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商业索赔数据源:PearlDiver和个体支付者数据库。

Commercial Claims Data Sources: PearlDiver and Individual Payer Databases.

作者信息

Bolognesi Michael P, Habermann Elizabeth B

机构信息

Division of Adult Reconstruction, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.

Division of Health Care Delivery Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.

出版信息

J Bone Joint Surg Am. 2022 Oct 19;104(Suppl 3):15-17. doi: 10.2106/JBJS.22.00607.

Abstract

Individual or pooled commercial claims data sources such as the IBM MarketScan and PearlDiver provide information from health-care encounters by individuals enrolled in participating health insurance plans. These data sources contain deidentified data on demographic characteristics, enrollment start and end dates, inpatient and outpatient procedures and medical diagnoses with associated service dates and settings, and dispensed medications. Although there are concerns that long-term follow-up is limited because of interruptions in the continuity of coverage and reliance on billing data may overrecord or underrecord diagnoses and confounders, these data sources are nevertheless valuable for orthopaedic studies focusing on short-term complications, costs, and utilization.

摘要

个体或汇总的商业理赔数据源,如IBM MarketScan和PearlDiver,提供参与健康保险计划的个人医疗保健就诊信息。这些数据源包含有关人口统计学特征、参保开始和结束日期、住院和门诊手术、相关服务日期和地点的医疗诊断以及配发药物的去识别化数据。尽管有人担心,由于保险覆盖的连续性中断,长期随访有限,且依赖计费数据可能会高估或低估诊断和混杂因素,但这些数据源对于关注短期并发症、成本和利用情况的骨科研究仍然很有价值。

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