Improving Longitudinal Outcomes, Efficiency, and Equity in the Care of Patients With Congenital Heart Disease.
Improving Longitudinal Outcomes, Efficiency, and Equity in the Care of Patients With Congenital Heart Disease.
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DOI：
10.1016/j.jacc.2021.08.040
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发表时间：
2021-10-26
影响因子：
24
通讯作者：
New York State Congenital Heart Surgery Collaborative for Longitudinal Outcomes and Utilization of Resources (CHS-COLOUR)
中科院分区：
文献类型：
--
作者：
Anderson BR;Dragan K;Crook S;Woo JL;Cook S;Hannan EL;Newburger JW;Jacobs M;Bacha EA;Vincent R;Nguyen K;Walsh-Spoonhower K;Mosca R;Devejian N;Kamenir SA;Alfieris GM;Swartz MF;Meyer D;Paul EA;Billings J;New York State Congenital Heart Surgery Collaborative for Longitudinal Outcomes and Utilization of Resources (CHS-COLOUR)
纵向随访、资源利用和健康差异是先天性心脏病研究和护理的首要任务。医疗补助要求包括住院病人，门诊病人，急诊，药房，康复，家庭健康利用和健康的社会决定因素，包括母婴配对的纵向数据。纽约先天性心脏病外科医生纵向结果和资源利用协作组织（CHS-COLOUR）将来自11个纽约先天性心脏病中心中的10个的当地州和国家登记处的可靠临床细节与医疗补助申请联系起来，建立了一种新颖的全州范围的机制，用于纵向评估结果，支出和健康不公平。我们纳入了2006年至2019年11家纽约中心中的10家接受心脏手术的所有<18岁儿童，这些儿童均纳入了胸外科学会先天性心脏手术数据库和/或纽约州儿科先天性心脏手术登记处。数据通过迭代，排名确定性匹配直接标识符。计算匹配率并进行比较。描述了3年、5年和10年内可追踪的相关队列的比例。在14，097例登记病例中，59%（n= 8，322）报告了医疗补助使用。其中，7，414人与纽约索赔有关，匹配率为89%。在匹配的病例中，我们跟踪了79%，74%和65%的3岁，5岁和10岁以上的儿童，他们需要接近连续的医疗补助登记。在允许更宽松的入学标准的情况下，我们追踪了86%、82%和76%。这段时间的死亡率分别为7.7%、8.4%和10.0%。手动验证显示约100%真实匹配。这为评估先天性心脏病儿童的纵向结局、卫生支出和差异建立了一个新的全州范围的数据资源。我们通过迭代，排名确定性匹配将州和国家临床登记数据与2006-2019年的医疗补助索赔联系起来。在14，097例登记病例中，59%（n= 8，322）使用医疗补助。我们链接了89%的医疗补助病例（n= 7，414）。在匹配的病例中，我们跟踪了79%，74%和65%的3年，5年和10年以上的儿童，需要接近连续的医疗补助登记。允许更宽松的入学率，我们跟踪了86%，82%和76%。此时的死亡率分别为7.7%、8.4%和10.0%。手动验证显示约100%真实匹配。这为评估先天性心脏病患者的纵向结局、卫生支出和差异建立了一个新的全州范围的数据源。
Longitudinal follow-up, resource utilization, and health disparities are top congenital heart research and care priorities. Medicaid claims include longitudinal data on in-patient, out-patient, emergency, pharmacy, rehabilitation, home health utilization, and social determinants of health—including mother-infant pairs. The New York Congenital Heart Surgeons Collaborative for Longitudinal Outcomes and Utilization of Resources (CHS-COLOUR) linked robust clinical details from locally held state and national registries from 10 of 11 NY congenital heart centers to Medicaid claims, building a novel, state-wide mechanism for longitudinal assessment of outcomes, expenditures, and health inequities. We included all children <18 undergoing cardiac surgery in the Society of Thoracic Surgeons Congenital Heart Surgery Database and/or the NY State Pediatric Congenital Cardiac Surgery Registry from 10 of 11 NY centers, 2006–2019. Data were linked via iterative, ranked deterministic matching on direct identifiers. Match rates were calculated and compared. Proportions of the linked cohort trackable over 3-, 5-, and 10-years were described. Of 14,097 registry cases, 59% (n=8,322) reported Medicaid use. Of these, 7,414 were linked to NY claims, at an 89% match rate. Of matched cases, we tracked 79%, 74%, and 65% of children over 3-, 5-, and 10-years when requiring near continuous Medicaid enrollment. Allowing more lenient enrollment criteria, we tracked 86%, 82%, and 76%. Mortality over this time was 7.7%, 8.4%, and 10.0%. Manual validation revealed ~100% true matches. This establishes a novel state-wide data resource for assessment of longitudinal outcome, health expenditure, and disparities for children with congenital heart disease. We linked state and national clinical registry data to Medicaid claims, 2006–2019, via iterative, ranked deterministic matching. Of 14,097 registry cases, 59% (n=8,322) used Medicaid. We linked 89% of Medicaid cases (n=7,414). Of matched cases, we tracked 79%, 74%, and 65% of children over 3-, 5-, and 10-years, requiring near continuous Medicaid enrollment. Allowing more relaxed enrollment, we tracked 86%, 82%, and 76%. Mortality over this time was 7.7%, 8.4%, and 10.0%. Manual validation revealed ~100% true matches. This establishes a novel state-wide data source for assessment of longitudinal outcome, health expenditure, and disparities for patients with congenital heart disease.
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影响因子：
4.8
作者：
Hammill, Bradley G.;Hernandez, Adrian F.;Curtis, Lesley H.
通讯作者：
Curtis, Lesley H.
影响因子：
37.8
作者：
Pasquali SK;Jacobs JP;Farber GK;Bertoch D;Blume ED;Burns KM;Campbell R;Chang AC;Chung WK;Riehle-Colarusso T;Curtis LH;Forrest CB;Gaynor WJ;Gaies MG;Go AS;Henchey P;Martin GR;Pearson G;Pemberton VL;Schwartz SM;Vincent R;Kaltman JR
通讯作者：
Kaltman JR
影响因子：
9.7
作者：
Schwartz, Aaron L.;Sommers, Benjamin D.
通讯作者：
Sommers, Benjamin D.
影响因子：
5.4
作者：
Oster ME;Riehle-Colarusso T;Simeone RM;Gurvitz M;Kaltman JR;McConnell M;Rosenthal GL;Honein MA
通讯作者：
Honein MA
影响因子：
26.1
作者：
Peterson, Cora;Ailes, Elizabeth;Riehle-Colarusso, Tiffany;Oster, Matthew E.;Olney, Richard S.;Cassell, Cynthia H.;Fixler, David E.;Carmichael, Suzan L.;Shaw, Gary M.;Gilboa, Suzanne M.
通讯作者：
Gilboa, Suzanne M.