TY - JOUR T1 - Identification of dementia: agreement among national survey data, medicare claims, and death certificates. JF - Health Serv Res Y1 - 2008 A1 - Truls Ostbye A1 - Donald H. Taylor Jr. A1 - Elizabeth C. Clipp A1 - Lynn Van Scoyoc A1 - Brenda L Plassman KW - Aged KW - Consensus KW - Data Interpretation, Statistical KW - Death Certificates KW - Dementia KW - Female KW - Health Surveys KW - Humans KW - Incidence KW - Insurance Claim Review KW - Male KW - Mass Screening KW - Medicare KW - Research Design KW - United States AB -

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'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.

PB - 43 VL - 43 IS - 1 Pt 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/18211532?dopt=Abstract U2 - PMC2323140 U4 - Dementia/Incidence/Cognitive Function/Survey questions/Medicare/Death Certificates ER - TY - JOUR T1 - 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 JF - BMC Public Health Y1 - 2003 A1 - Truls Ostbye A1 - Donald H. Taylor Jr. A1 - Lee, Ann Marie M. A1 - Gary N. Greenberg A1 - Lynn Van Scoyoc KW - Demographics KW - Health Conditions and Status AB - 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. PB - 3 VL - 3 IS - 41 U4 - Influenza/Vaccination/Racial Differences ER - TY - JOUR T1 - Health Insurance and Mammography: Would a Medicare buy-in take us to universal screening? JF - Health Services Research Y1 - 2002 A1 - Donald H. Taylor Jr. A1 - Lynn Van Scoyoc A1 - Hawley, Sarah T. KW - Health Conditions and Status KW - Medicare/Medicaid/Health Insurance KW - Women and Minorities AB - 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. PB - 37 VL - 37 IS - 6 U4 - Health Insurance/Mammography/Medicare/Women ER -