS discharge assessment. Conclusions and Implications: We highlighted differences in patient function between post-acute care settings. Our algorithms can help researchers, clinicians, and policymakers standardize patient-centered outcomes for comparative effectiveness research or quality initiatives. (c) 2024 AMDA- The Society for Post-Acute and Long-Term Care Medicine.
英文关键词	MeSH: dementia cognition activities of daily living medicare
类型	Article
语种	英语
收录类别	SCI-E
WOS记录号	WOS:001293552400001
WOS关键词	MULTIPLE IMPUTATION ; HOME HEALTH ; CARE
WOS类目	Geriatrics & Gerontology
WOS研究方向	Geriatrics & Gerontology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/404721
推荐引用方式 GB/T 7714	Pritchard, Kevin T.,Mahesri, Mufaddal,Chen, Qiaoxi,et al. Crosswalk Algorithms for Cognitive and Functional Outcomes Among 2013-2018 Medicare Beneficiaries With Dementia[J],2024,25(10).
APA	Pritchard, Kevin T..,Mahesri, Mufaddal.,Chen, Qiaoxi.,Yang, Chun-Ting.,Brill, Gregory.,...&Lin, Kueiyu Joshua.(2024).Crosswalk Algorithms for Cognitive and Functional Outcomes Among 2013-2018 Medicare Beneficiaries With Dementia.JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION,25(10).
MLA	Pritchard, Kevin T.,et al."Crosswalk Algorithms for Cognitive and Functional Outcomes Among 2013-2018 Medicare Beneficiaries With Dementia".JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION 25.10(2024).