Department of Biostatistics, University of Michigan, Ann Arbor, Michigan.
Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.
Ann Thorac Surg. 2018 May;105(5):1397-1402. doi: 10.1016/j.athoracsur.2017.11.044. Epub 2017 Dec 19.
The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) is a United States registry for adults receiving durable United States Food and Drug Administration-approved mechanical circulatory support devices (MCSDs). We merged INTERMACS records with Medicare claims to investigate the uncertainty of penetrance of Medicare beneficiaries within INTERMACS.
INTERMACS records and Medicare claims (January 1, 2008, through December 31, 2013) from the Centers for Medicare and Medicaid (CMS) were linked using a deterministic matching methodology.
There was annual growth of CMS and INTERMACS centers performing durable MCSD implants among adults from 2008 through 2013 (54% and 87% increase, respectively). The number of CMS centers outnumbered INTERMACS centers throughout all years, with the 68% to 88% of CMS centers being represented in INTERMACS. Although annual patient volume was greatest for INTERMACS, the absolute number of patients significantly increased annually across both data sets from 2008 through 2013 (149% increase in CMS; 268% increase in INTERMACS). As a proportion of all INTERMACS registrants, Medicare beneficiary representation grew from 30% in 2008 to a high of 48% in 2010 and remained stable thereafter. Representation within INTERMACS of MCSDs implanted in Medicare beneficiaries more than doubled, from 36% in 2008 to 77% in 2013.
Using a merged data set of MCSDs implanted between 2008 and 2013, we report that the vast majority of CMS centers and Medicare beneficiaries receiving MCSDs are increasingly captured in INTERMACS. Accordingly, contemporary studies in INTERMACS are relevant and generalizable to the Medicare population.
Interagency Registry for Mechanically Assisted Circulatory Support（INTERMACS）是一个美国注册系统，用于登记接受美国食品和药物管理局（FDA）批准的机械循环支持设备（MCSD）的成年患者。我们将 INTERMACS 记录与 Medicare 索赔记录合并，以研究 Medicare 受益人群在 INTERMACS 中的纳入率的不确定性。
我们使用确定性匹配方法将 Medicare 和 Medicaid（CMS）中心的 INTERMACS 记录和 Medicare 索赔记录（2008 年 1 月 1 日至 2013 年 12 月 31 日）进行关联。
2008 年至 2013 年，接受成人永久性 MCSD 植入术的 CMS 和 INTERMACS 中心数量呈逐年增长趋势（分别增长 54%和 87%）。在所有年份，CMS 中心的数量都超过 INTERMACS 中心，68%至 88%的 CMS 中心都有代表参与 INTERMACS。尽管 INTERMACS 的年度患者数量最多，但从 2008 年到 2013 年，两个数据集的患者绝对数量都呈逐年显著增加（CMS 增加 149%；INTERMACS 增加 268%）。作为所有 INTERMACS 登记患者的一部分， Medicare 受益人群的代表性从 2008 年的 30%增加到 2010 年的 48%，此后一直保持稳定。 Medicare 受益人群接受 MCSD 植入的患者在 INTERMACS 中的比例增加了一倍多，从 2008 年的 36%增加到 2013 年的 77%。
使用 2008 年至 2013 年期间植入的 MCSD 的合并数据集，我们报告说，越来越多的 CMS 中心和 Medicare 受益人群接受 MCSD 治疗，他们都被纳入了 INTERMACS。因此，INTERMACS 中的当代研究与 Medicare 人群相关且具有普遍性。
