IDENTIFICATION OF FRACTURES FROM COMPUTERIZED MEDICARE FILES
IDENTIFICATION OF FRACTURES FROM COMPUTERIZED MEDICARE FILES
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DOI：
10.1016/0895-4356(92)90047-q
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发表时间：
1992-07-01
影响因子：
7.2
通讯作者：
ADAMS, ML
中科院分区：
文献类型：
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作者：
RAY, WA;GRIFFIN, MR;ADAMS, ML
非髋部骨折是65岁以上老年人的一个严重公共卫生问题，由于缺乏一种经济的病例识别方法，对非髋部骨折的研究一直受到阻碍。我们评估了计算机化的医疗保险住院，急诊室，医院门诊部和医生索赔的效用，以确定在田纳西州的老年医疗补助人口骨折。我们用这些档案在1987年确定了3086个可能的骨折，并审查了1440个样本的医疗记录。使用这个样本，我们制定了一个可能骨折的定义，排除了不太可能代表新诊断骨折的声明。对于所有骨折，该定义的阳性预测值为94%，对于单个骨折部位，其范围为79%（胫骨/腓骨）至98%（髋关节）。在审查的样本中，91%的骨折被确定为可能骨折;灵敏度上限在75%（股骨干）和100%（髌骨）之间变化。这些数据表明，计算机化的医疗保险文件可以用于快速和经济的骨折确定的人大于或等于65岁。然而，需要进一步的工作，以获得更好的敏感性估计。
Study of non-hip fractures, which are aa serious public health problem for persons greater-than-or-equal-to 65 years of age, has been hindered by the absence of an economical method for case identification. We assessed the utility of computerized Medicare inpatient, emergency room, hospital outpatient department and physician claims for identifying fractures in an elderly Tennessee Medicaid population. We used these files for 1987 to identify 3086 possible fractures and reviewed medical records for aa sample of 1440. Using this sample, we developed aa definition of probable fractures that excluded claims unlikely to represent newly diagnosed fractures. For all fractures, this definition had aa positive predictive value of 94%, which for individual fracture sites, ranged from 79% (tibia/fibula) to 98% (hip). Of fractures in the reviewed sample, 91 % were identifed as probable fractures; this upper bound for sensitivity varied between 75% (femoral shaft) and 100% (patella). These data suggest that computerized Medicare files can be used for rapid and economical fracture ascertainment among persons greater-than-or-equal-to 65 years of age. However, further work is needed to obtain better estimates of sensitivity.