Medicare Data

在这个项目中，我们将研究联邦医疗保险A部分和B部分文件的时间轨迹，这些文件包含有关个别服务使用情况的记录，将在1982至2002年期间完全链接到1982、1984、1989、1884和1999年的NLTCS筛查、社区和机构面谈记录。随着时间的推移，对联邦医疗保险计算机文件和数据系统的修订增加了它们提供的有关特定联邦医疗保险治疗和诊断的信息。部分原因是数据库的信息内容和结构有所改善，部分原因是医疗实践和诊断精度的变化。所有年份的联邦医疗保险数据的共同之处在于，通过联邦医疗保险消费和支出的确切日期、持续时间和金额都在这些文件中可用，这些文件包含在NLTCS样本中的每个人在整个时间段1982至2002年的每一天。因此，个人的医疗保险记录可以随着时间、年龄、性别和其他人口统计学领域的需要而积累，以与NLTCS访谈数据中显示的功能状态和健康变化相关。个人的医疗保险服务使用数据将针对个人群体进行检查，既包括常用残疾类别(例如，1-2、3-4、5-6 ADL受损)的基本级别，也包括使用客观标度程序将多项调查衡量标准转换为少量残疾或健康分数的方法。一旦医疗保险数据随着时间的推移而被记录并与调查数据相关，就可以寻找与医疗保险计划的变化或老年(65岁)和高龄(85岁)人口和人口子组的新型治疗和诊断机制的可用性有关的时期效应的证据。

In this project we will examine the temporal trajectories of Medicare Part A and B files, which contain records on individual episodes of service use, will be fully linked for the period 1982 to 2002 to the 1982, 1984, 1989, 1884, and 1999 NLTCS screening, community, and institutional interview records. Revisions of the Medicare computer files and data systems increased the information they provide about specific Medicare treatments and diagnoses over time. In part this is due to an improvement in the information content and structure of the databases and, in part, it is due to changes in medical practice and diagnostic precision. What is common to all years of Medicare data is that the exact dates, durations, and amounts of services consumed and expenditures made through Medicare are available on those files for each person in the NLTCS sample for each day in the entire time period 1982 to 2002. Thus, the Medicare records for individuals can be accumulated over the time, age, gender, and other demographic domains as needed to be related to the functional status and health changes manifest in the NLTCS interview data. The Medicare service use data for individuals will be examined for groups of individuals, both at a basic level for commonly (in the literature) used disability categories (e.g., 1-2, 3-4, 5-6 ADLs impaired), and by using objective scaling procedures to transform batteries of multiple survey measures into a small number of disability or health scores. Once the Medicare data are recorded over time and related to survey data, it will be possible to also look for evidence of period effects related to changes in the Medicare Program or in the availability of new types of therapies and diagnostic mechanisms for the elderly (65+) and oldest old (85+) populations and demographic subgroups.