The accuracy of medicare claims data in identifying Alzheimer's disease
The accuracy of medicare claims data in identifying Alzheimer's disease
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DOI：
10.1016/s0895-4356(02)00452-3
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发表时间：
2002-09-01
影响因子：
7.2
通讯作者：
Ezell, ME
中科院分区：
文献类型：
--
作者：
Taylor, DH;Fillenbaum, GG;Ezell, ME
我们将医疗保险索赔数据与建立阿尔茨海默病登记处联盟（CERAD）中417名临床诊断为阿尔茨海默病的患者的信息联系起来，以确定他们中有多少比例在医疗保险索赔记录中被确定为患有阿尔茨海默病（AD）。使用5年的索赔数据，这些患者中有79%被确定为患有AD;当使用更广泛的ICD-9-CM代码集时，87%被确定为痴呆。Anderson-Gill计数过程方法用于模拟在医疗保险索赔数据中被识别为AD的患者的"危险"。轻度痴呆的CERAD患者不太可能在索赔数据中被确定为患有AD。一旦在医疗保险索赔中被确定为患有AD，患者更有可能再次被确定。当仅使用医生供应商和机构门诊档案时，约75%的CERAD患者被确定为患有AD;仅使用医院档案确定了不到三分之一（29%）的CERAD患者患有AD。数据表明，至少连续3年的医生供应商和医生门诊索赔文件应用于确定医疗保险受益人与AD使用医疗保险索赔。(C)2002年爱思唯尔科技有限公司All rights reserved.
We linked Medicare claims data to information on 417 patients with a clinical diagnosis of Alzheimer's disease in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) to determine what proportion of them were identified as having Alzheimer's disease (AD) in Medicare claims records. Seventy-nine percent of these patients were identified as having AD using 5 years of claims data; 87% were identified as demented when a broader set of ICD-9-CM codes was used. An Anderson-Gill counting process approach was used to model the "hazard" of patients being identified as having AD in Medicare claims data. CERAD patients with mild dementia were less likely to be identified in the claims data as having AD. Once identified in Medicare claims as having AD, patients were more likely to be so identified again. When using only the physician supplier and institutional outpatient files, approximately 75% of CERAD patients were identified as having AD; hospital files used alone identified less than one-third (29%) of the CERAD patients as having AD. The data indicate that at least 3 consecutive years of physician supplier and physician outpatient claim files should be used to identify Medicare beneficiaries with AD using Medicare claims. (C) 2002 Elsevier Science Inc. All rights reserved.