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Changes in the agreement between the Minimum Data Set and hospital Medicare claims measures of dementia
Cassandra L. Hua, Kali S. Thomas, Jennifer Bunker, Pedro L. Gozalo, Joan M. Teno. Journal of the American Geriatrics Society, 2021-04-30
Topic: Risk, prevention and care in population studies
The agreement between the two measures of dementia differed by age: in 2017, 79.2% of hospital claims for patients aged 66–74 had a diagnosis of dementia compared to older age categories that had dementia noted in over 85% of records. Compared to white patients, Asian patients were less likely to have a diagnosis of dementia noted. Approximately 84.2% of hospital records from Asian patients had a diagnosis of dementia compared to 86.6% of records from white patients in 2017. The overall increase in the accuracy of hospital claims may indicate that clinicians are recognizing dementia at higher rates in this setting. The remaining lack of documentation may be caused by physicians attributing cognitive problems to "normal aging" or prioritizing the documentation of physical ailments.9 Overall, there are encouraging signs that the gaps across age and race groups have narrowed over time; they do persist and warrant further attention. The funder had no role in the design or interpretation of the results.
Key findings
- The agreement between the two measures of dementia differed by age: in 2017, 79.2% of hospital claims for patients aged 66–74 had a diagnosis of dementia compared to older age categories that had dementia noted in over 85% of records.
- Compared to white patients, Asian patients were less likely to have a diagnosis of dementia noted.
- Approximately 84.2% of hospital records from Asian patients had a diagnosis of dementia compared to 86.6% of records from white patients in 2017.
- The overall increase in the accuracy of hospital claims may indicate that clinicians are recognizing dementia at higher rates in this setting.
- The remaining lack of documentation may be caused by physicians attributing cognitive problems to "normal aging" or prioritizing the documentation of physical ailments.9 Overall, there are encouraging signs that the gaps across age and race groups have narrowed over time; they do persist and warrant further attention.
Why it matters
This study found that agreement between nursing home and hospital records on dementia diagnosis improved over time but gaps by age and race persisted. It does not test any treatment, cure, or prevention for Alzheimer's disease.
Study details
- Participants1,273,348
- Effect size76.9%; 86.3%; 79.2%
- Evidence strengthLow
How this study scored 44/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | 3 / 4 | Journal of the American Geriatrics Society: journal h-index 344 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 4 / 4 | 1,273,348 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 4 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.6 citations a year over 7 year(s) since 2021 |
| Impact for its field and year | 1 / 6 | Cited 0.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Joan M. Teno: h-index 90 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Brown University: institution h-index 1,120 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 33929724) |
| Free to read | 2 / 2 | Free to read |
| Total | 44 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Hua, C. L., Thomas, K. S., Bunker, J., Gozalo, P. L., & Teno, J. M. (2021). Changes in the agreement between the Minimum Data Set and hospital Medicare claims measures of dementia. Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.17201
Vancouver
Hua CL, Thomas KS, Bunker J, Gozalo PL, Teno JM. Changes in the agreement between the Minimum Data Set and hospital Medicare claims measures of dementia. Journal of the American Geriatrics Society. 2021. doi:10.1111/jgs.17201. PMID: 33929724.
BibTeX
@article{hua2021-33929724,
author = {Hua, Cassandra L. and Thomas, Kali S. and Bunker, Jennifer and Gozalo, Pedro L. and Teno, Joan M.},
title = {{Changes in the agreement between the Minimum Data Set and hospital Medicare claims measures of dementia}},
journal = {Journal of the American Geriatrics Society},
year = {2021},
doi = {10.1111/jgs.17201},
pmid = {33929724},
url = {https://doi.org/10.1111/jgs.17201}
}
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