PMID- 30578532
OWN - NLM
STAT- MEDLINE
DCOM- 20200130
LR  - 20200309
IS  - 1532-5415 (Electronic)
IS  - 0002-8614 (Print)
IS  - 0002-8614 (Linking)
VI  - 67
IP  - 2
DP  - 2019 Feb
TI  - Home Time as a Patient-Centered Outcome in Administrative Claims Data.
PG  - 347-351
LID - 10.1111/jgs.15705 [doi]
AB  - BACKGROUND: Home time, the number of days alive and spent out of hospital and 
      skilled nursing facility, has been proposed as a patient-centered outcome that 
      can be readily calculated in administrative claims data. OBJECTIVES: To compare 
      home time against existing patient-centered outcome measures. DESIGN: 
      Retrospective cohort study. SETTING: Community. PARTICIPANTS: A total of 4594 
      Medicare beneficiaries 65 years or older with complete survey and claims data in 
      the Medicare Current Beneficiary Survey 2010 to 2011. MEASUREMENTS: Home time was 
      calculated from the 2011 claims data (range, 0-365 days). The 1-year incidence of 
      patient-centered outcomes (poor self-rated health, mobility impairment, 
      depression, limited social activity, and difficulty in self-care) was measured. 
      The minimum clinically important difference (MCID) was derived by contrasting the 
      mean home time between those who experienced functional decline or death and 
      those who did not. RESULTS: The mean home time was 355.8 days (SD, 42.1 days); 
      84.1% had a home time of 365 days, and 5.7% had a home time of 336 days or fewer. 
      The incidence of poor self-rated health ranged from 2% (home time, 365 days) to 
      21% (home time, less than 337 days). Similarly, the corresponding incidence risks 
      were 11% to 59% for mobility impairment, 5% to 19% for depression, 17% to 67% for 
      limited social activity, and 13% to 68% for difficulty in self-care. The risk of 
      mobility impairment, depression, and difficulty in self-care increased steeply 
      after home time loss of 15 days or greater. The MCID of home time was 18.6 days. 
      CONCLUSION: A loss in home time is associated with decline in several 
      patient-centered outcome measures in community-dwelling Medicare beneficiaries. 
      These results provide empirical evidence to promote adoption of home time and its 
      clinical interpretation for database studies of medical interventions. J Am 
      Geriatr Soc 67:347-351, 2019.
CI  - (c) 2018 The American Geriatrics Society.
FAU - Lee, Hemin
AU  - Lee H
AD  - Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, 
      Brigham and Women's Hospital, Boston, Massachusetts.
FAU - Shi, Sandra M
AU  - Shi SM
AUID- ORCID: 0000-0001-6801-5602
AD  - Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical 
      Center, Boston, Massachusetts.
AD  - Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts.
FAU - Kim, Dae Hyun
AU  - Kim DH
AUID- ORCID: 0000-0001-7290-6838
AD  - Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, 
      Brigham and Women's Hospital, Boston, Massachusetts.
AD  - Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical 
      Center, Boston, Massachusetts.
AD  - Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts.
LA  - eng
GR  - K08 AG051187/AG/NIA NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20181221
PL  - United States
TA  - J Am Geriatr Soc
JT  - Journal of the American Geriatrics Society
JID - 7503062
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Insurance Claim Review/*statistics & numerical data
MH  - Male
MH  - Medicare/statistics & numerical data
MH  - Outcome Assessment, Health Care/*methods
MH  - Patient Discharge/statistics & numerical data
MH  - Patient-Centered Care/*statistics & numerical data
MH  - Retrospective Studies
MH  - Skilled Nursing Facilities/statistics & numerical data
MH  - *Time Factors
MH  - United States
PMC - PMC6367008
MID - NIHMS998992
OTO - NOTNLM
OT  - administrative claims data
OT  - home time
OT  - patient-centered outcome
EDAT- 2018/12/24 06:00
MHDA- 2020/01/31 06:00
PMCR- 2020/02/01
CRDT- 2018/12/23 06:00
PHST- 2018/10/14 00:00 [received]
PHST- 2018/10/15 00:00 [accepted]
PHST- 2018/12/24 06:00 [pubmed]
PHST- 2020/01/31 06:00 [medline]
PHST- 2018/12/23 06:00 [entrez]
PHST- 2020/02/01 00:00 [pmc-release]
AID - 10.1111/jgs.15705 [doi]
PST - ppublish
SO  - J Am Geriatr Soc. 2019 Feb;67(2):347-351. doi: 10.1111/jgs.15705. Epub 2018 Dec 
      21.