Linking inpatient clinical registry data to Medicare claims data using indirect identifiers
Linking inpatient clinical registry data to Medicare claims data using indirect identifiers
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DOI：
10.1016/j.ahj.2009.04.002
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发表时间：
2009-06-01
影响因子：
4.8
通讯作者：
Curtis, Lesley H.
中科院分区：
文献类型：
--
作者：
Hammill, Bradley G.;Hernandez, Adrian F.;Curtis, Lesley H.
背景：住院患者临床登记系统提供急性发作后的纵向护理观点的能力有限。我们提出了一种方法来链接从登记处与医疗保险住院索赔数据的住院记录，而不使用直接标识符，创建一个独特的数据源，对丰富的临床数据与长期outcome data.Methods和结果该方法利用了医院集群观察到的每个数据库，通过展示，不同的组合间接标识符内的医院产生了很大比例的独特的患者记录。这种高度的唯一性还允许在不预先知道每个注册医院的Medicare提供者号码的情况下进行链接。我们将该方法应用于2个住院患者数据库，并能够识别大型心力衰竭患者临床注册表中39，178条记录的81%和医院住院患者数据库中6，581条心力衰竭记录的91%。链接的质量很高，并探讨了链接不完整的原因。最后，我们讨论了结合索赔和临床数据的具体analysis.Conclusions提供的独特机会，在没有直接标识符，它是可能的，以创建一个高质量的住院患者的临床登记数据和医疗保险索赔数据之间的联系。该方法将允许研究人员使用现有数据创建一个链接的索赔-临床数据库，该数据库利用两种类型数据源的优势。(Am心脏J 2009; 157：995-1000，）
Background Inpatient clinical registries generally have limited ability to provide a longitudinal perspective on care beyond the acute episode. We present a method to link hospitalization records from registries with Medicare inpatient claims data, without using direct identifiers, to create a unique data source that pairs rich clinical data with long-term outcome data.Methods and Results The method takes advantage of the hospital clustering observed in each database by demonstrating that different combinations of indirect identifiers within hospitals yield a large proportion of unique patient records. This high level of uniqueness also allows linking without advance knowledge of the Medicare provider number of each registry hospital. We applied this method to 2 inpatient databases and were able to identify 81% of 39,178 records in a large clinical registry of patients with heart failure and 91% of 6,581 heart failure records from a hospital inpatient database. The quality of the link is high, and reasons for incomplete linkage are explored. Finally, we discuss the unique opportunities afforded by combining claims and clinical data for specific analyses.Conclusions In the absence of direct identifiers, it is possible to create a high-quality link between inpatient clinical registry data and Medicare claims data. The method will allow researchers to use existing data to create a linked claims-clinical database that capitalizes on the strengths of both types of data sources. (Am Heart J 2009; 157:995-1000,)