Identifying observable medication use time in administrative databases: a tutorial using nursing home residents.
Nursing home (NH) residents are an important population for pharmacoepidemiologic research due to their prevalence of multimorbidity and polypharmacy. Medicare claims are commonly used to study medication use in this population, but medications dispensed during hospitalizations or post-acute care ar...
| Publicado en: | American Journal of Epidemiology Vol. 195; no. 2; pp. 587 - 596 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Feb2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191385325&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 191385325 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00029262 1X1 jtl: American Journal of Epidemiology issn: 00029262 maglogo: N pubinfo: dt: Feb2026 vid: 195 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 191385325 191385325 191385325 10.1093/aje/kwaf227 191385325 ppf: 587 ppct: 9 formats: tig: atl: Identifying observable medication use time in administrative databases: a tutorial using nursing home residents. aug: au: Harris, Daniel A D'Amico, Adam Mehta, Hemalkumar B Daiello, Lori A Berry, Sarah D Leonard, Charles E Hsu, Yu-Chia Kiel, Douglas Hayes, Kaleen N Riester, Melissa affil: Department of Epidemiology, College of Health Sciences, University of Delaware, Newark, DE, United StatesDepartment of Health Services, Policy, and Practice, School of Public Health, Brown University, Providence, RI, United States sug: subj: Drugs, Prescription Nursing Home Residents United States Medicare Billing and Claims Human Comorbidity Polypharmacy Algorithms United States Fee for Service Plans Patient Admission Aging Aged Male Female Sociodemographic Factors Length of Stay Data Analysis Software Descriptive Statistics Funding Source Medication Compliance Aged: 65+ years Male Female ab: Nursing home (NH) residents are an important population for pharmacoepidemiologic research due to their prevalence of multimorbidity and polypharmacy. Medicare claims are commonly used to study medication use in this population, but medications dispensed during hospitalizations or post-acute care are unobservable due to bundled payment structures. We developed algorithms to identify NH days when medication dispensings can be observed in claims. Using a cohort of NH residents in the United States from 2013 to 2020, we linked Medicare fee-for-service (FFS) claims with Minimum Data Set clinical assessments. NH days were classified as "observable medication use time" if residents were enrolled in Medicare parts A, B, and D were not receiving post-acute care and were not hospitalized. Among 12.3 million NH residents and 2.7 billion NH days, 1.1 billion days (72.4% of Medicare-enrolled days and 39.6% of all NH days) were identified as observable medication use time. Within the first 100 days of NH admission, 27.3% of days were medication-observable, increasing to 89.4% after 100 days. On average, we identified 68% more person-time, and 51% more residents, compared to standard 100-day definitions for "long-stay" NH residents. Our algorithms enhance researchers' ability to measure medication exposure time, improving the validity of pharmacoepidemiologic studies. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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