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How well does the minimum data set measure healthcare use? a validation study.

Malcolm B Doupe1,2, Jeff Poss3, Peter G Norton4

  • 1Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, 408-727 McDermot Avenue, Winnipeg, MB, R3E 3P5, Canada. Malcolm_doupe@cpe.umanitoba.ca.

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PubMed
Summary

The Minimum Data Set (MDS) accurately tracks nursing home (NH) resident admissions, transfers, and deaths. However, MDS data is less accurate for healthcare use, necessitating combined data sources for comprehensive research.

Keywords:
Healthcare useMDS recordsNursing homesValidation

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Area of Science:

  • Gerontology
  • Health Services Research
  • Data Science in Healthcare

Background:

  • Accurate data on nursing home (NH) residents and their healthcare utilization is crucial for care planning.
  • The Minimum Data Set (MDS) and administrative data are key sources for this information.
  • Evaluating the accuracy of MDS compared to administrative data for capturing resident status and healthcare use is essential.

Purpose of the Study:

  • To compare the accuracy of the Minimum Data Set (MDS) with administrative data in capturing nursing home (NH) resident status and healthcare use.
  • To assess the reliability of MDS for tracking NH admissions, transfers, deaths, and healthcare utilization metrics.

Main Methods:

  • A retrospective observational cohort study of 8832 NH residents in Winnipeg, Manitoba, from 2011 to 2013.
  • Compared MDS data with administrative data for NH user status (admission, transfer, death) and healthcare use (hospitalizations, ED visits, physician exams).
  • Calculated sensitivity, specificity, PPV, NPV, and kappa (κ) to evaluate agreement, using administrative data as the reference.

Main Results:

  • MDS demonstrated high accuracy for resident status: newly admitted (κ=0.97), transfers (κ=0.90), and deaths (κ=0.95).
  • Healthcare use measures were less accurate in MDS, showing under-reporting and false positives (e.g., hospitalization sensitivity=0.58, PPV=0.45).
  • Overall agreement for healthcare use was moderate (e.g., ED visits κ=0.39), with higher disagreement in for-profit facilities and among younger males.

Conclusions:

  • MDS is a reliable standalone tool for tracking basic nursing home (NH) resident transitions (admission, transfer, death).
  • MDS alone is insufficient for accurately capturing NH resident healthcare use compared to administrative data.
  • Future research on NH resident healthcare transitions should integrate both MDS and administrative data systems for comprehensive insights.