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...

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Publicado en:American Journal of Epidemiology Vol. 195; no. 2; pp. 587 - 596
Autores principales: 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
Formato: research tables/charts Journal Article
Publicado: Oxford University Press / USA Feb2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2026
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      pub: Oxford University Press / USA
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        atl: Identifying observable medication use time in administrative databases: a tutorial using nursing home residents.
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        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
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