Roberto Pamela, Brandt Nicole, Onukwugha Eberechukwu, Stuart Bruce
Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD.
Policy & Research Department, PhRMA, Washington, DC.
Health Serv Res. 2017 Jun;52(3):1239-1248. doi: 10.1111/1475-6773.12528. Epub 2016 Jul 24.
To assess the impact of substance abuse claims redaction on Medicare spending estimates for beneficiaries with serious mental illness.
The 2012 claims and unredacted beneficiary-level Medicare spending totals from CMS's Chronic Conditions Warehouse.
We identified beneficiaries with claims affected by the redaction by comparing claims-based spending estimates to unredacted spending totals. Differences in characteristics of beneficiaries with and without redacted claims were examined in bivariate analyses.
Claims-based spending totals differed from unredacted totals for 19.7 percent of the cohort. Part A spending for those with redacted claims was underreported by 57.0 percent. Characteristics of beneficiaries with and without redacted claims differed significantly.
Researchers who rely on Medicare claims to analyze spending outcomes for beneficiaries with serious mental illness should be aware of the potential for bias due to nonrandom redaction of substance abuse data.
评估药物滥用信息编辑对患有严重精神疾病受益人的医疗保险支出估算的影响。
来自医疗保险和医疗补助服务中心慢性病仓库的2012年索赔数据及未编辑的受益方层面医疗保险支出总额。
通过将基于索赔的支出估算与未编辑的支出总额进行比较，我们识别出索赔受编辑影响的受益人。在双变量分析中检验了有和没有编辑索赔的受益人在特征上的差异。
19.7%的队列中基于索赔的支出总额与未编辑的总额不同。有编辑索赔者的A部分支出少报了57.0%。有和没有编辑索赔的受益人特征存在显著差异。
依赖医疗保险索赔来分析患有严重精神疾病受益人的支出结果的研究人员应意识到由于药物滥用数据的非随机编辑而导致偏差的可能性。
