ArticleJournal of the American Geriatrics Society2023
Identifying Medicare beneficiaries with Alzheimer's disease and related dementia using home health OASIS assessments.
Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Applying the Brief Interview for Mental Status in a Diverse Home Health Patient Population.Journal of the American Medical Directors Association · 2026Article
- Patient-Driven Grouping Model and Home Health Use Among Traditional Medicare Beneficiaries.Journal of the American Medical Directors Association · 2026Article
- Lithium therapy and delayed progression of Alzheimer's disease and related dementias in patients with bipolar disorder and mild neurocognitive disorders.medRxiv : the preprint server for health sciences · 2026Article
- Dementia Severity Associated With Unmet Caregiving Needs During Skilled Home Health Care.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- Home Health Focus: A New Publicly Available Dataset to Study Community-Dwelling Populations Receiving Home Health Services.Annals of family medicine · 2025Article
- Undocumented Dementia Diagnosis During Skilled Home Health Care: Prevalence and Associated Factors.Journal of the American Geriatrics Society · 2025Article
- Home Health Care Use Among Medicare Beneficiaries From 2010 to 2020.Medical care research and review : MCRR · 2025Article
- Factors associated with change in activities of daily living performance in home health care patients with diabetes.Geriatric nursing (New York, N.Y.)Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundHome health services are an important site of care following hospitalization among Medicare beneficiaries, providing health assessments that can be leveraged to detect diagnoses that are not available in other data sources. In this work, we aimed to develop a parsimonious and accurate algorithm using home health outcome and assessment information set (OASIS) measures to identify Medicare beneficiaries with a diagnosis of Alzheimer's disease and related dementia (ADRD).
methodsWe conducted a retrospective cohort study of Medicare beneficiaries with a complete OASIS start of care assessment in 2014, 2016, 2018, or 2019 to determine how well the items from various versions could identify those with an ADRD diagnosis by the assessment date. The prediction model was developed iteratively, comparing the performance of different models in terms of sensitivity, specificity, and accuracy of prediction, from a multivariable logistic regression model using clinically relevant variables, to regression models with all available variables and predictive modeling techniques, to estimate the best performing parsimonious model.
resultsThe most important predictors of having a diagnosis of ADRD by the start of care OASIS assessment were a prior discharge diagnosis of ADRD among those admitted from an inpatient setting, and frequently exhibiting symptoms of confusion. Results from the parsimonious model were consistent across the four annual cohorts and OASIS versions with high specificity (above 96%), but poor sensitivity (below 58%). The positive predictive value was high, over 87% across study years.
conclusionsThe proposed algorithm has high accuracy, requires a single OASIS assessment, is easy to implement without sophisticated statistical models, and can be used across four OASIS versions and in situations where claims are not available to identify individuals with a diagnosis of ADRD, including the growing population of Medicare Advantage beneficiaries.
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