Lochner Kimberly A, Wynne Marc A, Wheatcroft Gloria H, Worrall Chris M, Kelman Jeffrey A
Centers for Medicare & Medicaid Services, Sam Nunn Atlanta Federal Center, Atlanta, Georgia; Office of Information Products and Data Analytics, Baltimore, Maryland.
Center for Medicare, Baltimore, Maryland.
Am J Prev Med. 2015 Apr;48(4):384-91. doi: 10.1016/j.amepre.2014.10.016. Epub 2015 Feb 18.
Although self-reported influenza vaccination status is routinely used in surveillance to estimate influenza vaccine coverage, Medicare data are becoming a promising resource for influenza surveillance to inform vaccination program management and planning.
To evaluate the concordance between self-reported influenza vaccination and influenza vaccination claims among Medicare beneficiaries.
This study compared influenza vaccination based upon Medicare claims and self-report among a sample of Medicare beneficiaries (N=9,378) from the 2011 Medicare Current Beneficiary Survey, which was the most recent year of data at the time of analysis (summer 2013). Sensitivity, specificity, positive predictive value, and negative predictive value were calculated using self-reported data as the referent standard. Logistic regression was used to compute the marginal mean proportions for whether a Medicare influenza vaccination claim was present among beneficiaries who reported receiving the vaccination.
Influenza vaccination was higher for self-report (69.4%) than Medicare claims (48.3%). For Medicare claims, sensitivity=67.5%, specificity=96.3%, positive predictive value=97.6%, and negative predictive value=56.7%. Among beneficiaries reporting receiving an influenza vaccination, the percentage of beneficiaries with a vaccination claim was lower for beneficiaries who were aged <65 years, male, non-Hispanic black or Hispanic, and had less than a college education.
The classification of influenza vaccination status for Medicare beneficiaries can differ based upon survey and claims. To improve Medicare claims-based surveillance studies, further research is needed to determine the sources of discordance in self-reported and Medicare claims data, specifically for sensitivity and negative predictive value.
尽管在监测中常规使用自我报告的流感疫苗接种状况来估计流感疫苗接种覆盖率，但医疗保险数据正成为流感监测的一个有前景的资源，可为疫苗接种计划管理和规划提供信息。
评估医疗保险受益人中自我报告的流感疫苗接种情况与流感疫苗接种理赔之间的一致性。
本研究比较了2011年医疗保险当前受益人调查中医疗保险受益人群体样本（N = 9378）基于医疗保险理赔和自我报告的流感疫苗接种情况，该调查是分析时（2013年夏季）可获取的最新年份数据。以自我报告数据作为参照标准计算敏感性、特异性、阳性预测值和阴性预测值。使用逻辑回归计算报告接种疫苗的受益人中存在医疗保险流感疫苗接种理赔的边际平均比例。
自我报告的流感疫苗接种率（69.4%）高于医疗保险理赔率（48.3%）。对于医疗保险理赔，敏感性 = 67.5%，特异性 = 96.3%，阳性预测值 = 97.6%，阴性预测值 = 56.7%。在报告接种流感疫苗的受益人中，年龄＜65岁、男性、非西班牙裔黑人或西班牙裔且受教育程度低于大学的受益人中有疫苗接种理赔的比例较低。
医疗保险受益人的流感疫苗接种状况分类可能因调查和理赔情况而异。为改进基于医疗保险理赔的监测研究，需要进一步研究以确定自我报告数据和医疗保险理赔数据不一致的来源，特别是关于敏感性和阴性预测值方面。
