Gilbert G H, Branch L G, Orav E J
Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville.
Health Serv Res. 1992 Feb;26(6):787-800.
Homebound status is a critical eligibility criterion for Medicare reimbursement of some home care services, yet little discussion has been undertaken to establish a valid definition of it. We propose an operational definition of homebound status, and we measure its validity for community-dwelling elderly in the Massachusetts Health Care Panel Study (MHCPS). The MHCPS is a longitudinal study of a cohort of elderly persons (N = 1,625), which began in 1974, with follow-up surveys in 1976, 1980, and 1985. Validity was measured by comparing responses from the operational measure to persons' responses to questions that we judged should be associated with a valid measure of homebound status. This construct validity method resulted in correlations that were significant and in the expected direction, and that suggested that this operational measure is a highly specific, moderately sensitive, valid measure. These results underscore the need for researchers investigating the homebound to discuss the validity and limitations of their homebound measures, and in what context these measures are useful.
居家状态是医疗保险对某些居家护理服务进行报销的一项关键资格标准，但对于如何确立其有效定义却鲜有讨论。我们提出了居家状态的操作性定义，并在马萨诸塞州医疗保健小组研究（MHCPS）中对其在社区居住老年人中的有效性进行了测量。MHCPS是一项对一组老年人（N = 1625）进行的纵向研究，始于1974年，并在1976年、1980年和1985年进行了随访调查。通过将操作性测量的回答与人们对我们认为应与有效居家状态测量相关的问题的回答进行比较来衡量有效性。这种结构效度方法产生了显著且符合预期方向的相关性，这表明该操作性测量是一种高度特异、中度敏感的有效测量。这些结果强调，研究居家状态的研究人员有必要讨论其居家状态测量方法的有效性和局限性，以及这些测量方法在何种背景下有用。
