Validation of Medicare Claims to Define Chemotherapy Use

描述（由申请人提供）：相关的SEER-Medicare数据已迅速成为衡量癌症治疗模式和结果的重要资源。除了注册数据外，使用医疗保险索赔的好处是，它们允许研究人员纵向和跨站点地跟踪护理。调查人员已经开始使用医疗保险索赔来描述特定的化疗药物。衡量医疗质量的需要和越来越多的医疗记录审查障碍表明，SEER-Medicare将成为评估美国癌症医疗的越来越重要的资源。然而，迄今为止，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，我们提出具体目标1：验证医疗保险索赔作为确定使用的资源：1)静脉化疗治疗；2)特定化疗药物；3)这些治疗的持续时间和频率。我们将通过比较来自纪念斯隆-凯特琳癌症中心和纽约医院网络附属门诊血液治疗实践的“金标准”药房记录来验证医疗保险的使用，以确定化疗的使用。这项验证性研究将使卫生服务研究界了解

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.