Validation of Medicare Claims to Define Chemotherapy Use

验证医疗保险索赔以定义化疗的使用

• 批准号: 6825924
• 负责人: Deborah Schrag
• 金额: $ 19.02万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-11 至 2006-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6825924
• 关键词: Medicare /Medicaid; clinical research; data collection methodology /evaluation; gemcitabine; health care quality; health care service evaluation; health services research tag; human data; intravenous administration; irinotecan; longitudinal human study; mathematical model; medical records; neoplasm /cancer chemotherapy; neoplasm /cancer pharmacology; paclitaxel; physicians; statistics /biometry

DESCRIPTION (provided by applicant): The linked SEER-Medicare data have rapidly become an important resource for measuring patterns and outcomes of cancer care. The advantage of using Medicare claims in addition to registry data is that they allow researchers to track care longitudinally and across sites. Investigators have begun to use Medicare claims to characterize particular chemotherapy drugs. The need to measure quality of care and increasing obstacles to medical record review indicate that SEER-Medicare will become an increasingly important resource for evaluating US cancer care. However, to date there have been few studies validating the use of SEER-Medicare to measure particular aspects of cancer treatment. Within the context of an IRB approved protocol, we propose Specific Aim 1: To validate Medicare claims as a resource for ascertaining use of: 1) intravenous chemotherapy treatment: 2) particular chemotherapeutic agents; and: 3) the duration and frequency of these treatments. We will validate the use of Medicare, claims for ascertaining chemotherapy use by comparing claims to "gold standard" pharmacy records from outpatient hemotherapy practices affiliated with Memorial Sloan-Kettering Cancer Center and the New York Hospital Network. This validation study will inform the health services research community about the reliability of using Medicare claims as a resource to understand the use of intravenous chemotherapy. If we determine Medicare claims have adequate sensitivity for specification of chemotherapy, we will address Specific Aim 2: To characterize the rate at which physicians adopt the use of new chemotherapeutic agents and to explore possible determinants of this process. Using SEER-Medicare data, we will describe how physicians adopted the use of chemotherapy drugs in response to FDA approval. We will specifically examine drugs approved in the mid-1990s including gemcitabine, paclitaxel, irinotecan and vinorelbine. We will characterize the rate at which physicians adopted each drug for specific cancers and, will identify patient, oncologist and drug-related parameters associated with slow diffusion. This knowledge has the potential to lay the groundwork for development of an inexpensive and efficient system for monitoring and improving the quality of US cancer care.

描述(由申请人提供)：关联的SEER-Medicare数据已迅速成为衡量癌症护理模式和结果的重要资源。除了登记数据外，使用联邦医疗保险索赔的好处是，它们允许研究人员纵向和跨地点跟踪护理。调查人员已经开始使用医疗保险声明来描述特定的化疗药物。衡量护理质量的需要和病历审查障碍的增加表明，SEER-Medicare将成为评估美国癌症护理的越来越重要的资源。然而，到目前为止，很少有研究证实使用SEER-Medicare来衡量癌症治疗的特定方面。在IRB批准的方案的背景下，我们提出了具体目标1：验证联邦医疗保险声明作为确定以下用途的资源：1)静脉化疗：2)特定化疗药物；以及3)这些治疗的持续时间和频率。我们将验证Medicare的使用，通过将索赔与附属于纪念斯隆-凯特琳癌症中心和纽约医院网络的门诊血液疗法的“黄金标准”药房记录进行比较，以确定化疗的使用。这项验证研究将向卫生服务研究社区通报 将医疗保险声明作为了解静脉化疗使用的资源的可靠性。 如果我们确定医疗保险索赔对指定化疗具有足够的敏感性，我们将 解决具体目标2：描述医生采用新化疗药物的速度，并探索这一过程的可能决定因素。使用SEER-Medicare数据，我们将描述医生如何在FDA批准的情况下采用化疗药物。我们将具体审查1990年代中期批准的药物，包括吉西他滨、紫杉醇、伊立替康和长春瑞滨。我们将确定医生对特定癌症采用每种药物的比率，并确定与缓慢扩散相关的患者、肿瘤学家和药物相关参数。这些知识有可能为开发一种廉价而高效的系统来监测和提高美国癌症护理的质量奠定基础。