Information gained from linking SEER cancer registry data to state-level hospital discharge abstracts
Information gained from linking SEER cancer registry data to state-level hospital discharge abstracts
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DOI：
10.1097/00005650-200011000-00007
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发表时间：
2000-11-01
期刊：
影响因子：
3
通讯作者：
Chen-Hardee, S
中科院分区：
文献类型：
--
作者：
Brooks, JM;Chrischilles, E;Chen-Hardee, S
目标。我们的目标是将爱荷华州监测、流行病学和最终结果（SEER）登记处的患者与爱荷华州医疗保健成本和利用项目（HCUP）格式数据库中各自的住院出院摘要联系起来，并评估这种联系是否提供了与癌症治疗变化相关的信息。计算机算法将爱荷华州SEER登记处的患者与出院摘要联系起来，使用数据库之间一致定义的5个变量（医院标识、出生日期、入院日期、出院日期和邮政编码）。对摘要进行效度审查，不通过表面效度的链接被排除。我们的样本包含7296例早期乳腺癌（I, IIa, IIb）患者，这些患者来自1989年至1994年爱荷华州SEER登记处，仅与爱荷华州医院接触。在我们的样本中，住院患者出院摘要与86.4%的患者相关。超过96%的医疗保险患者有相应的医疗保险索赔。超过45%的相关患者没有被医疗保险覆盖。共病指数与其他已发表的资料相当。第三方支付者在诊断、合并症和治疗方面存在显著差异。这种联系提供了一个有价值的合并症和保险数据的来源，也许是没有保险的人获得次要临床信息的唯一来源。这种联系最适合需要住院治疗的癌症，以及那些过境治疗较少的州。
OBJECTIVES. Our goal was to link patients from the Iowa Surveillance, Epidemiology, and End Results (SEER) Registry to their respective inpatient discharge abstracts from an Iowa Health Care Cost and Utilization Project (HCUP)-formatted database and evaluate whether this linkage provides information related to cancer treatment variation.METHODS. Computer algorithms linked patients from the Iowa SEER Registry to discharge abstracts using 5 variables consistently defined between the databases (hospital identification, date of birth, admission date, discharge date, and zip code). Abstracts were reviewed for validity, and links not passing face validity were excluded.,SUBJECTS. Our sample contained 7,296 patients with early-stage breast cancer (I, IIa, IIb) with surgery from the Iowa SEER Registry from 1989 through 1994 with contacts only with Iowa hospitals.RESULTS. Inpatient discharges abstracts were linked to 86.4% of the patients in our sample. More than 96% of the linked discharges for Medicare patients had a corresponding Medicare claim. Over 45% of the linked patients were not covered by Medicare. Comorbidity indexes were comparable to other published sources. Significant differences in diagnosis, comorbidities, and treatment were found across third-party payers.CONCLUSIONS. This linkage provides a valuable source of comorbidity and insurance data and perhaps the only source of secondary clinical information for the uninsured. This linkage is best suited for cancers requiring inpatient stays for treatment and for those states where border crossing for treatment is low.