Defining emergency department episodes by severity and intensity: A 15-year study of Medicare beneficiaries

Background Episodes of Emergency Department (ED) service use among older adults previously have not been constructed, or evaluated as multi-dimensional phenomena. In this study, we constructed episodes of ED service use among a cohort of older adults over a 15-year observation period, measured the e...
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Autor*in:	Kaskie, Brian [verfasserIn] Obrizan, Maksym Cook, Elizabeth A Jones, Michael P Liu, Li Bentler, Suzanne Wallace, Robert B Geweke, John F Wright, Kara B Chrischilles, Elizabeth A Pavlik, Claire E Ohsfeldt, Robert L Rosenthal, Gary E Wolinsky,, Fredric D

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2010

Schlagwörter:	Emergency Department Emergency Department Visit Medicare Claim Subsequent Hospitalization Emergency Department Care

Anmerkung:	© Kaskie et al; licensee BioMed Central Ltd. 2010

Übergeordnetes Werk:	Enthalten in: BMC health services research - London : BioMed Central, 2001, 10(2010), 1 vom: 21. Juni
Übergeordnetes Werk:	volume:10 ; year:2010 ; number:1 ; day:21 ; month:06

Links:	Volltext

DOI / URN:	10.1186/1472-6963-10-173

Katalog-ID:	SPR028242866

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520			\|a Background Episodes of Emergency Department (ED) service use among older adults previously have not been constructed, or evaluated as multi-dimensional phenomena. In this study, we constructed episodes of ED service use among a cohort of older adults over a 15-year observation period, measured the episodes by severity and intensity, and compared these measures in predicting subsequent hospitalization. Methods We conducted a secondary analysis of the prospective cohort study entitled the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD). Baseline (1993) data on 5,511 self-respondents ≥70 years old were linked to their Medicare claims for 1991-2005. Claims then were organized into episodes of ED care according to Medicare guidelines. The severity of ED episodes was measured with a modified-NYU algorithm using ICD9-CM diagnoses, and the intensity of the episodes was measured using CPT codes. Measures were evaluated against subsequent hospitalization to estimate comparative predictive validity. Results Over 15 years, three-fourths (4,171) of the 5,511 AHEAD participants had at least 1 ED episode, with a mean of 4.5 episodes. Cross-classification indicated the modified-NYU severity measure and the CPT-based intensity measure captured different aspects of ED episodes (kappa = 0.18). While both measures were significant independent predictors of hospital admission from ED episodes, the CPT measure had substantially higher predictive validity than the modified-NYU measure (AORs 5.70 vs. 3.31; p < .001). Conclusions We demonstrated an innovative approach for how claims data can be used to construct episodes of ED care among a sample of older adults. We also determined that the modified-NYU measure of severity and the CPT measure of intensity tap different aspects of ED episodes, and that both measures were predictive of subsequent hospitalization.
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allfields	10.1186/1472-6963-10-173 doi (DE-627)SPR028242866 (SPR)1472-6963-10-173-e DE-627 ger DE-627 rakwb eng Kaskie, Brian verfasserin aut Defining emergency department episodes by severity and intensity: A 15-year study of Medicare beneficiaries 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Kaskie et al; licensee BioMed Central Ltd. 2010 Background Episodes of Emergency Department (ED) service use among older adults previously have not been constructed, or evaluated as multi-dimensional phenomena. In this study, we constructed episodes of ED service use among a cohort of older adults over a 15-year observation period, measured the episodes by severity and intensity, and compared these measures in predicting subsequent hospitalization. Methods We conducted a secondary analysis of the prospective cohort study entitled the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD). Baseline (1993) data on 5,511 self-respondents ≥70 years old were linked to their Medicare claims for 1991-2005. Claims then were organized into episodes of ED care according to Medicare guidelines. The severity of ED episodes was measured with a modified-NYU algorithm using ICD9-CM diagnoses, and the intensity of the episodes was measured using CPT codes. Measures were evaluated against subsequent hospitalization to estimate comparative predictive validity. Results Over 15 years, three-fourths (4,171) of the 5,511 AHEAD participants had at least 1 ED episode, with a mean of 4.5 episodes. Cross-classification indicated the modified-NYU severity measure and the CPT-based intensity measure captured different aspects