Medicare Data

在这个项目中，我们将研究医疗保险A部分和B部分档案的时间轨迹，其中包含个人服务使用记录，将1982年至2002年期间与1982年、1984年、1989年、1884年和1999年NLTCS筛查、社区和机构访谈记录完全联系起来。随着时间的推移，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关于特定医疗保险治疗和诊断的信息。这部分是由于数据库的信息内容和结构有所改进，部分是由于医疗实践和诊断精度的变化。所有年份医疗保险数据的共同之处在于，在1982年至2002年的整个时间段内，NLTCS样本中每个人每天的确切日期、持续时间和通过医疗保险消费和支出的服务数量在这些文件中都是可用的。因此，个人的医疗保险记录可以按时间、年龄、性别和其他需要的人口统计领域累积，以与NLTCS访谈数据中显示的功能状态和健康变化相关。个人医疗保险服务使用数据将对个人群体进行检查，包括在常用（文献中）使用的残疾类别（例如，1-2、3-4、5-6 adl受损）的基本水平上，以及通过使用客观的标度程序将多种调查措施转换为少量残疾或健康评分。一旦医疗保险数据随时间记录下来并与调查数据相关联，就有可能寻找与医疗保险计划变化或针对老年人（65岁以上）和最高龄老年人（85岁以上）人口和人口亚组的新型治疗和诊断机制的可用性相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.