Federspiel C F, Ray W A, Schaffner W
Med Care. 1976 Feb;14(2):166-72. doi: 10.1097/00005650-197602000-00006.
Health care researchers rarely employ Medicaid claim files as a data base, in part because they are designed to serve fiscal and administrative ends. Indeed, some investigators have emphasized the deficiencies in such records. In contrast, we have found Tennessee Medicaid data to be suitable for research. A statewide automated data processing system reduces the occurrence of many of the errors noted by others. Further, analysis of the July 1974 month of payment file illustrates the accuracy and internal consistency of Tennessee Medicaid data. Specimen legend drug results for ambulatory patients suggest investigations of physician prescribing patterns. Evaluation of the Medicaid claims processing system suggests other applications in health care administration and research. In a time when available resources are dwindling, the incisive use of Medicaid claims files offers an attractive alternative to expensive new systems of data collection and analysis.
医疗保健研究人员很少将医疗补助索赔档案用作数据库,部分原因在于这些档案是为财政和行政目的而设计的。事实上,一些研究人员强调了此类记录中的缺陷。相比之下,我们发现田纳西州的医疗补助数据适合用于研究。全州范围的自动化数据处理系统减少了其他人所指出的许多错误的发生。此外,对1974年7月支付档案的分析表明了田纳西州医疗补助数据的准确性和内部一致性。门诊患者的样本图例药物结果提示了对医生处方模式的调查。对医疗补助索赔处理系统的评估表明了其在医疗保健管理和研究中的其他应用。在可用资源日益减少的时代,对医疗补助索赔档案的有效利用为昂贵的新数据收集和分析系统提供了一个有吸引力的替代方案。