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J Comp Eff Res. 2012 Nov;1(6):519-25. doi: 10.2217/cer.12.56.
Medicare claims data sets have been used widely in outcomes research over the last decade. In 2010, the Centers for Medicare & Medicaid Services established a program to create de-identified basic standalone public use files (PUFs) from Medicare claims data, each one containing claims information from a 5% sample of beneficiaries.
We conducted a series of structured key informant interviews with research stakeholders to compile recommendations that would guide the creation of these PUFs. In this paper, we describe the interview methodology and present our findings. Fifteen researchers, representing a range of clinical health services and health policy expertise, were interviewed.
All respondents supported the use of Medicare claims in comparative effectiveness research and responded favorably to the creation of PUFs for this purpose. The interviews resulted in administrative-, technical- and content-related recommendations, some of which led to important changes in the PUFs.
A primary trade-off in the development of the proposed PUFs involved assuring maximum research utility of the files while assuring security of beneficiaries' protected health information. Protection of protected health information was considered a requirement. Given this constraint, the proposed PUFs may be most useful for two primary activities in comparative effectiveness research: first, working through the beginning stages of a research project; and second, examining high-level questions.
在过去十年中,医疗保险索赔数据已广泛用于结局研究。2010 年,医疗保险和医疗补助服务中心设立了一个项目,从医疗保险索赔数据中创建去标识化的基本独立公共使用文件(PUF),每个 PUF 都包含来自 5%的受益人的索赔信息。
我们对研究利益相关者进行了一系列结构化的关键知情人访谈,以汇编指导这些 PUF 创建的建议。在本文中,我们描述了访谈方法并介绍了研究结果。采访了 15 名研究人员,他们代表了一系列临床医疗服务和健康政策专业知识。
所有受访者都支持在比较效果研究中使用医疗保险索赔,并对为此目的创建 PUF 表示赞成。访谈结果产生了与行政、技术和内容相关的建议,其中一些建议导致 PUF 发生了重要变化。
拟议 PUF 开发中的一个主要权衡是在确保文件最大的研究效用的同时确保受益人的受保护健康信息的安全性。保护受保护的健康信息被认为是一项要求。考虑到这一限制,拟议的 PUF 可能最适用于比较效果研究中的两个主要活动:第一,完成研究项目的初步阶段;第二,研究高级别问题。