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BMC Research Notes

, 3:205

First Online: 21 July 2010Received: 18 March 2010Accepted: 21 July 2010DOI: 10.1186-1756-0500-3-205

Cite this article as: Kahn, J.M. & Iwashyna, T.J. BMC Res Notes 2010 3: 205. doi:10.1186-1756-0500-3-205

Abstract

BackgroundLong-term acute care hospitals LTACs provide specialized care for patients recovering from severe acute illness. In order to facilitate research into LTAC utilization and outcomes, we studied whether or not the discharge destination field in administrative data accurately identifies patients transferred to an LTAC following acute care hospitalization.

FindingsWe used the 2006 hospitalization claims for United States Medicare beneficiaries to examine the performance characteristics of the discharge destination field in the administrative record, compared to the reference standard of directly observing LTAC transfers in the claims. We found that the discharge destination field was highly specific 99.7%, 95 percent CI: 99.7% - 99.8% but modestly sensitive 77.3%, 95 percent CI: 77.0% - 77.6%, with corresponding low positive predictive value 72.6%, 95 percent CI: 72.3% - 72.9% and high negative predictive value 99.8%, 95 percent CI: 99.8% - 99.8%. Sensitivity and specificity were similar when limiting the analysis to only intensive care unit patients and mechanically ventilated patients, two groups with higher rates of LTAC utilization. Performance characteristics were slightly better when limiting the analysis to Pennsylvania, a state with relatively high LTAC penetration.

ConclusionsThe discharge destination field in administrative data can result in misclassification when used to identify patients transferred to long-term acute care hospitals. Directly observing transfers in the claims is the preferable method, although this approach is only feasible in identified data.

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Autor: Jeremy M Kahn - Theodore J Iwashyna

Fuente: https://link.springer.com/



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