Accurate identification of hospital admissions from care homes; development and validation of an automated algorithm

Background: measuring the complex needs of care home residents is crucial for resource allocation. Hospital patient administration systems (PAS) may not accurately identify admissions from care homes. Objective: to develop and validate an accurate, practical method of identifying care home resident...

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Main Authors: Housley, Gemma, Lewis, Sarah, Usman, Adeela, Gordon, Adam L., Shaw, Dominick E.
Format: Article
Published: Oxford University Press 2017
Subjects:
Online Access:https://eprints.nottingham.ac.uk/48905/
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author Housley, Gemma
Lewis, Sarah
Usman, Adeela
Gordon, Adam L.
Shaw, Dominick E.
author_facet Housley, Gemma
Lewis, Sarah
Usman, Adeela
Gordon, Adam L.
Shaw, Dominick E.
author_sort Housley, Gemma
building Nottingham Research Data Repository
collection Online Access
description Background: measuring the complex needs of care home residents is crucial for resource allocation. Hospital patient administration systems (PAS) may not accurately identify admissions from care homes. Objective: to develop and validate an accurate, practical method of identifying care home resident hospital admission using routinely collected PAS data. Method: admissions data between 2011 and 2012 (n = 103,105) to an acute Trust were modelled to develop an automated tool which compared the hospital PAS address details with the Care Quality Commission’s (CQC) database, producing a likelihood of care home residency. This tool and the Nuffield method (CQC postcode match only) were validated against a manual check of a random sample of admissions (n = 2,000). A dataset from a separate Trust was analysed to assess generalisability. Results:the hospital PAS was inaccurate; none of the admissions from a care home identified on manual check had a care home source of admission recorded on the PAS. Both methods performed well; the automated tool had a higher positive predictive value than the Nuffield method (100% 95% confidence interval (CI) 98.23–100% versus 87.10% 95%CI 82.28–91.00%), meaning those coded as care home residents were more likely to actually be from a care home. Our automated tool had a high level of agreement 99.2% with the second Trust’s data (Kappa 0.86 P < 0.001). Conclusions: care home status is not routinely or accurately captured. Automated matching offers an accurate, repeatable, scalable method to identify care home residency and could be used as a tool to benchmark how care home residents use acute hospital resources across the National Health Service.
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spelling nottingham-489052020-05-04T19:22:59Z https://eprints.nottingham.ac.uk/48905/ Accurate identification of hospital admissions from care homes; development and validation of an automated algorithm Housley, Gemma Lewis, Sarah Usman, Adeela Gordon, Adam L. Shaw, Dominick E. Background: measuring the complex needs of care home residents is crucial for resource allocation. Hospital patient administration systems (PAS) may not accurately identify admissions from care homes. Objective: to develop and validate an accurate, practical method of identifying care home resident hospital admission using routinely collected PAS data. Method: admissions data between 2011 and 2012 (n = 103,105) to an acute Trust were modelled to develop an automated tool which compared the hospital PAS address details with the Care Quality Commission’s (CQC) database, producing a likelihood of care home residency. This tool and the Nuffield method (CQC postcode match only) were validated against a manual check of a random sample of admissions (n = 2,000). A dataset from a separate Trust was analysed to assess generalisability. Results:the hospital PAS was inaccurate; none of the admissions from a care home identified on manual check had a care home source of admission recorded on the PAS. Both methods performed well; the automated tool had a higher positive predictive value than the Nuffield method (100% 95% confidence interval (CI) 98.23–100% versus 87.10% 95%CI 82.28–91.00%), meaning those coded as care home residents were more likely to actually be from a care home. Our automated tool had a high level of agreement 99.2% with the second Trust’s data (Kappa 0.86 P < 0.001). Conclusions: care home status is not routinely or accurately captured. Automated matching offers an accurate, repeatable, scalable method to identify care home residency and could be used as a tool to benchmark how care home residents use acute hospital resources across the National Health Service. Oxford University Press 2017-12-18 Article PeerReviewed Housley, Gemma, Lewis, Sarah, Usman, Adeela, Gordon, Adam L. and Shaw, Dominick E. (2017) Accurate identification of hospital admissions from care homes; development and validation of an automated algorithm. Age and Ageing . ISSN 0002-0729 care homes algorithm secondary care informatics patient admission older people https://academic.oup.com/ageing/advance-article/doi/10.1093/ageing/afx182/4757114 doi:10.1093/ageing/afx182 doi:10.1093/ageing/afx182
spellingShingle care homes
algorithm
secondary care
informatics
patient admission
older people
Housley, Gemma
Lewis, Sarah
Usman, Adeela
Gordon, Adam L.
Shaw, Dominick E.
Accurate identification of hospital admissions from care homes; development and validation of an automated algorithm
title Accurate identification of hospital admissions from care homes; development and validation of an automated algorithm
title_full Accurate identification of hospital admissions from care homes; development and validation of an automated algorithm
title_fullStr Accurate identification of hospital admissions from care homes; development and validation of an automated algorithm
title_full_unstemmed Accurate identification of hospital admissions from care homes; development and validation of an automated algorithm
title_short Accurate identification of hospital admissions from care homes; development and validation of an automated algorithm
title_sort accurate identification of hospital admissions from care homes; development and validation of an automated algorithm
topic care homes
algorithm
secondary care
informatics
patient admission
older people
url https://eprints.nottingham.ac.uk/48905/
https://eprints.nottingham.ac.uk/48905/
https://eprints.nottingham.ac.uk/48905/