Incremental value of using Medicaid claim files to study comorbid conditions and treatments in dually eligible beneficiaries.
Incremental value of using Medicaid claim files to study comorbid conditions and treatments in dually eligible beneficiaries.
复制标题
DOI：
10.1097/mlr.0b013e3181b72395
复制
发表时间：
2010-01
期刊：
影响因子：
3
通讯作者：
Koroukian S
中科院分区：
文献类型：
--
作者：
Bradley CJ;Dahman B;Bataki PM;Koroukian S
虽然使用医疗保险索赔文件的调查在卫生服务研究文献中无处不在，但医疗补助索赔文件的使用频率较低。尽管如此，医疗补助是低收入者医疗保健的主要支付者。评估Medicaid索赔文件的附加值，以确定双重合格样本中的共病状况和癌症治疗。数据来源于两个相邻的中西部州（密歇根州和俄亥俄州）的全州肿瘤登记处、医疗保险和医疗补助登记文件以及医疗保险和医疗补助索赔文件。我们仅通过计算医疗保险索赔文件中患有这些疾病的患者数量来估计查尔森合并症指数疾病的患病率。然后，我们估计了通过使用Medicare和Medicaid索赔文件可以获得的合并症患病率的预期百分比增加（沿着95%置信区间）。我们遵循类似的程序来确定为双重合格患者提供的治疗。医疗补助索赔增加了很少的个人与共病条件超过那些通过医疗保险索赔文件确定。合并症患病率的增加在0%至2.5%之间。同样，医疗补助索赔确定了一些没有通过医疗保险索赔文件确定的癌症治疗人员，尽管两个州之间存在差异。这项研究表明，医疗补助住院，门诊和运营商索赔的增量价值相对较小，可以从医疗保险索赔数据中获得。
Although investigations using Medicare claims files are ubiquitous in the health services research literature, Medicaid claims files are used less frequently. Nonetheless, Medicaid is the major payer for healthcare among low-income persons. To assess the added value of Medicaid claim files for identifying comorbid conditions and cancer treatments in a dually eligible sample. Data were obtained from linked statewide tumor registries from 2 contiguous Midwestern states (Michigan and Ohio), Medicare and Medicaid enrollment files, and Medicare and Medicaid claims files. We estimated the prevalence of Charlson Comorbidity Index conditions by counting the number of patients with these conditions in the Medicare claims files alone. We then estimate the expected percent increase in the prevalence of comorbid conditions (along with the 95% confidence interval) that could be obtained by using both Medicare and Medicaid claim files. We followed a similar procedure to identify treatments provided to dually eligible patients. Medicaid claims added very few individuals with comorbid conditions over those identified through Medicare claim files. The increase in the prevalence of comorbid conditions was between 0% and 2.5%. Likewise, Medicaid claims identified few individuals with cancer treatments who were not already identified through Medicare claim files, although variations were noted between the 2 states. This study suggests that the incremental value of Medicaid inpatient, outpatient, and carrier claims is relatively small over what can be obtained from Medicare claims data.
登录
查看更多内容
影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
3
作者：
Baldwin, Laura-Mae;Klabunde, Carrie N.;Wright, George
通讯作者：
Wright, George
影响因子：
16.2
作者：
McCall, DT;Sauaia, A;Barton, P
通讯作者：
Barton, P
影响因子：
7.2
作者：
Klabunde, CN;Potosky, AL;Warren, JL
通讯作者：
Warren, JL
影响因子：
--
作者：
Bradley, Cathy J.;Given, Charles W.;Fitzgerald, Timothy L.
通讯作者：
Fitzgerald, Timothy L.