of ED episodes (kappa = 0.18). While both measures were significant independent predictors of hospital admission from ED episodes, the CPT measure had substantially higher predictive validity than the modified-NYU measure (AORs 5.70 vs. 3.31; p < .001). Conclusions We demonstrated an innovative approach for how claims data can be used to construct episodes of ED care among a sample of older adults. We also determined that the modified-NYU measure of severity and the CPT measure of intensity tap different aspects of ED episodes, and that both measures were predictive of subsequent hospitalization. Emergency Department (dpeaa)DE-He213 Emergency Department Visit (dpeaa)DE-He213 Medicare Claim (dpeaa)DE-He213 Subsequent Hospitalization (dpeaa)DE-He213 Emergency Department Care (dpeaa)DE-He213 Obrizan, Maksym aut Cook, Elizabeth A aut Jones, Michael P aut Liu, Li aut Bentler, Suzanne aut Wallace, Robert B aut Geweke, John F aut Wright, Kara B aut Chrischilles, Elizabeth A aut Pavlik, Claire E aut Ohsfeldt, Robert L aut Rosenthal, Gary E aut Wolinsky,, Fredric D aut Enthalten in BMC health services research London : BioMed Central, 2001 10(2010), 1 vom: 21. Juni (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:10 year:2010 number:1 day:21 month:06 https://dx.doi.org/10.1186/1472-6963-10-173 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2010 1 21 06
spelling	10.1186/1472-6963-10-173 doi (DE-627)SPR028242866 (SPR)1472-6963-10-173-e DE-627 ger DE-627 rakwb eng Kaskie, Brian verfasserin aut Defining emergency department episodes by severity and intensity: A 15-year study of Medicare beneficiaries 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Kaskie et al; licensee BioMed Central Ltd. 2010 Background Episodes of Emergency Department (ED) service use among older adults previously have not been constructed, or evaluated as multi-dimensional phenomena. In this study, we constructed episodes of ED service use among a cohort of older adults over a 15-year observation period, measured the episodes by severity and intensity, and compared these measures in predicting subsequent hospitalization. Methods We conducted a secondary analysis of the prospective cohort study entitled the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD). Baseline (1993) data on 5,511 self-respondents ≥70 years old were linked to their Medicare claims for 1991-2005. Claims then were organized into episodes of ED care according to Medicare guidelines. The severity of ED episodes was measured with a modified-NYU algorithm using ICD9-CM diagnoses, and the intensity of the episodes was measured using CPT codes. Measures were evaluated against subsequent hospitalization to estimate comparative predictive validity. Results Over 15 years, three-fourths (4,171) of the 5,511 AHEAD participants had at least 1 ED episode, with a mean of 4.5 episodes. Cross-classification indicated the modified-NYU severity measure and the CPT-based intensity measure captured different aspects of ED episodes (kappa = 0.18). While both measures were significant independent predictors of hospital admission from ED episodes, the CPT measure had substantially higher predictive validity than the modified-NYU measure (AORs 5.70 vs. 3.31; p < .001). Conclusions We demonstrated an innovative approach for how claims data can be used to construct episodes of ED care among a sample of older adults. We also determined that the modified-NYU measure of severity and the CPT measure of intensity tap different aspects of ED episodes, and that both measures were predictive of subsequent hospitalization. Emergency Department (dpeaa)DE-He213 Emergency Department Visit (dpeaa)DE-He213 Medicare Claim (dpeaa)DE-He213 Subsequent Hospitalization (dpeaa)DE-He213 Emergency Department Care (dpeaa)DE-He213 Obrizan, Maksym aut Cook, Elizabeth A aut Jones, Michael P aut Liu, Li aut Bentler, Suzanne aut Wallace, Robert B aut Geweke, John F aut Wright, Kara B aut Chrischilles, Elizabeth A aut Pavlik, Claire E aut Ohsfeldt, Robert L aut Rosenthal, Gary E aut Wolinsky,, Fredric D aut Enthalten in BMC health services research London : BioMed Central, 2001 10(2010), 1 vom: 21. Juni (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:10 year:2010 number:1 day:21 month:06 https://dx.doi.org/10.1186/1472-6963-10-173 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2010 1 21 06
