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Data Reporting and Recording01:24

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Reporting and recording are crucial in data documentation. The timely, thorough, and accurate documentation of facts is essential when recording patient data. Failure to record findings during an assessment or interpretation of a problem will result in loss of information and make the patient document unreliable. The reader is left with general impressions if the information is not specific. A recording is documenting data of the individual's health information in a traceable, secure, and...
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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
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Risk screening in a medicare/medicaid population administrative data versus self report.

C L Vojta1, D D Vojta, T R TenHave

  • 1Division of Geriatrics, Department of Medicine at the University of Pennsylvania, Philadelphia, USA. chris.vojta@uphs.upenn.edu

Journal of General Internal Medicine
|September 15, 2001
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Summary

A survey-based tool and a database-derived proxy were compared to identify high-cost dual-eligible Medicare/Medicaid members. The administrative proxy performed similarly to the survey, proving useful for all patients.

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Area of Science:

  • Health Services Research
  • Gerontology
  • Health Economics

Background:

  • Dual-eligible Medicare/Medicaid members represent a high-cost population within healthcare systems.
  • Accurate identification of high-cost individuals is crucial for effective resource allocation and targeted interventions.
  • Existing screening tools may have limitations in terms of response rates or applicability to all patient subgroups.

Purpose of the Study:

  • To compare the prospective identification abilities of a survey-based index (Probability of Repeat Admission Questionnaire - Pra) and a database-derived administrative proxy.
  • To evaluate the utility of these indices in identifying high-cost, dual-eligible Medicare/Medicaid members aged 65 and older.
  • To assess the performance of these tools in a real-world Medicaid health maintenance organization setting.

Main Methods:

  • A longitudinal cohort study was conducted with 558 dual-eligible Medicare/Medicaid enrollees aged 65+.
  • A survey containing the Pra was administered to participants, and an administrative proxy was created using existing data.
  • Sensitivity, specificity, and receiver operating characteristic (ROC) curve areas were calculated to compare the predictive abilities of both indices for identifying high-cost patients over a 6-month follow-up period.

Main Results:

  • The administrative proxy achieved a sensitivity of 55% at a cut point of 0.40, compared to 50% for the survey Pra.
  • Both indices identified a similar proportion of high-risk patients, but there was significant disagreement between them.
  • ROC curve analysis indicated comparable overall discriminative abilities for identifying healthcare costs between the survey Pra and the administrative proxy for both respondents and nonrespondents.

Conclusions:

  • The survey Pra had a limited response rate (53%), impacting its practical utility for screening this population.
  • The administrative proxy demonstrated comparable performance to the survey Pra and was applicable to nonrespondents.
  • While database screening has time-lag limitations, combining survey-based and database-driven approaches may enhance the targeting of patients for case management interventions.