Mouchawar Judy, Byers Tim, Warren Meghan, Schluter W William
Kaiser Permanente Colorado, Colorado, USA.
Med Care Res Rev. 2004 Mar;61(1):116-27. doi: 10.1177/1077558703260182.
Mammography use is monitored through Medicare billing claims; however, the sensitivity of this data source has not been previously described. This study included 10,852 Colorado women ages 65 and older with a mammogram in 1998 as registered by the Colorado Mammography Project who were Medicare fee-for-service (FFS) enrollees. These records were matched to Medicare billing data to assess the proportion of those mammograms submitted for payment to Medicare. The overall sensitivity of the FFS Medicare billing data for screening mammography was 85 percent. Medicare billing claims were less sensitive for younger women, African Americans, women with some college education, and women with supplementary private insurance. In Colorado, the Medicare FFS billing claims understates mammography usage by 15 percent. Care must be taken when comparing mammography use derived from Medicare billing claims, as the sensitivity of billing data can vary substantially by age, race, and socioeconomic status.
乳房X光检查的使用情况通过医疗保险计费索赔进行监测；然而，此前尚未描述过该数据源的敏感性。本研究纳入了10852名科罗拉多州65岁及以上的女性，她们在1998年进行了乳房X光检查，这些女性是科罗拉多乳房X光检查项目登记在册的医疗保险按服务收费（FFS）参保者。将这些记录与医疗保险计费数据进行匹配，以评估提交给医疗保险报销的乳房X光检查的比例。FFS医疗保险计费数据用于筛查性乳房X光检查的总体敏感性为85%。医疗保险计费索赔对年轻女性、非裔美国人、接受过一些大学教育的女性以及拥有补充私人保险的女性敏感性较低。在科罗拉多州，医疗保险FFS计费索赔低估了15%的乳房X光检查使用率。在比较源自医疗保险计费索赔的乳房X光检查使用情况时必须谨慎，因为计费数据的敏感性可能因年龄、种族和社会经济地位而有很大差异。
