Agreement of Medicare claims and tumor registry data for assessment of cancer-related treatment
Agreement of Medicare claims and tumor registry data for assessment of cancer-related treatment
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DOI：
10.1097/00005650-200004000-00008
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发表时间：
2000-04-01
期刊：
影响因子：
3
通讯作者：
Rimm, AA
中科院分区：
文献类型：
--
作者：
Cooper, GS;Yuan, Z;Rimm, AA
背景虽然健康声明数据越来越多地用于评估癌症护理模式和结果的变化，但对这些数据与肿瘤登记信息的可比性知之甚少。评估医疗保险索赔和肿瘤登记数据在测量老年癌症患者诊断和治疗程序模式方面的一致性。对年龄大于或等于65岁的癌症患者的监测、流行病学和最终结果（SEER）登记数据和医疗保险索赔数据库的分析。1984年至1993年诊断为浸润性乳腺癌、结直肠癌、子宫内膜癌、肺癌、胰腺癌和前列腺癌的361，255名医疗保险患者。SEER文件与相应医疗保险索赔的一致性。医疗保险索赔通常根据SEER（即，一致性大于或等于85%-90%）确定接受切除术和根治性手术的患者，但不太可能进行活检或局部切除（即，一致性小于或等于50%）。在某些情况下，索赔还将患者归类为比SEER中列出的更具侵入性的手术，并提供了有关4个月后使用手术治疗的增量信息。SEER文件和医疗保险索赔在较小程度上确定了其他数据源中不包括的放射治疗，医疗保险文件也捕获了大量具有化疗代码的患者。医疗保险文件可能适用于研究外科治疗的使用模式，但不适用于诊断程序。医疗保险索赔在识别延迟手术干预和化疗方面的潜在益处值得进一步研究。
BACKGROUND. Although health claims data are increasingly used in evaluating variations in patterns of cancer care and outcomes, little is known about the comparability of these data with tumor registry information.OBJECTIVES. To evaluate the agreement between Medicare claims and tumor registry data in measuring patterns of diagnostic and therapeutic procedures for older cancer patients.RESEARCH DESIGN. Analysis of a database linking Surveillance, Epidemiology and End Results (SEER) registry data and Medicare claims in patients aged greater than or equal to 65 years with cancer.SUBJECTS. 361,255 Medicare patients with invasive breast, colorectal, endometrial, lung, pancreatic, and prostate cancer diagnosed between 1984 and 1993.MEASURES. Concordance of SEER files with corresponding Medicare claims.RESULTS. Medicare claims generally identified patients who underwent resection and radical surgery according to SEER (ie, concordance greater than or equal to 85%-90%) but less likely biopsy or local excision (ie, concordance less than or equal to 50%). In some instances, claims also categorized patients as having more invasive surgery than was listed in SEER and also provided incremental information about the use of surgical treatment after 4 months. SEER files and, to a lesser degree, Medicare claims identified radiation therapy not included in the other data source, and Medicare files also captured a significant number of patients with codes for chemotherapy.CONCLUSIONS. Medicare files may be appropriate for studies of patterns of use of surgical treatment, but not for diagnostic procedures. The potential benefit of Medicare claims in identifying delayed surgical intervention and chemotherapy deserves further study.