Underreporting of nursing home utilization on the CMS-2728 in older incident dialysis patients and implications for assessing mortality risk. Bowling, C., B., Zhang, R., Franch, H., Huang, Y., Mirk, A., McClellan, W., M., Johnson ,2nd, T., M., & Kutner, N. BMC Nephrology, 16(1):32, BioMed Central, 21, 2015.
Underreporting of nursing home utilization on the CMS-2728 in older incident dialysis patients and implications for assessing mortality risk [link]Website  abstract   bibtex   
Background: The usage of nursing home (NH) services is a marker of frailty among older adults. Although the Centers for Medicare & Medicaid Services (CMS) revised the Medical Evidence Report Form CMS-2728 in 2005 to include data collection on NH institutionalization, the validity of this item has not been reported.; Methods: There were 27,913 patients ≥ 75 years of age with incident end-stage renal disease (ESRD) in 2006, which constituted our analysis cohort. We determined the accuracy of the CMS-2728 using a matched cohort that included the CMS Minimum Data Set (MDS) 2.0, often employed as a "gold standard" metric for identifying patients receiving NH care. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the CMS-2728 NH item. Next, we compared characteristics and mortality risk by CMS-2728 and MDS NH status agreement.; Results: The sensitivity, specificity, PPV and NPV of the CMS-2728 for NH status were 33%, 97%, 80% and 79%, respectively. Compared to those without the MDS or CMS-2728 NH indicator (No MDS/No 2728), multivariable adjusted hazard ratios (95% confidence interval) for mortality associated with NH status were 1.55 (1.46 - 1.64) for MDS/2728, 1.48 (1.42 - 1.54) for MDS/No 2728, and 1.38 (1.25 - 1.52) for No MDS/2728. NH utilization was more strongly associated with mortality than other CMS-2728 items in the model.; Conclusions: The CMS-2728 underestimated NH utilization among older adults with incident ESRD. The potential for misclassification may have important ramifications for assessing prognosis, developing advanced care plans and providing coordinated care.;
@article{
 title = {Underreporting of nursing home utilization on the CMS-2728 in older incident dialysis patients and implications for assessing mortality risk},
 type = {article},
 year = {2015},
 identifiers = {[object Object]},
 pages = {32},
 volume = {16},
 websites = {http://login.ezproxy.library.ualberta.ca/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=25880589&site=ehost-live&scope=site},
 month = {21},
 publisher = {BioMed Central},
 city = {Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Atlanta Veterans Affairs Medical Center, 1670 Clairmont Road (11B), Decatur, GA, 30033, USA. cbbowli@emory.edu.; Division of General Medicine and Geriatrics, Department of Medicine, Em},
 id = {79e0a84a-3153-3b57-8c31-e049ee176a34},
 created = {2016-08-20T16:55:44.000Z},
 file_attached = {false},
 profile_id = {217ced55-4c79-38dc-838b-4b5ea8df5597},
 group_id = {408d37d9-5f1b-3398-a9f5-5c1a487116d4},
 last_modified = {2017-03-14T09:54:45.334Z},
 read = {false},
 starred = {false},
 authored = {false},
 confirmed = {true},
 hidden = {false},
 source_type = {JOUR},
 notes = {ID: 25880589; Accession Number: 25880589. Language: English. Date Revised: 20150417. Date Created: 20150416. Update Code: 20150423. Publication Type: JOURNAL ARTICLE. Journal ID: 100967793. Publication Model: Print-Electronic. Cited Medium: Internet. NLM ISO Abbr: BMC Nephrol. Linking ISSN: 14712369. Date of Electronic Publication: 2015 Mar 21. ; Original Imprints: Publication: London : BioMed Central, 2000-},
 folder_uuids = {3f8d7ce1-e3f4-4c64-add9-a1fb30f8c887},
 private_publication = {false},
 abstract = {Background: The usage of nursing home (NH) services is a marker of frailty among older adults. Although the Centers for Medicare & Medicaid Services (CMS) revised the Medical Evidence Report Form CMS-2728 in 2005 to include data collection on NH institutionalization, the validity of this item has not been reported.; Methods: There were 27,913 patients ≥ 75 years of age with incident end-stage renal disease (ESRD) in 2006, which constituted our analysis cohort. We determined the accuracy of the CMS-2728 using a matched cohort that included the CMS Minimum Data Set (MDS) 2.0, often employed as a "gold standard" metric for identifying patients receiving NH care. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the CMS-2728 NH item. Next, we compared characteristics and mortality risk by CMS-2728 and MDS NH status agreement.; Results: The sensitivity, specificity, PPV and NPV of the CMS-2728 for NH status were 33%, 97%, 80% and 79%, respectively. Compared to those without the MDS or CMS-2728 NH indicator (No MDS/No 2728), multivariable adjusted hazard ratios (95% confidence interval) for mortality associated with NH status were 1.55 (1.46 - 1.64) for MDS/2728, 1.48 (1.42 - 1.54) for MDS/No 2728, and 1.38 (1.25 - 1.52) for No MDS/2728. NH utilization was more strongly associated with mortality than other CMS-2728 items in the model.; Conclusions: The CMS-2728 underestimated NH utilization among older adults with incident ESRD. The potential for misclassification may have important ramifications for assessing prognosis, developing advanced care plans and providing coordinated care.;},
 bibtype = {article},
 author = {Bowling, C B and Zhang, Rebecca and Franch, Harold and Huang, Yijian and Mirk, Anna and McClellan, William M and Johnson ,2nd, Theodore M and Kutner, Nancy},
 journal = {BMC Nephrology},
 number = {1}
}

Downloads: 0