Medicare Data

在这个项目中，我们将研究医疗保险A部分和B文件的时间轨迹，其中包含对服务使用的个人事件的记录，将完全链接到1982年至2002年期间的1982年，1984年，1989年，1884年和1999年NLTCS筛选，社区和机构的采访记录。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有关特定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进，部分原因是医疗实践和诊断精确度发生了变化。 所有年份的医疗保险数据的共同点是，在1982年至2002年的整个时间段内，NLTCS样本中每个人每天的医疗保险服务消费和支出的确切日期、持续时间和金额都可以在这些文件中找到。因此，个人的医疗保险记录可以在时间、年龄、性别和其他人口统计学域上累积，以根据需要与NLTCS访谈数据中表现的功能状态和健康变化相关。将对个人的医疗保险服务使用数据进行检查，这两种数据都是在常用（文献中）残疾类别的基本水平上（例如，1-2、3-4、5-6 ADL受损），并通过使用客观缩放程序将多个调查指标组合转换为少量残疾或健康评分。一旦医疗保险数据随着时间的推移被记录并与调查数据相关，就有可能寻找与医疗保险计划或老年人（65岁以上）和最老的老年人（85岁以上）人口和人口统计学亚组的新型治疗和诊断机制的可用性变化相关的时期效应证据。

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.