allfields_unstemmed	10.1186/1472-6963-10-173 doi (DE-627)SPR028242866 (SPR)1472-6963-10-173-e DE-627 ger DE-627 rakwb eng Kaskie, Brian verfasserin aut Defining emergency department episodes by severity and intensity: A 15-year study of Medicare beneficiaries 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Kaskie et al; licensee BioMed Central Ltd. 2010 Background Episodes of Emergency Department (ED) service use among older adults previously have not been constructed, or evaluated as multi-dimensional phenomena. In this study, we constructed episodes of ED service use among a cohort of older adults over a 15-year observation period, measured the episodes by severity and intensity, and compared these measures in predicting subsequent hospitalization. Methods We conducted a secondary analysis of the prospective cohort study entitled the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD). Baseline (1993) data on 5,511 self-respondents ≥70 years old were linked to their Medicare claims for 1991-2005. Claims then were organized into episodes of ED care according to Medicare guidelines. The severity of ED episodes was measured with a modified-NYU algorithm using ICD9-CM diagnoses, and the intensity of the episodes was measured using CPT codes. Measures were evaluated against subsequent hospitalization to estimate comparative predictive validity. Results Over 15 years, three-fourths (4,171) of the 5,511 AHEAD participants had at least 1 ED episode, with a mean of 4.5 episodes. Cross-classification indicated the modified-NYU severity measure and the CPT-based intensity measure captured different aspects of ED episodes (kappa = 0.18). While both measures were significant independent predictors of hospital admission from ED episodes, the CPT measure had substantially higher predictive validity than the modified-NYU measure (AORs 5.70 vs. 3.31; p < .001). Conclusions We demonstrated an innovative approach for how claims data can be used to construct episodes of ED care among a sample of older adults. We also determined that the modified-NYU measure of severity and the CPT measure of intensity tap different aspects of ED episodes, and that both measures were predictive of subsequent hospitalization. Emergency Department (dpeaa)DE-He213 Emergency Department Visit (dpeaa)DE-He213 Medicare Claim (dpeaa)DE-He213 Subsequent Hospitalization (dpeaa)DE-He213 Emergency Department Care (dpeaa)DE-He213 Obrizan, Maksym aut Cook, Elizabeth A aut Jones, Michael P aut Liu, Li aut Bentler, Suzanne aut Wallace, Robert B aut Geweke, John F aut Wright, Kara B aut Chrischilles, Elizabeth A aut Pavlik, Claire E aut Ohsfeldt, Robert L aut Rosenthal, Gary E aut Wolinsky,, Fredric D aut Enthalten in BMC health services research London : BioMed Central, 2001 10(2010), 1 vom: 21. Juni (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:10 year:2010 number:1 day:21 month:06 https://dx.doi.org/10.1186/1472-6963-10-173 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2010 1 21 06
allfieldsGer	10.1186/1472-6963-10-173 doi (DE-627)SPR028242866 (SPR)1472-6963-10-173-e DE-627 ger DE-627 rakwb eng Kaskie, Brian verfasserin aut Defining emergency department episodes by severity and intensity: A 15-year study of Medicare beneficiaries 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Kaskie et al; licensee BioMed Central Ltd. 2010 Background Episodes of Emergency Department (ED) service use among older adults previously have not been constructed, or evaluated as multi-dimensional phenomena. In this study, we constructed episodes of ED service use among a cohort of older adults over a 15-year observation period, measured the episodes by severity and intensity, and compared these measures in predicting subsequent hospitalization. Methods We conducted a secondary analysis of the prospective cohort study entitled the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD). Baseline (1993) data on 5,511 self-respondents ≥70 years old were linked to their Medicare claims for 1991-2005. Claims then were organized into episodes of ED care according to Medicare guidelines. The severity of ED episodes was measured with a modified-NYU algorithm using ICD9-CM diagnoses, and the intensity of the episodes was measured using CPT codes. Measures were evaluated against subsequent hospitalization to estimate comparative predictive validity. Results Over 15 years, three-fourths (4,171) of the 5,511 AHEAD participants had at least 1 ED episode, with a mean of 4.5 episodes. Cross-classification indicated the modified-NYU severity measure and the CPT-based intensity measure captured different aspects of ED episodes (kappa = 0.18). While both measures were significant independent predictors of hospital admission from ED episodes, the CPT measure had substantially higher predictive validity than the modified-NYU measure (AORs 5.70 vs. 3.31; p < .001). Conclusions We demonstrated an innovative approach for how claims data can be used to construct episodes of ED care among a sample of older adults. We also determined that the modified-NYU measure of severity and the CPT measure of intensity tap different aspects of ED episodes, and that both measures were predictive of subsequent hospitalization. Emergency Department (dpeaa)DE-He213 Emergency Department Visit (dpeaa)DE-He213 Medicare Claim (dpeaa)DE-He213 Subsequent Hospitalization (dpeaa)DE-He213 Emergency Department Care (dpeaa)DE-He213 Obrizan, Maksym aut Cook, Elizabeth A aut Jones, Michael P aut Liu, Li aut Bentler, Suzanne aut Wallace, Robert B aut Geweke, John F aut Wright, Kara B aut Chrischilles, Elizabeth A aut Pavlik, Claire E aut Ohsfeldt, Robert L aut Rosenthal, Gary E aut Wolinsky,, Fredric D aut Enthalten in BMC health services research London : BioMed Central, 2001 10(2010), 1 vom: 21. Juni (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:10 year:2010 number:1 day:21 month:06 https://dx.doi.org/10.1186/1472-6963-10-173 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2010 1 21 06
