DATA MANAGEMENT CORE

要了解不同医生、医生群体和 在医院提供医疗服务的效率方面，关键是要有一个全面的 数据库具有足够的能力来描述卫生保健利用的详细模式并能够 将这些文件链接到现在可从其他来源获得的补充数据，如患者或提供者调查。 联邦医疗保险索赔数据是这项任务的理想选择，因为它有三个关键特征。首先，它们是全国性的 适用范围：98%的老年人有资格享受医疗保险，因为几乎所有的医院和医生都提供 对于联邦医疗保险参保人的护理，数据可以提供对影响医院业绩的因素的洞察 医生的执业范围也更广。其次，索赔数据提供了详细的人口统计和财务数据 信息，以及关于向按服务付费的参与者提供的具体服务的丰富临床细节。第三, 在获得适当的批准以保护机密性的情况下，可以使用符合以下条件的个人标识符来获取数据 可以支持跨文件、随时间推移和到其他来源的链接。这些数据在各种情况下的效用 医疗保健和经济研究已经得到了充分的证明。 分析这些数据的复杂性和成本激发了该数据核心的具体目标： 1.维护和更新全面和安全的医疗保险登记文件、报销申请数据库 记录和补充文件。 2.获取和管理本计划项目拨款所需的具体研究文件，并制定 项目特定的分析文件。 3.为了保持计算基础设施和程序能够管理大量患者可识别的， 保密数据，同时确保及时和适当地接触授权调查人员。 4.将根据本计划项目拨款开发的研究文件提供给研究人员 社区在法律允许的范围内。 关于向联邦医疗保险受益人提供的具体服务以及质量和 他们接受的护理费用可以为提高医疗保健效率提供强有力的工具。这个 这些数据库的机密性和个人性要求它们必须在安全和 高效的数据中心，可以有效地管理它们，同时保护数据的完整性 支持授权调查人员的需求。

To understand the causes and consequences of differences across physicians, physician groups, and hospitals in the efficiency with which they deliver medical care, it is crucial to have a comprehensive database with sufficient power to characterize detailed patterns of health care utilization and to be able to link those files to supplemental data now available from other sources such as patient or provider surveys. The Medicare claims data are ideal for this task because of three key features. First, they are national in scope: 98% of the elderly are eligible for Medicare, and because almost all hospitals and physicians provide care to Medicare enrollees, the data can provide insight into factors that influence both hospital performance and physician practice more generally. Second, the claims data provides detailed demographic and financial information, as well as rich clinical detail on the specific services provided to fee-for-service enrollees. Third, with appropriate approvals to preserve confidentiality, the data can be obtained with individual identifiers that can support linkage across files, over time, and to other sources. The utility of these data for a wide range of health care and economic research studies has been amply demonstrated. The complexity and costs of analyzing these data motivate the specific aims of this Data Core: 1. To maintain and update a comprehensive and secure database of Medicare enrollment files, claims records, and supplementary files. 2. To obtain and manage specific research files required for this Program Project Grant and to develop project-specific analytic files. 3. To maintain a computing infrastructure and procedures capable of managing a high volume of patientidentifiable, confidential data while ensuring timely and appropriate access to authorized investigators. 4. To make the research files developed under this program project grant available to the research community to the extent permissible under law. Comprehensive information on the specific services provided to Medicare beneficiaries and the quality and costs of the care they receive can provide a powerful tool for improving the efficiency of medical care. The confidential and personal nature of these databases mandates that they be maintained in a secure and efficient data center that can manage them effectively while protecting the integrity of the data and supporting the needs of authorized investigators.