Care after the onset of serious illness: a novel claims-based dataset exploiting substantial cross-set linkages to study end-of-life care.
Care after the onset of serious illness: a novel claims-based dataset exploiting substantial cross-set linkages to study end-of-life care.
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DOI：
10.1089/109662102760269751
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发表时间：
2002-08-01
影响因子：
2.8
通讯作者：
Zhang, James X
中科院分区：
文献类型：
--
作者：
Christakis, Nicholas A;Iwashyna, Theodore J;Zhang, James X
到目前为止，还没有一项研究使用了一个大型的，具有全国代表性的严重疾病患者群体，这些患者有临终关怀使用的风险，并且及时随访以了解临终关怀使用的决定因素。在本文中，我们概述了一个大型的新队列的发展，1，221，153名医疗保险受益人在1993年新诊断为13种严重疾病中的1种，该队列可用于研究美国的临终关怀。在描述我们的方法，我们说明了可能的效用的医疗保险索赔的生命结束的研究。我们的队列成员随访临终关怀和其他卫生保健使用到1997年12月，死亡率到1999年6月。还收集了关于他们住院和门诊医院使用的医疗保险索赔数据。根据队列成员居住的邮政编码和县，我们还能够描述队列成员的医疗保健市场，并获得有关他们的其他社会经济信息。还提供了有关队列成员的医疗保健提供者的信息。还收集了队列成员配偶的详细健康信息。最后，我们强调了可以在此数据集中进行的分析类型。
To date, there has not been a study using a large, nationally representative group of patients with serious illness who are at risk for hospice use and who are followed forward in time to understand the determinants of hospice use. In this paper, we outline the development of a large new cohort of 1,221,153 Medicare beneficiaries newly diagnosed with 1 of 13 serious conditions in 1993, a cohort that can be used to study end-of-life care in the United States. In describing our methods, we illustrate the possible utility of Medicare claims for end-of-life research. The members of our cohort are followed forward for hospice and other health care use through December 1997, and for mortality through June 1999. Medicare claims data on their inpatient and outpatient hospital use is also collected. Based on the ZIP Codes and counties in which cohort members lived, we were also able to characterize the health care markets of cohort members, as well as obtain other socioeconomic information about them. Information about cohort member's health care providers is also available. Detailed health information about cohort members' spouses was also collected. We conclude by highlighting the types of analyses that can be conducted in this data set.