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

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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

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Abstract

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.

Item Type: Article
RIS ID: https://nottingham-repository.worktribe.com/output/900375
Keywords: care homes, algorithm, secondary care, informatics, patient admission, older people
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Epidemiology and Public Health
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Respiratory Medicine
Identification Number: https://doi.org/10.1093/ageing/afx182
Depositing User: Claringburn, Tara
Date Deposited: 03 Jan 2018 12:19
Last Modified: 04 May 2020 19:22
URI: https://eprints.nottingham.ac.uk/id/eprint/48905

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