Mokyr Horner Elizabeth, Cullen Mark R
American Institutes for Research, 2800 Campus Drive, Suite 200, San Mateo, CA, 94403, USA.
Stanford University, Stanford Medical School, MSOB 1265 Welch Rd X338, Stanford, CA, 94305, USA.
BMC Public Health. 2015 Sep 30;15:995. doi: 10.1186/s12889-015-2329-6.
Researchers investigating health outcomes for populations over age 65 can utilize Medicare claims data, but these data include no direct information about individuals' health prior to age 65 and are not typically linkable to files containing data on exposures and behaviors during their worklives. The current paper is a proof-of-concept, of merging employers' administrative data and private, employment-based health claims with Medicare data. Characteristics of the linked data, including sensitivity and specificity, are evaluated with an eye toward potential uses of such linked data. This paper uses a sample of former manufacturing workers from an industrial cohort as a test case. The dataset created by this integration could be useful to research in areas such as social epidemiology and occupational health.
Medicare and employment administrative data were linked for a large cohort of manufacturing workers (employed at some point during 1996-2008) who transitioned onto Medicare between 2001-2009. Data on work-life health, including biometric indicators, were used to predict health at age 65 and to investigate the concordance of employment-based insurance claims with subsequent Medicare insurance claims.
Chronic diseases were found to have relatively high levels of concordance between employment-based private insurance and subsequent Medicare insurance. Information about patient health prior to receipt of Medicare, including biometric indicators, were found to predict health at age 65.
Combining these data allows for evaluation of continuous health trajectories, as well as modeling later-life health as a function of work-life behaviors and exposures. It also provides a potential endpoint for occupational health research. This is the first harmonization of its kind, providing a proof-of-concept. The dataset created by this integration could be useful for research in areas such as social epidemiology and occupational health.
研究65岁以上人群健康状况的研究人员可以利用医疗保险理赔数据，但这些数据不包含有关个人65岁之前健康状况的直接信息，并且通常无法与包含其工作期间接触情况和行为数据的文件相链接。本文是一项将雇主行政数据、基于就业的私人健康理赔数据与医疗保险数据合并的概念验证研究。对链接数据的特征（包括敏感性和特异性）进行了评估，以关注此类链接数据的潜在用途。本文以一个工业队列中的前制造业工人样本作为测试案例。这种整合创建的数据集可能对社会流行病学和职业健康等领域的研究有用。
将医疗保险和就业行政数据链接起来，涉及一大群制造业工人（在1996 - 2008年期间的某个时间受雇），他们在2001 - 2009年期间开始享受医疗保险。关于工作期间健康状况的数据，包括生物特征指标，被用于预测65岁时的健康状况，并调查基于就业的保险理赔与后续医疗保险理赔的一致性。
发现慢性病在基于就业的私人保险和后续医疗保险之间具有相对较高的一致性水平。发现包括生物特征指标在内的医疗保险参保前患者健康信息可预测65岁时的健康状况。
合并这些数据有助于评估连续的健康轨迹，以及将晚年健康状况建模为工作期间行为和接触情况的函数。它还为职业健康研究提供了一个潜在的终点。这是首次进行此类整合，提供了一个概念验证。这种整合创建的数据集可能对社会流行病学和职业健康等领域的研究有用。
