CLAIMS DATA PROJECT

索赔数据项目

• 批准号: 6100419
• 负责人: KATHERINE KAHN
• 金额: --
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-09-15 至 1999-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6100419
• 关键词: behavioral /social science research tag; clinical research; health care quality; health care service evaluation; health care service utilization; health insurance; health services research tag; human data; human subject; rheumatoid arthritis

The purpose of this study is to evaluate the utility of claims data as a data source to evaluate quality of care in new onset rheumatoid arthritis; to measure the quality of care for patients with new onset rheumatoid arthritis with regard to arthritis co-morbid conditions and health care maintenance, and to identify factors associated with better attainment of quality standards. This study will prospectively follow a cohort of 400 patients with new onset rheumatoid arthritis for two years through patient surveys and claims data. Subjects will be enrolled through one large managed care organization (MCO) located in Southern California which represents an average of 2.8 million covered lives per year. Using a claims based algorithm, the 1998 through 1999 claims data for this MCO will be screened for incident cases of rheumatoid arthritis. Patients between ages 18 and 62 will be eligible for enrollment. A screening survey which will ascertain 1) whether a patient has been diagnosed with rheumatoid arthritis and/or 2) if the patient meets the 1987 American Rheumatism Association (ARA) criteria for rheumatoid arthritis by self report will be sent by mail to all eligible patients to invite participation. The first 400 responding patients who have had a prior diagnosis or meet the ARA criteria will be enrolled. Patients will complete telephone surveys which assess health status every six during the study. By using data elements from claims data, patient self report. and medical records, the structure, process, outcomes and quality of care will be assessed. Items measured in the claims data will be validated through the patient self report and medical record review. This study will inform us regarding the predictive value of claims data for identifying patients with rheumatoid arthritis and describing utilization. It will also describe the utility of claims data for assessing the process and quality of care for rheumatoid arthritis.

这项研究的目的是评估索赔数据作为 数据来源：评估新发类风湿性关节炎患者的护理质量； 衡量新发类风湿患者的护理质量 关于关节炎的并存情况和保健 维护，并确定与更好地实现 质量标准。这项研究将前瞻性地跟踪400人的队列 首次发病两年的类风湿性关节炎患者 调查和索赔数据。科目将通过一个大的 位于南加州的管理型医疗组织(MCO) 相当于平均每年有280万人参加保险。使用 基于索赔的算法，该MCO从1998年到1999年的索赔数据 将对类风湿性关节炎的病例进行筛查。病人 年龄在18岁到62岁之间的人将有资格参加。筛查调查 这将确定1)患者是否已被诊断为 类风湿性关节炎和/或2)如果患者遇到1987年的美国人 风湿病协会(ARA)自评类风湿性关节炎标准 报告将邮寄给所有符合条件的患者，邀请 参与。前400名有反应的患者有前科 诊断或符合ARA标准的患者将被录取。患者会 完成电话调查，每六年评估一次健康状况 学习。通过使用索赔数据中的数据元素，患者自我报告。和 医疗记录、结构、过程、结果和质量将 被评估。在索赔数据中测量的项目将通过 患者自我报告和病历审查。这项研究将告诉我们 美国关于索赔数据对识别患者的预测价值 类风湿性关节炎并描述其用途。它还将 描述索赔数据对评估过程和质量的效用 治疗类风湿性关节炎。