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Predictive validity of a questionnaire that identifies older persons at risk for hospital admission
1Department of Family Practice and Community Health, University of Minnesota Medical School, Minneapolis, USA.
Objective:
To determine the predictive validity of a mailed questionnaire designed to measure older adults' risk of repeated hospitalization.
Design:
Prospective cohort study.
Setting:
Ramsey County, Minnesota.
Participants:
Medicaid recipients aged 70 and older who completed the questionnaire.
Measurements:
Responses were used to calculate the subjects' probability of repeated admission (Pra) to hospitals within 4 years. Subjects were classified as low-risk (Pra < 0.5) or high risk (Pra > or = 0.5). One year later, Medicaid claims data were analyzed to determine the subjects' actual use of hospitals.
Results:
One-fifth of the respondents (20.6%) were classified as high-risk at baseline. During the following year, the high-risk subjects used hospitals at approximately twice the rate of the low-risk subjects (4.5 vs 2.4 days/person-year, P = .009).
Conclusions:
The instrument, which was previously found to be valid in a national sample of Medicare beneficiaries, appears to be valid also in a local sample of Medicaid beneficiaries. Older adults at risk of heavy hospital use can be identified prospectively through their responses to this brief, mailed, self-administered questionnaire. The instrument may be useful in targeting older persons for interventions designed to prevent the need for hospital care.