allfieldsSound	10.1186/1472-6963-10-173 doi (DE-627)SPR028242866 (SPR)1472-6963-10-173-e DE-627 ger DE-627 rakwb eng Kaskie, Brian verfasserin aut Defining emergency department episodes by severity and intensity: A 15-year study of Medicare beneficiaries 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Kaskie et al; licensee BioMed Central Ltd. 2010 Background Episodes of Emergency Department (ED) service use among older adults previously have not been constructed, or evaluated as multi-dimensional phenomena. In this study, we constructed episodes of ED service use among a cohort of older adults over a 15-year observation period, measured the episodes by severity and intensity, and compared these measures in predicting subsequent hospitalization. Methods We conducted a secondary analysis of the prospective cohort study entitled the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD). Baseline (1993) data on 5,511 self-respondents ≥70 years old were linked to their Medicare claims for 1991-2005. Claims then were organized into episodes of ED care according to Medicare guidelines. The severity of ED episodes was measured with a modified-NYU algorithm using ICD9-CM diagnoses, and the intensity of the episodes was measured using CPT codes. Measures were evaluated against subsequent hospitalization to estimate comparative predictive validity. Results Over 15 years, three-fourths (4,171) of the 5,511 AHEAD participants had at least 1 ED episode, with a mean of 4.5 episodes. Cross-classification indicated the modified-NYU severity measure and the CPT-based intensity measure captured different aspects of ED episodes (kappa = 0.18). While both measures were significant independent predictors of hospital admission from ED episodes, the CPT measure had substantially higher predictive validity than the modified-NYU measure (AORs 5.70 vs. 3.31; p < .001). Conclusions We demonstrated an innovative approach for how claims data can be used to construct episodes of ED care among a sample of older adults. We also determined that the modified-NYU measure of severity and the CPT measure of intensity tap different aspects of ED episodes, and that both measures were predictive of subsequent hospitalization. Emergency Department (dpeaa)DE-He213 Emergency Department Visit (dpeaa)DE-He213 Medicare Claim (dpeaa)DE-He213 Subsequent Hospitalization (dpeaa)DE-He213 Emergency Department Care (dpeaa)DE-He213 Obrizan, Maksym aut Cook, Elizabeth A aut Jones, Michael P aut Liu, Li aut Bentler, Suzanne aut Wallace, Robert B aut Geweke, John F aut Wright, Kara B aut Chrischilles, Elizabeth A aut Pavlik, Claire E aut Ohsfeldt, Robert L aut Rosenthal, Gary E aut Wolinsky,, Fredric D aut Enthalten in BMC health services research London : BioMed Central, 2001 10(2010), 1 vom: 21. Juni (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:10 year:2010 number:1 day:21 month:06 https://dx.doi.org/10.1186/1472-6963-10-173 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2010 1 21 06
language	English
source	Enthalten in BMC health services research 10(2010), 1 vom: 21. Juni volume:10 year:2010 number:1 day:21 month:06
sourceStr	Enthalten in BMC health services research 10(2010), 1 vom: 21. Juni volume:10 year:2010 number:1 day:21 month:06
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Emergency Department Emergency Department Visit Medicare Claim Subsequent Hospitalization Emergency Department Care
isfreeaccess_bool	true
container_title	BMC health services research
authorswithroles_txt_mv	Kaskie, Brian @@aut@@ Obrizan, Maksym @@aut@@ Cook, Elizabeth A @@aut@@ Jones, Michael P @@aut@@ Liu, Li @@aut@@ Bentler, Suzanne @@aut@@ Wallace, Robert B @@aut@@ Geweke, John F @@aut@@ Wright, Kara B @@aut@@ Chrischilles, Elizabeth A @@aut@@ Pavlik, Claire E @@aut@@ Ohsfeldt, Robert L @@aut@@ Rosenthal, Gary E @@aut@@ Wolinsky,, Fredric D @@aut@@
publishDateDaySort_date	2010-06-21T00:00:00Z
hierarchy_top_id	331018756
id	SPR028242866
language_de	englisch
