Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.
Department of Surgery, University of Michigan, Ann Arbor, Michigan.
J Surg Res. 2024 Mar;295:274-280. doi: 10.1016/j.jss.2023.11.002. Epub 2023 Dec 3.
Trauma registries and their quality improvement programs only collect data from the acute hospital admission, and no additional information is captured once the patient is discharged. This lack of long-term data limits these programs' ability to affect change. The goal of this study was to create a longitudinal patient record by linking trauma registry data with third party payer claims data to allow the tracking of these patients after discharge.
Trauma quality collaborative data (2018-2019) was utilized. Inclusion criteria were patients age ≥18, ISS ≥5 and a length of stay ≥1 d. In-hospital deaths were excluded. A deterministic match was performed with insurance claims records based on the hospital name, date of birth, sex, and dates of service (±1 d). The effect of payer type, ZIP code, International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis specificity and exact dates of service on the match rate was analyzed.
The overall match rate between these two patient record sources was 27.5%. There was a significantly higher match rate (42.8% versus 6.1%, P < 0.001) for patients with a payer that was contained in the insurance collaborative. In a subanalysis, exact dates of service did not substantially affect this match rate; however, specific International Classification of Diseases, Tenth Revision, Clinical Modification codes (i.e., all 7 characters) reduced this rate by almost half.
We demonstrated the successful linkage of patient records in a trauma registry with their insurance claims. This will allow us to the collect longitudinal information so that we can follow these patients' long-term outcomes and subsequently improve their care.
创伤登记处及其质量改进计划仅从急性住院期间收集数据，一旦患者出院，就不再收集其他信息。这种缺乏长期数据的情况限制了这些计划改变现状的能力。本研究的目的是通过将创伤登记处的数据与第三方支付者索赔数据相联系，创建一个纵向的患者记录，以便在出院后跟踪这些患者。
利用创伤质量协作数据（2018-2019 年）。纳入标准为年龄≥18 岁、ISS≥5 且住院时间≥1 天。排除院内死亡患者。根据医院名称、出生日期、性别和服务日期（±1 天），与保险索赔记录进行确定性匹配。分析了支付者类型、ZIP 码、国际疾病分类、第十次修订版、临床修正诊断特异性以及服务日期的确切性对匹配率的影响。
这两个患者记录源之间的总体匹配率为 27.5%。在包含在保险协作中的支付者的患者中，匹配率显著更高（42.8%比 6.1%，P<0.001）。在一个亚分析中，服务日期的确切性并没有显著影响这种匹配率；然而，具体的国际疾病分类第十次修订版临床修正代码（即所有 7 个字符）使这种匹配率降低了近一半。
我们成功地将创伤登记处的患者记录与他们的保险索赔相联系。这将使我们能够收集纵向信息，以便我们可以跟踪这些患者的长期结果，并随后改善他们的护理。
