@article{ref1,
title="Identification of fall-related injuries in nursing home residents using administrative claims data",
journal="Journals of gerontology. Series A: Biological sciences and medical sciences",
year="2021",
author="Mintz, Joel and Duprey, Matthew S. and Zullo, Andrew R. and Lee, Yoojin and Kiel, Douglas P. and Daiello, Lori A. and Rodriguez, Kenneth E. and Venkatesh, Arjun K. and Berry, Sarah D.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Fall-related injuries (FRIs) are a leading cause of morbidity, mortality, and costs among nursing home (NH) residents. Carefully defining FRIs in administrative data is essential for improving injury-reduction efforts. We developed a series of novel claims-based algorithms for identifying FRIs in long-stay NH residents. <br><br>METHODS: This is a retrospective cohort of residents of NH residing there for ≥100 days who were continuously enrolled in Medicare Parts A and B in 2016. FRIs were identified using four claims-based case-qualifying (CQ) definitions [Inpatient (CQ1), Outpatient and Provider with Procedure (CQ2), Outpatient and Provider with Fall (CQ3), or Inpatient or Outpatient and Provider with Fall (CQ4)]. Correlation was calculated using phi correlation coefficients. <br><br>RESULTS: Of 153,220 residents (mean [SD] age 81.2 [12.1], 68.0% female), we identified 10,104 with at least one FRI according to one or more CQ definition. Among 2,950 residents with hip fractures, 1,852 (62.8%) were identified by all algorithms. Algorithm CQ4 (n=326 to 2,775) identified more FRIs across all injuries while CQ1 identified less (n=21 to 2,320). CQ2 identified more intracranial bleeds (1,028 v. 448) than CQ1. For non-fracture categories, few FRIs were identified using CQ1 (n= 20 to 488). Of the 2,320 residents with hip fractures identified by CQ1, 2,145 (92.5%) had external cause of injury codes. All algorithms were strongly correlated, with phi coefficients ranging from 0.82-0.99. <br><br>CONCLUSIONS: Claims-based algorithms applied to outpatient and provider claims identify more non-fracture FRIs. When identifying risk factors, stakeholders should select the algorithm(s) suitable for the FRI and study purpose.<p /> <p>Language: en</p>",
language="en",
issn="1079-5006",
doi="10.1093/gerona/glab274",
url="http://dx.doi.org/10.1093/gerona/glab274"
}