@article {7207, title = {Identification of dementia: agreement among national survey data, medicare claims, and death certificates.}, journal = {Health Serv Res}, volume = {43}, year = {2008}, month = {2008 Feb}, pages = {313-26}, publisher = {43}, abstract = {

OBJECTIVE: To estimate the proportion of seniors with dementia from three independent data sources and their agreement.

DATA SOURCES: The longitudinal Asset and Health Dynamics among the Oldest Old (AHEAD) study (n=7,974), Medicare claims, and death certificate data.

STUDY DESIGN: Estimates of the proportion of individuals with dementia from: (1) self- or proxy-reported cognitive status measures from surveys, (2) Medicare claims, and (3) death certificates. Agreement using Cohen{\textquoteright}s kappa; multivariate logistic regression.

PRINCIPAL FINDINGS: The proportion varied substantially among the data sources. Agreement was poor (kappa: 0.14-0.46 depending upon comparison assessed); the individuals identified had relatively modest overlap.

CONCLUSIONS: Estimates of dementia occurrence based on cognitive status measures from three independent data sources were not interchangeable. Further validation of these sources is needed. Caution should be used if policy is based on only one data source.

}, keywords = {Aged, Consensus, Data Interpretation, Statistical, Death Certificates, Dementia, Female, Health Surveys, Humans, Incidence, Insurance Claim Review, Male, Mass Screening, Medicare, Research Design, United States}, issn = {0017-9124}, doi = {10.1111/j.1475-6773.2007.00748.x}, author = {Truls Ostbye and Donald H. Taylor Jr. and Elizabeth C. Clipp and Lynn Van Scoyoc and Brenda L Plassman} } @article {6875, title = {Racial Differences in Influenza Vaccination Among Older Americans, 1996-2000: Longitudinal analysis of the Health and Retirement Study (HRS) and the Asset and Health Dynamics among the Oldest Old (AHEAD) survey}, journal = {BMC Public Health}, volume = {3}, year = {2003}, publisher = {3}, abstract = {Background: Influenza is a common and serious public health problem among the elderly. The influenza vaccine is safe and effective. Methods: The purpose of the study was to determine whether frequencies of receipt vary by race, age group, gender, and time (progress from 1995/1996 to 2000), and whether any racial differences remain in age groups covered by Medicare. Subjects were selected from the Health and Retirement Study (HRS) (12,652 Americans 50 61 years of age (1992 2000)) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey (8,124 community-dwelling seniors aged 70 years (1993 2000)). Using multivariate logistic regression, adjusting for potential confounders, we estimated the relationship between race, age group, gender, time and the main outcome measure, receipt of influenza vaccination in the last 2 years. Results: There has been a clear increase in the unadjusted rates of receipt of influenza vaccination for all groups from 1995/1996 to 2000. However, the proportions immunized are 10 20 higher among White than among Black elderly, with no obvious narrowing of the racial gap from 1995/1996 to 2000. There is an increase in rates from age 50 to age 65. After age 70, the rate appears to plateau. In multivariate analyses, the racial difference remains after adjusting for a series of socioeconomic, health, and health care related variables. (HRS: OR = 0.63 (0.55 0.72), AHEAD: OR = 0.55 (0.44 0.66)) Conclusions: There is much work left if the Healthy People 2010 goal of 90 of the elderly immunized against influenza annually is to be achieved. Close coordination between public health programs and clinical prevention efforts in primary care is necessary, but to be truly effective, these services must be culturally appropriate.}, keywords = {Demographics, Health Conditions and Status}, doi = {https://doi.org/10.1186/1471-2458-3-41}, author = {Truls Ostbye and Donald H. Taylor Jr. and Lee, Ann Marie M. and Gary N. Greenberg and Lynn Van Scoyoc} } @article {6831, title = {Health Insurance and Mammography: Would a Medicare buy-in take us to universal screening?}, journal = {Health Services Research}, volume = {37}, year = {2002}, pages = {1469-1486}, publisher = {37}, abstract = {Objective. To determine whether health insurance expansioins via a Medicare buy-in might Plausibly increase mammography screening rates among women aged 50-64.Data Sources. Two waves of the Health and Retirement Study (HRS) (1994, 1996).Study Design. A longitudinal study with most explanatory variables measured at the second wave of HRS (1994); receipt of mammography, number of physician visits, and breast self exam (BSE) were measured at the third wave (1996).Data Extraction. Our sample included women aged 50-62 in 1994 who answered the second and third HRS interview (n=4,583).Principal Findings. From 1994 to 199,6, 72.7 percent of women received a mammogram. Being insured increased mammography in both unadjusted and adjusted analyses. A simulation of universal insurance coverage in,this age group increased mammography rates only to 75-79 percent from the observed 72.7 percent. When we accounted for potential endogeneity of physician visits and BSE to mammo graphy, physician visits remained a strong predictor of mammography but BSE did not.Conclusion. Even in the presence of universal coverage and very optimistic scenarios regarding the effect of insurance on mammography for, newly insured women, mammography rates would only increase a small amount and gaps in screening would remain. Thus, a Medicare buy-in could be expected to have a small impact on mammography screening rates.}, keywords = {Health Conditions and Status, Medicare/Medicaid/Health Insurance, Women and Minorities}, author = {Donald H. Taylor Jr. and Lynn Van Scoyoc and Hawley, Sarah T.} }