A mailed questionnaire successfully identified older Medicaid recipients at high risk for hospitalization, who used hospitals at approximately twice the rate of low-risk subjects (4.5 vs 2.4 days/person-year, P=.009).
Cohort
No
Does a mailed questionnaire predicting probability of repeated admission accurately identify older Medicaid recipients at high risk for hospital use?
A brief, mailed questionnaire can prospectively identify older Medicaid beneficiaries at high risk for heavy hospital use, allowing for targeted preventive interventions.
Absolute Event Rate: 4.5% vs 2.4%
p-value: p=.009
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 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.
Pacala et al. (1995) conducted a cohort in Risk of repeated hospitalization. High-risk classification (Pra ≥ 0.5) via mailed questionnaire vs. Low-risk classification (Pra < 0.5) was evaluated on Actual use of hospitals (days/person-year) (p=.009). A mailed questionnaire successfully identified older Medicaid recipients at high risk for hospitalization, who used hospitals at approximately twice the rate of low-risk subjects (4.5 vs 2.4 days/person-year, P=.009).