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In this study, we constructed episodes of ED service use among a cohort of older adults over a 15-year observation period, measured the episodes by severity and intensity, and compared these measures in predicting subsequent hospitalization. Methods We conducted a secondary analysis of the prospective cohort study entitled the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD). Baseline (1993) data on 5,511 self-respondents ≥70 years old were linked to their Medicare claims for 1991-2005. Claims then were organized into episodes of ED care according to Medicare guidelines. The severity of ED episodes was measured with a modified-NYU algorithm using ICD9-CM diagnoses, and the intensity of the episodes was measured using CPT codes. Measures were evaluated against subsequent hospitalization to estimate comparative predictive validity. Results Over 15 years, three-fourths (4,171) of the 5,511 AHEAD participants had at least 1 ED episode, with a mean of 4.5 episodes. Cross-classification indicated the modified-NYU severity measure and the CPT-based intensity measure captured different aspects of ED episodes (kappa = 0.18). While both measures were significant independent predictors of hospital admission from ED episodes, the CPT measure had substantially higher predictive validity than the modified-NYU measure (AORs 5.70 vs. 3.31; p < .001). Conclusions We demonstrated an innovative approach for how claims data can be used to construct episodes of ED care among a sample of older adults. 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author	Kaskie, Brian
spellingShingle	Kaskie, Brian misc Emergency Department misc Emergency Department Visit misc Medicare Claim misc Subsequent Hospitalization misc Emergency Department Care Defining emergency department episodes by severity and intensity: A 15-year study of Medicare beneficiaries
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topic_title	Defining emergency department episodes by severity and intensity: A 15-year study of Medicare beneficiaries Emergency Department (dpeaa)DE-He213 Emergency Department Visit (dpeaa)DE-He213 Medicare Claim (dpeaa)DE-He213 Subsequent Hospitalization (dpeaa)DE-He213 Emergency Department Care (dpeaa)DE-He213
topic	misc Emergency Department misc Emergency Department Visit misc Medicare Claim misc Subsequent Hospitalization misc Emergency Department Care
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title	Defining emergency department episodes by severity and intensity: A 15-year study of Medicare beneficiaries
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title_full	Defining emergency department episodes by severity and intensity: A 15-year study of Medicare beneficiaries
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author_browse	Kaskie, Brian Obrizan, Maksym Cook, Elizabeth A Jones, Michael P Liu, Li Bentler, Suzanne Wallace, Robert B Geweke, John F Wright, Kara B Chrischilles, Elizabeth A Pavlik, Claire E Ohsfeldt, Robert L Rosenthal, Gary E Wolinsky,, Fredric D
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title_sort	defining emergency department episodes by severity and intensity: a 15-year study of medicare beneficiaries
title_auth	Defining emergency department episodes by severity and intensity: A 15-year study of Medicare beneficiaries
abstract	Background Episodes of Emergency Department (ED) service use among older adults previously have not been constructed, or evaluated as multi-dimensional phenomena. In this study, we constructed episodes of ED service use among a cohort of older adults over a 15-year observation period, measured the episodes by severity and intensity, and compared these measures in predicting subsequent hospitalization. Methods We conducted a secondary analysis of the prospective cohort study entitled the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD). Baseline (1993) data on 5,511 self-respondents ≥70 years old were linked to their Medicare claims for 1991-2005. Claims then were organized into episodes of ED care according to Medicare guidelines. The severity of ED episodes was measured with a modified-NYU algorithm using ICD9-CM diagnoses, and the intensity of the episodes was measured using CPT codes. Measures were evaluated against subsequent hospitalization to estimate comparative predictive validity. Results Over 15 years, three-fourths (4,171) of the 5,511 AHEAD participants had at least 1 ED episode, with a mean of 4.5 episodes. Cross-classification indicated the modified-NYU severity measure and the CPT-based intensity measure captured different aspects of ED episodes (kappa = 0.18). While both measures were significant independent predictors of hospital admission from ED episodes, the CPT measure had substantially higher predictive validity than the modified-NYU measure (AORs 5.70 vs. 3.31; p < .001). Conclusions We demonstrated an innovative approach for how claims data can be used to construct episodes of ED care among a sample of older adults. We also determined that the modified-NYU measure of severity and the CPT measure of intensity tap different aspects of ED episodes, and that both measures were predictive of subsequent hospitalization. © Kaskie et al; licensee BioMed Central Ltd. 2010
