Linking individual medicare health claims data with work-life claims and other administrative data.
Linking individual medicare health claims data with work-life claims and other administrative data.
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DOI：
10.1186/s12889-015-2329-6
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发表时间：
2015-09-30
影响因子：
4.5
通讯作者：
Cullen MR
中科院分区：
文献类型：
--
作者：
Mokyr Horner E;Cullen MR
调查65岁以上人群健康结果的研究人员可以利用医疗保险索赔数据，但这些数据不包括65岁之前个人健康的直接信息，通常也无法与包含工作期间暴露和行为数据的文件链接。目前的论文是一个概念验证，将雇主的行政数据和私人的、基于就业的健康索赔与医疗保险数据合并。关联数据的特征，包括敏感性和特异性，应着眼于此类关联数据的潜在用途进行评估。本文以一个工业队列中的前制造业工人为样本作为测试案例。这种整合产生的数据集可能对社会流行病学和职业健康等领域的研究有用。医疗保险和就业管理数据与2001-2009年过渡到医疗保险的大量制造业工人（1996-2008年期间的某个时间点）联系在一起。包括生物特征指标在内的工作-生活健康数据用于预测65岁时的健康状况，并调查基于就业的保险索赔与随后的医疗保险索赔的一致性。慢性疾病在以就业为基础的私人保险和随后的医疗保险之间具有相对较高的一致性。研究发现，患者在接受医疗保险之前的健康信息，包括生物特征指标，可以预测65岁时的健康状况。结合这些数据，可以评估连续的健康轨迹，并将晚年健康建模为工作-生活行为和暴露的函数。它也为职业健康研究提供了一个潜在的终点。这是此类协调的第一次，提供了概念验证。这种整合产生的数据集可能对社会流行病学和职业健康等领域的研究有用。
Researchers investigating health outcomes for populations over age 65 can utilize Medicare claims data, but these data include no direct information about individuals’ health prior to age 65 and are not typically linkable to files containing data on exposures and behaviors during their worklives. The current paper is a proof-of-concept, of merging employers’ administrative data and private, employment-based health claims with Medicare data. Characteristics of the linked data, including sensitivity and specificity, are evaluated with an eye toward potential uses of such linked data. This paper uses a sample of former manufacturing workers from an industrial cohort as a test case. The dataset created by this integration could be useful to research in areas such as social epidemiology and occupational health. Medicare and employment administrative data were linked for a large cohort of manufacturing workers (employed at some point during 1996–2008) who transitioned onto Medicare between 2001–2009. Data on work-life health, including biometric indicators, were used to predict health at age 65 and to investigate the concordance of employment-based insurance claims with subsequent Medicare insurance claims. Chronic diseases were found to have relatively high levels of concordance between employment-based private insurance and subsequent Medicare insurance. Information about patient health prior to receipt of Medicare, including biometric indicators, were found to predict health at age 65. Combining these data allows for evaluation of continuous health trajectories, as well as modeling later-life health as a function of work-life behaviors and exposures. It also provides a potential endpoint for occupational health research. This is the first harmonization of its kind, providing a proof-of-concept. The dataset created by this integration could be useful for research in areas such as social epidemiology and occupational health.