Can Older Adults Accurately Report Their Use of Physical Rehabilitation Services?

Vicki A. Freedman, Judith D. Kasper, Alan Jette

Research output: Contribution to journalArticle

Abstract

Objective: To explore the accuracy of rehabilitation service use reports by older adults as well as variation in accuracy by demographic characteristics, time since use, duration, and setting (inpatient, outpatient, home). Design: Longitudinal observational study. Setting: Participants' homes. Participants: Community-dwelling adults ages 65 and older (N=4228) in the 2015 National Health and Aging Trends Study who were enrolled in Medicare Parts A and B for 12 months before their interview. Interventions: Not applicable. Main Outcome Measures: Respondents were asked whether they received rehabilitation services in the past year and the duration and location of services. Healthcare Common Procedure Coding System codes and Revenue Center codes were used to identify Medicare-eligible rehabilitation service. Results: Survey-based reports and Medicare claims yielded similar estimates of rehabilitation use over the past year. Self-reported measures had high sensitivity (77%) and positive predictive value (80%) and even higher specificity and negative predictive value (approaching 95%). However, in adjusted models, sensitivity was lower for black enrollees, the very old, and those with lower education levels. Conclusions: Survey-based measures of rehabilitation accurately captured use over the past year, but differential reporting should be considered when characterizing rehabilitation use in certain subgroups of older Americans.

Original languageEnglish (US)
JournalArchives of Physical Medicine and Rehabilitation
DOIs
StateAccepted/In press - Jan 1 2018

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Rehabilitation
Medicare
Healthcare Common Procedure Coding System
Medicare Part A
Medicare Part B
Independent Living
Observational Studies
Longitudinal Studies
Inpatients
Outpatients
Demography
Outcome Assessment (Health Care)
Interviews
Education
Health
Surveys and Questionnaires

Keywords

  • Aging
  • Health surveys
  • Methods
  • Rehabilitation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

Can Older Adults Accurately Report Their Use of Physical Rehabilitation Services? / Freedman, Vicki A.; Kasper, Judith D.; Jette, Alan.

In: Archives of Physical Medicine and Rehabilitation, 01.01.2018.

Research output: Contribution to journalArticle

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abstract = "Objective: To explore the accuracy of rehabilitation service use reports by older adults as well as variation in accuracy by demographic characteristics, time since use, duration, and setting (inpatient, outpatient, home). Design: Longitudinal observational study. Setting: Participants' homes. Participants: Community-dwelling adults ages 65 and older (N=4228) in the 2015 National Health and Aging Trends Study who were enrolled in Medicare Parts A and B for 12 months before their interview. Interventions: Not applicable. Main Outcome Measures: Respondents were asked whether they received rehabilitation services in the past year and the duration and location of services. Healthcare Common Procedure Coding System codes and Revenue Center codes were used to identify Medicare-eligible rehabilitation service. Results: Survey-based reports and Medicare claims yielded similar estimates of rehabilitation use over the past year. Self-reported measures had high sensitivity (77{\%}) and positive predictive value (80{\%}) and even higher specificity and negative predictive value (approaching 95{\%}). However, in adjusted models, sensitivity was lower for black enrollees, the very old, and those with lower education levels. Conclusions: Survey-based measures of rehabilitation accurately captured use over the past year, but differential reporting should be considered when characterizing rehabilitation use in certain subgroups of older Americans.",
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