abstractGer	Background Episodes of Emergency Department (ED) service use among older adults previously have not been constructed, or evaluated as multi-dimensional phenomena. In this study, we constructed episodes of ED service use among a cohort of older adults over a 15-year observation period, measured the episodes by severity and intensity, and compared these measures in predicting subsequent hospitalization. Methods We conducted a secondary analysis of the prospective cohort study entitled the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD). Baseline (1993) data on 5,511 self-respondents ≥70 years old were linked to their Medicare claims for 1991-2005. Claims then were organized into episodes of ED care according to Medicare guidelines. The severity of ED episodes was measured with a modified-NYU algorithm using ICD9-CM diagnoses, and the intensity of the episodes was measured using CPT codes. Measures were evaluated against subsequent hospitalization to estimate comparative predictive validity. Results Over 15 years, three-fourths (4,171) of the 5,511 AHEAD participants had at least 1 ED episode, with a mean of 4.5 episodes. Cross-classification indicated the modified-NYU severity measure and the CPT-based intensity measure captured different aspects of ED episodes (kappa = 0.18). While both measures were significant independent predictors of hospital admission from ED episodes, the CPT measure had substantially higher predictive validity than the modified-NYU measure (AORs 5.70 vs. 3.31; p < .001). Conclusions We demonstrated an innovative approach for how claims data can be used to construct episodes of ED care among a sample of older adults. We also determined that the modified-NYU measure of severity and the CPT measure of intensity tap different aspects of ED episodes, and that both measures were predictive of subsequent hospitalization. © Kaskie et al; licensee BioMed Central Ltd. 2010
abstract_unstemmed	Background Episodes of Emergency Department (ED) service use among older adults previously have not been constructed, or evaluated as multi-dimensional phenomena. In this study, we constructed episodes of ED service use among a cohort of older adults over a 15-year observation period, measured the episodes by severity and intensity, and compared these measures in predicting subsequent hospitalization. Methods We conducted a secondary analysis of the prospective cohort study entitled the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD). Baseline (1993) data on 5,511 self-respondents ≥70 years old were linked to their Medicare claims for 1991-2005. Claims then were organized into episodes of ED care according to Medicare guidelines. The severity of ED episodes was measured with a modified-NYU algorithm using ICD9-CM diagnoses, and the intensity of the episodes was measured using CPT codes. Measures were evaluated against subsequent hospitalization to estimate comparative predictive validity. Results Over 15 years, three-fourths (4,171) of the 5,511 AHEAD participants had at least 1 ED episode, with a mean of 4.5 episodes. Cross-classification indicated the modified-NYU severity measure and the CPT-based intensity measure captured different aspects of ED episodes (kappa = 0.18). While both measures were significant independent predictors of hospital admission from ED episodes, the CPT measure had substantially higher predictive validity than the modified-NYU measure (AORs 5.70 vs. 3.31; p < .001). Conclusions We demonstrated an innovative approach for how claims data can be used to construct episodes of ED care among a sample of older adults. We also determined that the modified-NYU measure of severity and the CPT measure of intensity tap different aspects of ED episodes, and that both measures were predictive of subsequent hospitalization. © Kaskie et al; licensee BioMed Central Ltd. 2010
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title_short	Defining emergency department episodes by severity and intensity: A 15-year study of Medicare beneficiaries
url	https://dx.doi.org/10.1186/1472-6963-10-173
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author2	Obrizan, Maksym Cook, Elizabeth A Jones, Michael P Liu, Li Bentler, Suzanne Wallace, Robert B Geweke, John F Wright, Kara B Chrischilles, Elizabeth A Pavlik, Claire E Ohsfeldt, Robert L Rosenthal, Gary E Wolinsky,, Fredric D
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up_date	2024-07-03T18:12:17.667Z
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Defining emergency department episodes by severity and intensity: A 15-year study of Medicare beneficiaries

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