Brown School, Washington University in St. Louis, St. Louis, MO.
Health Care Evaluation, NORC at the University of Chicago, Bethesda, MD.
Med Care. 2023 Dec 1;61(12 Suppl 2):S122-S130. doi: 10.1097/MLR.0000000000001896. Epub 2023 Nov 9.
Medicare patients and other stakeholders often make health care decisions that have economic consequences. Research on economic variables that patients have identified as important is referred to as patient-centered outcomes research (PCOR) and can generate evidence that informs decision-making. Medicare fee-for-service (FFS) claims are widely used for research and are a potentially valuable resource for studying some economic variables, particularly when linked to other datasets.
The aim of this study was to identify and assess the characteristics of federally funded administrative and survey data sources that can be linked to Medicare claims for conducting PCOR on some economic outcomes.
A targeted internet search was conducted to identify a list of relevant data sources. A technical panel and key informant interviews were used for guidance and feedback.
We identified 12 survey and 6 administrative sources of linked data for Medicare FFS beneficiaries. A majority provide longitudinal data and are updated annually. All linked sources provide some data on social determinants of health and health equity-related factors. Fifteen sources capture direct medical costs (beyond Medicare FFS payments); 5 capture indirect costs (eg, lost wages from absenteeism), and 7 capture direct nonmedical costs (eg, transportation).
Linking Medicare FFS claims data to other federally funded data sources can facilitate research on some economic outcomes for PCOR. However, few sources capture direct nonmedical or indirect costs. Expanding linkages to include additional data sources, and reducing barriers to existing data sources, remain important objectives for increasing high-quality, patient-centered economic research.
医疗保险患者和其他利益相关者经常做出对经济有影响的医疗保健决策。研究患者认为重要的经济变量的研究被称为以患者为中心的结果研究(PCOR),可以生成为决策提供信息的证据。医疗保险按服务收费(FFS)索赔被广泛用于研究,并且是研究某些经济变量的潜在有价值的资源,尤其是当与其他数据集相关联时。
本研究旨在确定和评估可与医疗保险索赔相关联的联邦资助的行政和调查数据源的特征,以开展某些经济结果的 PCOR。
进行了有针对性的互联网搜索,以确定相关数据源的列表。技术小组和关键意见访谈用于指导和反馈。
我们确定了 12 个与医疗保险 FFS 受益人的调查和 6 个行政数据链接来源。大多数提供纵向数据并每年更新。所有链接的来源都提供一些关于健康的社会决定因素和与健康公平相关的因素的数据。15 个来源记录了直接医疗费用(超出医疗保险 FFS 付款);5 个记录了间接费用(例如,缺勤导致的工资损失),7 个记录了直接非医疗费用(例如,交通费用)。
将医疗保险 FFS 索赔数据与其他联邦资助的数据源相关联可以促进 PCOR 对某些经济结果的研究。然而,很少有来源记录直接非医疗或间接费用。扩大链接以包括其他数据源,并降低现有数据源的障碍,仍然是增加高质量、以患者为中心的经济研究的重要目标。