Injury Diagnosis Code Accuracy in Medicaid Claims Data

这个应用程序寻求一个新的研究者培训奖，以提供支持，以初级教师进一步发展独立的研究技能，在一个新成立的伤害研究中心。根据其使用ICD-9-CM和国家电子伤害监测系统（NEISS）的经验，申请人建议验证医疗补助急诊科（艾德）索赔数据中的儿童伤害诊断代码。医疗补助索赔数据可随时用于伤害研究和计划评估，因为所有州都必须向医疗保险和医疗补助服务中心提交此类数据。 然而，对数据中损伤诊断代码的准确性知之甚少。本研究的具体目的是：（1）检查医疗补助索赔数据中关键人口统计学变量的质量;（2）调查伤害诊断代码识别儿童伤害的准确性和敏感性;（3）评估NEISS和ICD-9-CM伤害诊断代码的可比性。从2003年NEISS在研究中心收集的21,554例伤害病例中分层抽样，将产生851例医疗补助伤害病例。这项研究将把NEISS收集的伤害数据与医疗补助索赔数据联系起来。CDC急诊系统数据元素标准将用于检查Medicaid索赔数据中关键人口统计变量（例如出生日期和性别）的数据质量。病历审查将调查ICD-9-CM损伤诊断代码的准确性和敏感性。一个创新的桥接方案将评估NEISS损伤诊断评分和ICD-9-CM损伤诊断代码的可比性。该项目是由applicantto开发的多组件研究计划的第一部分 调查贫困儿童和残疾儿童的伤害。如果证明有效和可靠，申请人将寻求资金，使用医疗补助索赔数据来研究医疗补助儿童的伤害医疗费用和有心理健康问题的儿童的伤害风险。

This applicationseeks a New Investigator Training Award to providesupport to a junior faculty member to further develop independent research skillsat a newly established injury research center. Based on his experience using ICD-9-CM and the National Electronic Injury Surveillance System (NEISS), the applicant proposes to validate the childhood injury diagnosis codes in Medicaid emergency department (ED) claims data. Medicaid claims data are readily available for injury research and program evaluation due to mandatory submissionof such data by all states to the Center for Medicare and Medicaid Service. However, little is known about the accuracy of the injury diagnosis codes in the data. The specific aims of the study are to: (1) examine the quality of key demographic variables in Medicaid claims data; (2) investigate the accuracy and the sensitivityof injury diagnosiscodes to identify children's injuries; and (3) evaluate comparability of the NEISS and the ICD-9-CM injury diagnosis codes. A stratified sample from 21,554 injury cases captured by the NEISS in 2003 at the study site will result in 851 Medicaid injury cases. This studywill link injury data captured by the NEISS with Medicaid claims data. Standards in CDC Data Elements for Emergency Department Systems will be used to examine the data quality of key demographic variables (e.g. date of birth and gender) in Medicaid claims data. Medical records review will investigate the accuracy and the sensitivity of ICD-9-CM injury diagnosis codes. An innovative bridging scheme will evaluate the comparability of the NEISS injurydiagnosiscodes and ICD-9-CM injurydiagnosis codes. This project is the first part of a multi-component research programdeveloped by the applicantto investigate injuries among poor children and those with disabilities.If proved valid and reliable, funding will be sought next by the applicant to use Medicaid claims data to studythe injury medical care costs among Medicaid children and the injury risk among children with mental health problems.