Characteristics of the SAGE database: A new resource for research on outcomes in long-term care

Background. Because there is a lack of databases specific to long-term care , standardized assessments of nursing home residents are seen as a potentia l new resource for studying an important but neglected population. We descr ibe the design and principal population characteristics of the first integr ated database combining detailed clinical information and administrative cl aims data. Methods. We studied nearly 300,000 residents admitted between 1992 and 1994 to all Medicare/Medicaid certified nursing homes of five U.S. states (Kans as, Maine, Mississippi, New York, and South Dakota). The database crosslink s: (a) Resident Data: over 350 items (demographic, diagnostic, clinical, an d treatments) collected with the Minimum Data Set; (b) Drug Data: brand nam e, dosage, route, and frequency of administration for all drugs consumed by each resident; (c) Medicare Data: eligibility and inpatient hospital claim s; (d) Facilities Data: structural and staffing information on nursing home s; and (e) County Data: information on population, health professions and f acility data, and economic parameters. Results. Ninety-two percent of the residents were aged 65 years and older. Residents were predominantly white (85%) and female (72%). The average numb er of medical diagnoses was above three, and residents were receiving an av erage of six medications. Sixty-five percent of residents had at least one hospital claim following the initial assessment, most commonly related to c ardiovascular diseases and metabolic disorders. Fifty-five percent of the f acilities were for-profit and 33% were of small size. Quality indicators an d staffing level varied significantly by state. Conclusions. The SAGE (Systematic Assessment of Geriatric drug use via Epid emiology) database provides a unique resource to study the relation between treatments received and outcomes experienced, particularly functional and health services outcomes, that have not been possible before in very old, f rail people.