Lewis N J, Patwell J T, Briesacher B A
Institute for Pharmaceutical Economics, Philadelphia College of Pharmacy and Science, Pennsylvania.
Pharmacoeconomics. 1993 Nov;4(5):323-30. doi: 10.2165/00019053-199304050-00003.
The use of insurance claims databases in drug therapy outcomes research holds great promise as a cost-effective alternative to post-marketing clinical trials. Claims databases uniquely capture information about episodes of care across healthcare services and settings. They also facilitate the examination of drug therapy effects on cohorts of patients and specific patient subpopulations. However, there are limitations to the use of insurance claims databases including incomplete diagnostic and provider identification data. The characteristics of the population included in the insurance plan, the plan benefit design, and the variables of the database itself can influence the research results. Given the current concerns regarding the completeness of insurance claims databases, and the validity of their data, outcomes research usually requires original data to validate claims data or to obtain additional information. Improvements to claims databases such as standardisation of claims information reporting, addition of pertinent clinical and economic variables, and inclusion of information relative to patient severity of illness, quality of life, and satisfaction with provided care will enhance the benefit of such databases for outcomes research.
在药物治疗结果研究中使用保险理赔数据库，作为上市后临床试验具有成本效益的替代方案，前景广阔。理赔数据库独特地捕捉了跨医疗服务和环境的护理事件信息。它们还便于考察药物治疗对患者群体和特定患者亚群的影响。然而，使用保险理赔数据库存在局限性，包括诊断和提供者识别数据不完整。保险计划中纳入人群的特征、计划福利设计以及数据库本身的变量都会影响研究结果。鉴于目前对保险理赔数据库完整性及其数据有效性的担忧，结果研究通常需要原始数据来验证理赔数据或获取额外信息。对理赔数据库的改进，如理赔信息报告的标准化、添加相关临床和经济变量以及纳入与患者疾病严重程度、生活质量和对所提供护理满意度相关的信息，将提高此类数据库在结果研究中的效益。
