Use of the Medicare database in epidemiologic and health services research: a valuable source of real-world evidence on the older and disabled populations in the US.
Use of the Medicare database in epidemiologic and health services research: a valuable source of real-world evidence on the older and disabled populations in the US.
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DOI：
10.2147/clep.s105613
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发表时间：
2017
影响因子：
3.9
通讯作者：
Gilbertson DT
中科院分区：
文献类型：
--
作者：
Mues KE;Liede A;Liu J;Wetmore JB;Zaha R;Bradbury BD;Collins AJ;Gilbertson DT
联邦医疗保险是针对年龄≥65岁的美国人、65岁以下的残疾人和终末期肾脏疾病患者的联邦健康保险计划。医疗保险和医疗补助服务中心允许研究人员访问医疗保险行政索赔数据库，以进行流行病学和健康结果研究。这些数据涵盖了受益人与卫生保健系统的接触以及接受治疗干预措施的情况，包括药物、程序和服务。医疗保险数据已被用于描述发病率和死亡率的模式，描述疾病负担，比较药物治疗的有效性，检查护理成本，评估提供者实践对提供护理和患者结果的影响，并探索医疗保险政策重要变化对健康的影响。考虑到绝大多数≥65岁的美国公民都有医疗保险，对医疗保险数据的分析现在对于了解美国老年人医疗保健的提供至关重要，并且对于提供实际证据来指导决策者至关重要。本综述旨在为研究人员提供医疗保险数据的摘要，包括捕获的数据类型，以及如何在流行病学和健康结果研究中使用这些数据。在使用医疗保险数据设计研究时，我们强调优势、局限性和关键考虑因素。此外，我们还说明了医疗保险和医疗补助服务中心政策变化可能对数据收集、编码以及最终对数据得出的结果产生的潜在影响。
Medicare is the federal health insurance program for individuals in the US who are aged ≥65 years, select individuals with disabilities aged <65 years, and individuals with end-stage renal disease. The Centers for Medicare and Medicaid Services grants researchers access to Medicare administrative claims databases for epidemiologic and health outcomes research. The data cover beneficiaries’ encounters with the health care system and receipt of therapeutic interventions, including medications, procedures, and services. Medicare data have been used to describe patterns of morbidity and mortality, describe burden of disease, compare effectiveness of pharmacologic therapies, examine cost of care, evaluate the effects of provider practices on the delivery of care and patient outcomes, and explore the health impacts of important Medicare policy changes. Considering that the vast majority of US citizens ≥65 years of age have Medicare insurance, analyses of Medicare data are now essential for understanding the provision of health care among older individuals in the US and are critical for providing real-world evidence to guide decision makers. This review is designed to provide researchers with a summary of Medicare data, including the types of data that are captured, and how they may be used in epidemiologic and health outcomes research. We highlight strengths, limitations, and key considerations when designing a study using Medicare data. Additionally, we illustrate the potential impact that Centers for Medicare and Medicaid Services policy changes may have on data collection, coding, and ultimately on findings derived from the data.