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将美国移植登记处与行政索赔数据相连接:拓展移植研究的潜力。

Linking the US transplant registry to administrative claims data: expanding the potential of transplant research.

作者信息

Gilmore Amanda S, Helderman J Harold, Ricci Jean-Francois, Ryskina Kira L, Feng Sandy, Kang Ning, Legorreta Antonio P

机构信息

Health Benchmarks, Inc., Woodland Hills, California, USA.

出版信息

Med Care. 2007 Jun;45(6):529-36. doi: 10.1097/MLR.0b013e3180326121.

Abstract

OBJECTIVE

In the United States, data on transplanted and waitlisted patients collected by the Organ Procurement and Transplantation Network (OPTN) have been widely used in transplantation research. Administrative claims data, collected by health plans for reimbursement purposes, are also commonly used in health-services research. This study linked OPTN and private payer claims data to assess the relationship between data elements common to both sources.

METHODS

All transplanted or waitlisted patients in the registry were considered for inclusion. A multistep match algorithm was employed to link OPTN and payer data from years 1995 to 2004. Variables common to both datasets that contained relevant information for similar time periods were compared.

RESULTS

A total of 21,419 solid organ transplant recipients and 8808 waitlist patients were included in the final linked database. Organ type and demographic variable distributions in the linked dataset were similar to the overall OPTN database. Using claims as the reference group, sensitivity and specificity values were on average 0.72 and 0.69, respectively, and were highest for the indicators of immunosuppression use at discharge and follow-up.

CONCLUSION

This comparison of payer data with information reported by transplant centers to the OPTN provides important insight into the value of both data sources. Using administrative claims to augment the registry data with utilization and cost information will be useful for evaluation of both economic and clinical endpoints in solid organ transplantation.

摘要

目的

在美国,器官获取与移植网络(OPTN)收集的移植患者和等待名单上患者的数据已广泛用于移植研究。健康计划为报销目的收集的行政索赔数据也常用于卫生服务研究。本研究将OPTN数据与私人支付方索赔数据相链接,以评估两个数据源共有的数据元素之间的关系。

方法

登记处所有接受移植或在等待名单上的患者均被纳入研究。采用多步骤匹配算法将1995年至2004年的OPTN数据与支付方数据相链接。对两个数据集在相似时间段内包含相关信息的共同变量进行比较。

结果

最终的链接数据库共纳入了21419名实体器官移植受者和8808名等待名单上的患者。链接数据集中的器官类型和人口统计学变量分布与整个OPTN数据库相似。以索赔数据作为参照组,敏感性和特异性值平均分别为0.72和0.69,且在出院时和随访时免疫抑制使用指标方面最高。

结论

将支付方数据与移植中心向OPTN报告的数据进行比较,为了解这两个数据源的价值提供了重要见解。利用行政索赔数据,用利用情况和成本信息来补充登记数据,将有助于评估实体器官移植中的经济和临床终点。

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