Prevalence of multiple chronic conditions in the United States' Medicare population
Prevalence of multiple chronic conditions in the United States' Medicare population
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DOI：
10.1186/1477-7525-7-82
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发表时间：
2009-09-08
影响因子：
3.6
通讯作者：
Dean, Debbie
中科院分区：
文献类型：
--
作者：
Schneider, Kathleen M.;O'Donnell, Brian E.;Dean, Debbie
2006年，负责管理美国医疗保险计划的医疗保险和医疗补助服务中心推出了慢性病数据仓库(CCW)。CCW包含1999年1月1日起随机抽取5%的联邦医疗保险受益人(以及从2000年起100%的联邦医疗保险人口)的所有联邦医疗保险服务收费(FFS)机构和非机构索赔、疗养院和家庭健康评估数据以及登记/资格信息。21个预定义的慢性疾病指标变量被编码在《特定常规武器公约》中，以促进对慢性疾病的研究。本文描述了这一新的数据源，作者展示了《特定常规武器公约》在描述医疗保险受益人慢性病程度方面的效用。分析了2005年联邦医疗保险FFS人群中一些常见和高成本慢性病的患病率、利用率和联邦医疗保险计划成本。调查的慢性疾病包括糖尿病、慢性阻塞性肺疾病(COPD)、心力衰竭、癌症、慢性肾脏疾病(CKD)和抑郁症。50%的联邦医疗保险FFS受益人正在接受这些慢性疾病中的一种或多种的护理。糖尿病的患病率最高，近四分之一的联邦医疗保险FFS研究队列接受了这种疾病的治疗(24.3%)。2005年，慢性肾脏病(9.51天)和慢性阻塞性肺病(8.18天)的年住院天数最高。随着慢性病人数的增加，每个受益人的平均医疗保险支付金额大幅增加。只有一种慢性病的受益人每年的联邦医疗保险金额为7,172美元。对于有两种情况的人，支付金额跃升至14,931美元，对于有三种或三种以上情况的人，每位受益人的年联邦医疗保险支付为32,498美元。《特定常规武器公约》的数据文件对卫生服务研究具有巨大的价值。《特定常规武器公约》内的纵向数据和受益者联系是这一数据来源的特点，这使其成为进一步研究疾病流行和随时间发展的理想工具。随着《特定常规武器公约》积累更多年的管理数据，受益服务的扩展历史增加了这一本已丰富的数据源的价值。
In 2006, the Centers for Medicare & Medicaid Services, which administers the Medicare program in the United States, launched the Chronic Condition Data Warehouse (CCW). The CCW contains all Medicare fee-for-service (FFS) institutional and non-institutional claims, nursing home and home health assessment data, and enrollment/eligibility information from January 1, 1999 forward for a random 5% sample of Medicare beneficiaries (and 100% of the Medicare population from 2000 forward). Twenty-one predefined chronic condition indicator variables are coded within the CCW, to facilitate research on chronic conditions.The current article describes this new data source, and the authors demonstrate the utility of the CCW in describing the extent of chronic disease among Medicare beneficiaries. Medicare claims were analyzed to determine the prevalence, utilization, and Medicare program costs for some common and high cost chronic conditions in the Medicare FFS population in 2005. Chronic conditions explored include diabetes, chronic obstructive pulmonary disease (COPD), heart failure, cancer, chronic kidney disease (CKD), and depression.Fifty percent of Medicare FFS beneficiaries were receiving care for one or more of these chronic conditions. The highest prevalence is observed for diabetes, with nearly one-fourth of the Medicare FFS study cohort receiving treatment for this condition (24.3 percent). The annual number of inpatient days during 2005 is highest for CKD (9.51 days) and COPD (8.18 days). As the number of chronic conditions increases, the average per beneficiary Medicare payment amount increases dramatically. The annual Medicare payment amounts for a beneficiary with only one of the chronic conditions is $7,172. For those with two conditions, payment jumps to $14,931, and for those with three or more conditions, the annual Medicare payments per beneficiary is $32,498.The CCW data files have tremendous value for health services research. The longitudinal data and beneficiary linkage within the CCW are features of this data source which make it ideal for further studies regarding disease prevalence and progression over time. As additional years of administrative data are accumulated in the CCW, the expanded history of beneficiary services increases the value of this already rich data source.