Tags

Type your tag names separated by a space and hit enter

Impact of patient selection criteria on prevalence estimates and prevalence of diagnosed dementia in a Medicaid population.
Alzheimer Dis Assoc Disord. 2007 Apr-Jun; 21(2):92-100.AD

Abstract

OBJECTIVES

This study estimated the prevalence of diagnosed dementia among Indiana Medicaid beneficiaries in 2004. The dependence of prevalence estimates upon use of several patient selection criteria to identify patients with dementia also was evaluated.

METHODS

Indiana Medicaid claims data were analyzed for the period July 1, 2002 to December 31, 2004. An expert panel survey was conducted to assess perceived specificity of ICD codes used in previous studies to define dementia. Prevalence estimates were calculated with varying levels of each selection criteria, that is, ICD code set, interval of data examined, and number of occurrences of dementia-related claims. To assess specificity and sensitivity of the dementia patient selection criteria, Minimum Data Set data for a subset of beneficiaries that resided in a nursing home any time in 2004 were examined.

RESULTS

Depending on the patient selection criteria used, estimates of prevalence of diagnosed dementia for individuals 40 years old or older varied from 7.7% to 15.3%, whereas prevalence estimates for individuals 60 years old or older varied from 14.5% to 26.6%. When the following selection criteria were used: (1) occurrence of one or more dementia-related claims, (2) the expert panel ICD set, and (3) up to 30 months of data for defining dementia, the prevalence estimates in the Indiana Medicaid population were 10.9% for individuals 40 years old or older and 20.3% for individuals 60 years old or older.

CONCLUSIONS

Careful selection of claims-based criteria for identifying patients with dementia is important because the criteria may affect estimates by 100%. Prevalence of diagnosed dementia among Indiana Medicaid beneficiaries was 3 to 4 times higher than the reported prevalence from a decade ago in Medicaid populations of other states, even when the same patient selection criteria were used. A number of factors beyond increased occurrence of the disease including increased screening, greater likelihood of recording dementia codes in claims, or other factors may be responsible. The combination of patient selection criteria used in this study had good sensitivity, specificity, and accuracy when compared with Minimum Data Set data.

Authors+Show Affiliations

Quintiles Strategic Research and Safety, Falls Church, VA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17545733

Citation

Bharmal, Murtuza F., et al. "Impact of Patient Selection Criteria On Prevalence Estimates and Prevalence of Diagnosed Dementia in a Medicaid Population." Alzheimer Disease and Associated Disorders, vol. 21, no. 2, 2007, pp. 92-100.
Bharmal MF, Weiner M, Sands LP, et al. Impact of patient selection criteria on prevalence estimates and prevalence of diagnosed dementia in a Medicaid population. Alzheimer Dis Assoc Disord. 2007;21(2):92-100.
Bharmal, M. F., Weiner, M., Sands, L. P., Xu, H., Craig, B. A., & Thomas, J. (2007). Impact of patient selection criteria on prevalence estimates and prevalence of diagnosed dementia in a Medicaid population. Alzheimer Disease and Associated Disorders, 21(2), 92-100.
Bharmal MF, et al. Impact of Patient Selection Criteria On Prevalence Estimates and Prevalence of Diagnosed Dementia in a Medicaid Population. Alzheimer Dis Assoc Disord. 2007 Apr-Jun;21(2):92-100. PubMed PMID: 17545733.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of patient selection criteria on prevalence estimates and prevalence of diagnosed dementia in a Medicaid population. AU - Bharmal,Murtuza F, AU - Weiner,Michael, AU - Sands,Laura P, AU - Xu,Huiping, AU - Craig,Bruce A, AU - Thomas,Joseph,3rd PY - 2007/6/5/pubmed PY - 2007/9/27/medline PY - 2007/6/5/entrez SP - 92 EP - 100 JF - Alzheimer disease and associated disorders JO - Alzheimer Dis Assoc Disord VL - 21 IS - 2 N2 - OBJECTIVES: This study estimated the prevalence of diagnosed dementia among Indiana Medicaid beneficiaries in 2004. The dependence of prevalence estimates upon use of several patient selection criteria to identify patients with dementia also was evaluated. METHODS: Indiana Medicaid claims data were analyzed for the period July 1, 2002 to December 31, 2004. An expert panel survey was conducted to assess perceived specificity of ICD codes used in previous studies to define dementia. Prevalence estimates were calculated with varying levels of each selection criteria, that is, ICD code set, interval of data examined, and number of occurrences of dementia-related claims. To assess specificity and sensitivity of the dementia patient selection criteria, Minimum Data Set data for a subset of beneficiaries that resided in a nursing home any time in 2004 were examined. RESULTS: Depending on the patient selection criteria used, estimates of prevalence of diagnosed dementia for individuals 40 years old or older varied from 7.7% to 15.3%, whereas prevalence estimates for individuals 60 years old or older varied from 14.5% to 26.6%. When the following selection criteria were used: (1) occurrence of one or more dementia-related claims, (2) the expert panel ICD set, and (3) up to 30 months of data for defining dementia, the prevalence estimates in the Indiana Medicaid population were 10.9% for individuals 40 years old or older and 20.3% for individuals 60 years old or older. CONCLUSIONS: Careful selection of claims-based criteria for identifying patients with dementia is important because the criteria may affect estimates by 100%. Prevalence of diagnosed dementia among Indiana Medicaid beneficiaries was 3 to 4 times higher than the reported prevalence from a decade ago in Medicaid populations of other states, even when the same patient selection criteria were used. A number of factors beyond increased occurrence of the disease including increased screening, greater likelihood of recording dementia codes in claims, or other factors may be responsible. The combination of patient selection criteria used in this study had good sensitivity, specificity, and accuracy when compared with Minimum Data Set data. SN - 0893-0341 UR - https://www.unboundmedicine.com/medline/citation/17545733/Impact_of_patient_selection_criteria_on_prevalence_estimates_and_prevalence_of_diagnosed_dementia_in_a_Medicaid_population_ L2 - https://doi.org/10.1097/WAD.0b013e31805c0835 DB - PRIME DP - Unbound Medicine ER -