Efficacy of nursing home preadmission screening

This study evaluates the efficacy of four state nursing home preadmission screening instruments. Using data from three community-based services demonstration experiments, the screens were compared on measures of sensitivity, specificity, and proportions of false negatives and false positives. Results indicate that the more restrictive screens tended to have lower sensitivity but higher specificity, and to generate a higher proportion of false negative decisions than the more liberal screens. Overall rates of correct prediction were higher for the more restrictive screens. Results highlight differences in eligibility restrictiveness across states as well as possible tradeoffs of cost containment and access in designing a preadmission screen.