Evaluation of Data Linkage Methodology to Improve Estimates of Elder Mistreatment

描述（由申请人提供）：老年人虐待是一个重要的、未被充分研究和报道的公共卫生问题，鉴于美国老年人口的迅速增长，美国国家老龄研究所（National Institute on Aging）高度重视这一问题。该项目将评估应用数据联系方法的可行性，该方法曾成功地用于改进对亲密伴侣暴力和虐待儿童的估计，以改进对虐待老人的发生率和普遍程度的估计。目前存在提供所报告的虐待老人信息的数据库，但尚未充分利用这些数据库，使国家和地方了解所报告的虐待老人的程度以及与虐待有关的风险因素。将从全国普遍可用的数据库中链接州级数据。这些数据库包括成人保护服务、医院急诊科和出院、执法/刑事司法、长期护理和国家暴力死亡报告系统的RI组成部分。将获得身体、性和心理虐待受害者以及忽视和经济剥削受害者的不重复计数。包括住在社区和机构的长者。这项研究将通过结合各报告来源报告的虐待老年人案件的数据，尽可能提供已知案件的最完整情况，从而填补知识方面的重要空白。还将评估受害和犯罪的危险因素，以便用于发现以前未被确认的病例。将采用捕获-再捕获方法来估计未报告病例的数量。此外，将召集一个多学科的虐待老人评估工作组，为每一种虐待老人的行为制定可跨学科应用的标准化操作定义。拟议的方法有望在全国范围内应用，并与调查数据结合使用，大大改善对虐待老年人的发生率和流行程度的估计。

DESCRIPTION (provided by applicant): Elder mistreatment is an important, understudied and under-reported public health problem and a high priority for the National Institute on Aging in light of the burgeoning United States elderly population. This project will evaluate the feasibility of applying data linkage methodology used successfully to improve estimates of intimate partner violence and child maltreatment to improve estimates of incidence and prevalence of elder mistreatment. Databases that provide information on reported elder mistreatment currently exist but have not been utilized to full advantage to provide both a national and local understanding of the extent of reported elder mistreatment and risk factors associated with mistreatment. Linkage of state-level data from databases generally available nationally will be conducted. The databases include Adult Protective Services, hospital Emergency Department and Hospital Discharge, Law Enforcement/Criminal Justice, Long Term Care, and the RI component of the National Violent Death Reporting System. Unduplicated counts of victims of physical, sexual, and psychological abuse as well as victims of neglect and financial exploitation will be obtained. Elders residing in both community and institutional settings will be included. This study will fill an important gap in knowledge by combining data on reported cases of elder mistreatment across reporting sources to afford the most complete picture possible of known cases. Risk factors for victimization and perpetration will also be assessed for use in detection of previously unrecognized cases. Capture-recapture methodology will be utilized to estimate the number of unreported cases. In addition, a multi-disciplinary Elder Mistreatment Assessment Working Group will be convened to develop standardized operational definitions for each type of elder mistreatment that can be applied across disciplines. The proposed methodology holds promise as methodology that could be applied nationally and, used in concert with survey data, significantly improve estimates of the incidence and prevalence of elder mistreatment. This application will fill an important gap in our knowledge by combining data on reported cases of elder mistreatment across reporting sources to afford us the most complete picture possible of known cases. Until this work is undertaken we will not know how representative cases from individual sources are of the population of all reported cases of elder mistreatment that occur. With this information and collection of survey data in the future, we will finally have a clearer picture of the extent of elder mistreatment in the population and have the information essential to develop and target more effective public health interventions.