Can Older Adults Accurately Report Their Use of Physical Rehabilitation Services?
Can Older Adults Accurately Report Their Use of Physical Rehabilitation Services?
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DOI：
10.1016/j.apmr.2018.03.010
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发表时间：
2018-08-01
影响因子：
4.3
通讯作者：
Jette, Alan
中科院分区：
文献类型：
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作者：
Freedman, Vicki A.;Kasper, Judith D.;Jette, Alan
目的：探讨老年人康复服务使用报告的准确性以及人口统计学特征、使用时间、持续时间和环境的准确性变化设计：纵向观察性研究。设置：参与者的家中。参与者：65岁及以上的社区居住成人（N=4228）在2015年国家健康和老龄化趋势研究中，他们在面试前参加了12个月的医疗保险A部分和B部分。不适用。主要结果测量：被访者被问及他们在过去一年中是否接受过康复服务，以及服务的持续时间和地点。医疗保健共同程序编码系统代码和收入中心代码被用来确定Medicare合格的康复service.Results：基于调查的报告和医疗保险索赔产生了类似的估计康复使用在过去的一年。自我报告的措施有较高的敏感性（77%）和阳性预测值（80%），甚至更高的特异性和阴性预测值（接近95%）。然而，在调整后的模型，灵敏度较低的黑人入学者，非常老，和那些教育水平较低的结论：调查为基础的康复措施准确地捕获使用在过去的一年中，但差异报告时，应考虑在某些亚组的老年美国人康复使用的特点。(C)2018年美国康复医学大会
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. (C) 2018 by the American Congress of Rehabilitation Medicine