Pacala J T, Boult C, Boult L
Department of Family Practice and Community Health, University of Minnesota Medical School, Minneapolis, USA.
J Am Geriatr Soc. 1995 Apr;43(4):374-7. doi: 10.1111/j.1532-5415.1995.tb05810.x.
To determine the predictive validity of a mailed questionnaire designed to measure older adults' risk of repeated hospitalization.
Prospective cohort study.
Ramsey County, Minnesota.
Medicaid recipients aged 70 and older who completed the questionnaire.
Responses were used to calculate the subjects' probability of repeated admission (Pra) to hospitals within 4 years. Subjects were classified as low-risk (Pra < 0.5) or high risk (Pra > or = 0.5). One year later, Medicaid claims data were analyzed to determine the subjects' actual use of hospitals.
One-fifth of the respondents (20.6%) were classified as high-risk at baseline. During the following year, the high-risk subjects used hospitals at approximately twice the rate of the low-risk subjects (4.5 vs 2.4 days/person-year, P = .009).
The instrument, which was previously found to be valid in a national sample of Medicare beneficiaries, appears to be valid also in a local sample of Medicaid beneficiaries. Older adults at risk of heavy hospital use can be identified prospectively through their responses to this brief, mailed, self-administered questionnaire. The instrument may be useful in targeting older persons for interventions designed to prevent the need for hospital care.
确定一份旨在测量老年人再次住院风险的邮寄问卷的预测效度。
前瞻性队列研究。
明尼苏达州拉姆齐县。
完成问卷的70岁及以上医疗补助受助者。
用回答来计算研究对象在4年内再次入院的概率（Pra）。研究对象被分为低风险（Pra < 0.5）或高风险（Pra ≥ 0.5）。一年后，分析医疗补助索赔数据以确定研究对象实际的住院情况。
五分之一的受访者（20.6%）在基线时被归类为高风险。在接下来的一年里，高风险研究对象的住院使用率约为低风险研究对象的两倍（4.5天/人年对2.4天/人年，P = 0.009）。
该工具先前在全国医疗保险受益人的样本中被证明是有效的，在当地医疗补助受益人的样本中似乎也有效。通过对这份简短的、邮寄的、自我填写的问卷的回答，可以前瞻性地识别出有大量住院风险的老年人。该工具可能有助于针对老年人进行干预，以防止住院治疗的需求。
