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利用医疗补助计划索赔数据研究处方药使用情况及结果:优势、局限性与策略

Studying prescription drug use and outcomes with medicaid claims data: strengths, limitations, and strategies.

作者信息

Crystal Stephen, Akincigil Ayse, Bilder Scott, Walkup James T

机构信息

Center for Health Services Research on Pharmacotherapy, Chronic Disease Management and Outcomes, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey, USA.

出版信息

Med Care. 2007 Oct;45(10 Supl 2):S58-65. doi: 10.1097/MLR.0b013e31805371bf.

Abstract

Medicaid claims and eligibility data, particularly when linked to other sources of patient-level and contextual information, represent a powerful and under-used resource for health services research on the use and outcomes of prescription drugs. However, their effective use poses many methodological and inferential challenges. This article reviews strengths, limitations, challenges, and recommended strategies in using Medicaid data for research on the initiation, continuation, and outcomes of prescription drug therapies. Drawing from published research using Medicaid data by the investigators and other groups, we review several key validity and methodological issues. We discuss strategies for claims-based identification of diagnostic subgroups and procedures, measuring and modeling initiation and persistence of regimens, analysis of treatment disparities, and examination of comorbidity patterns. Based on this review, we discuss "best practices" for appropriate data use and validity checking, approaches to statistical modeling of longitudinal patterns in the presence of typical challenges, and strategies for strengthening the power and potential of Medicaid datasets. Finally, we discuss policy implications, including the potential for the research use of Medicare Part D data and the need for further initiatives to systematically develop and optimally use research datasets that link Medicaid and other sources of clinical and outcome information.

摘要

医疗补助计划的报销申请和资格数据,尤其是当与患者层面的其他信息来源以及背景信息相联系时,对于研究处方药的使用情况和治疗结果而言,是一种强大但未得到充分利用的资源。然而,有效利用这些数据会带来诸多方法学和推断方面的挑战。本文回顾了在利用医疗补助计划数据开展处方药治疗的起始、持续情况及治疗结果研究时的优势、局限性、挑战以及推荐策略。借鉴研究人员和其他团队利用医疗补助计划数据发表的研究成果,我们回顾了几个关键的效度和方法学问题。我们讨论了基于报销申请来识别诊断亚组和程序、衡量和建模治疗方案的起始与持续情况、分析治疗差异以及检查合并症模式的策略。基于这一回顾,我们讨论了数据合理使用和效度核查的“最佳实践”、在面对典型挑战时对纵向模式进行统计建模的方法以及增强医疗补助计划数据集效力和潜力的策略。最后,我们讨论政策影响,包括医疗保险D部分数据用于研究的潜力,以及进一步开展系统性开发和优化使用将医疗补助计划与其他临床及结果信息来源相联系的研究数据集的倡议的必要性。

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