Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data?
Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data?
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支持健康保险扩展：电子健康记录是否具有有效的保险验证和投保数据？
DOI：
10.1093/jamia/ocv033
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Devoe,Jennifer
中科院分区：
文献类型：
--
作者：
Heintzman,John;Marino,Miguel;Hoopes,Megan;Bailey,SteffaniR;Gold,Rachel;O'Malley,Jean;Angier,Heather;Nelson,Christine;Cottrell,Erika;Devoe,Jennifer
ObjectiveTo validate electronic health record (EHR) insurance information for low-income pediatric patients at Oregon community health centers (CHCs), compared to reimbursement data and Medicaid coverage data.Materials and MethodsSubjectsChildren visiting any of 96 CHCs (N= 69 189) from 2011 to 2012.AnalysisThe authors measured correspondence (whether or not the visit was covered by Medicaid) between EHR coverage data and (i) reimbursement data and (ii) coverage data from Medicaid.ResultsCompared to reimbursement data and Medicaid coverage data, EHR coverage data had high agreement (87% and 95%, respectively), sensitivity (0.97 and 0.96), positive predictive value (0.88 and 0.98), but lower kappa statistics (0.32 and 0.49), specificity (0.27 and 0.60), and negative predictive value (0.66 and 0.45). These varied among clinics.Discussion/ConclusionsEHR coverage data for children had a high overall correspondence with Medicaid data and reimbursement data, suggesting that in some systems EHR data could be utilized to promote insurance stability in their patients. Future work should attempt to replicate these analyses in other settings.
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