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. 2022 Apr;41(4):918-927.
doi: 10.1177/07334648211018530. Epub 2021 Jun 2.

Diagnostic Coding of Elder Mistreatment: Results From a National Database of Medicare Advantage and Private Insurance Patients, 2011-2017

Tony Rosen  1 , Katherine Wen  2 , Lena K Makaroun  3   4 , Alyssa Elman  1 , Yiye Zhang  5 , Philip J Jeng  5 , Veronica M LoFaso  1 , Mark S Lachs  1 , Sunday Clark  6 , Yuhua Bao  5
Affiliations

Diagnostic Coding of Elder Mistreatment: Results From a National Database of Medicare Advantage and Private Insurance Patients, 2011-2017

Tony Rosen et al. J Appl Gerontol. 2022 Apr.

Abstract

Health care providers may play an important role in detection of elder mistreatment, which is common but underrecognized. We used the Health Care Cost Institute insurance claims database to describe elder mistreatment diagnosis among Medicare Advantage (MA) and private insurance patients in the United States from 2011 to 2017. We used International Classification of Diseases (ICD) coding to identify cases, examining the impact of transition from ICD-9 (Ninth Revision) to ICD-10 (Tenth Revision), which occurred in October 2015 and added 14 new codes for "suspected" mistreatment. 8,127 patients (0.051% of all aged ≥ 65), including 6,304 with MA (0.058%) and 1,823 with private insurance (0.026%) received elder mistreatment diagnosis. Transition from ICD-9 to ICD-10 was associated with a small increase in diagnosis rate, with "suspected" codes used in 45.3% of ICD-10 versus 9.7% of ICD-9 cases. Overall rates remained low. Rates, settings, and types of diagnosis differed between MA and private insurance patients.

Keywords: abuse and neglect; diagnostic coding; elder mistreatment; geriatrics; health services.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors have no conflicts of interest to report.

Figures

Figure 1:
Figure 1:
Trends in Diagnosis of Different Types of Elder Mistreatment among Medicare Advantage and Private Insurance Patients Aged ≥65, 2011–17
Figure 2:
Figure 2:
Trends in Diagnosis of Elder Mistreatment by Sex among Medicare Advantage and Private Insurance Patients
Figure 3:
Figure 3:
Trends in Diagnosis of Elder Mistreatment by Age Group among Medicare Advantage and Private Insurance Patients
Figure 4:
Figure 4:
Trends in Diagnosis of Elder Mistreatment in Different Health Care Settings among Medicare Advantage and Private Insurance Patients
See this image and copyright information in PMC

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