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Evaluating pressure ulcer occurrence in long-term care: pitfalls in interpreting administrative data
D R Berlowitz1, G H Brandeis, H K Brand
1HSR&D Field Program, Bedford Veterans Affairs Medical Center, Bedford, MA 01730, USA.
Journal of Clinical Epidemiology
|March 1, 1996
Summary
Administrative data can obscure pressure ulcer development in long-term care. Selective patient discharge biases findings, making early and later assessments noncomparable and requiring careful interpretation of administrative data.
Area of Science:
- Gerontology
- Health Services Research
- Clinical Informatics
Background:
- Administrative databases for long-term care often use fixed assessment dates, leading to lost follow-up for discharged or deceased patients.
- This data collection method may not accurately capture the full patient experience or disease progression over an entire care episode.
Purpose of the Study:
- To examine pressure ulcer occurrence in long-term care using administrative data.
- To assess the validity of administrative data for tracking pressure ulcer development, considering potential biases.
Main Methods:
- Utilized the VA Patient Assessment File, an administrative database for long-term care.
- Analyzed pressure ulcer occurrence based on assessment timing (within 2 months vs. 3-6 months post-admission).
Main Results:
- Pressure ulcer development appeared less common in patients assessed within 2 months of admission compared to those assessed later.
- This discrepancy is likely due to selective patient discharge, creating noncomparable patient groups.
Conclusions:
- Interpreting pressure ulcer data from administrative databases requires caution due to potential biases from fixed assessment dates and selective discharge.
- Findings suggest that administrative data may not accurately reflect true pressure ulcer incidence without careful consideration of follow-up loss and patient selection.