Mitchell J B, Bubolz T, Paul J E, Pashos C L, Escarce J J, Muhlbaier L H, Wiesman J M, Young W W, Epstein R S, Javitt J C
Health Economics Research, Inc., Waltham, MA 02154.
Med Care. 1994 Jul;32(7 Suppl):JS38-51.
Medicare claims databases have several advantages for use in constructing episodes of care for outcomes research. They are population-based, relatively inexpensive to obtain, include large numbers of cases, and can be used for long-term follow-up. However, the sheer size of these claims databases, along with their primarily administrative (as opposed to clinical) nature, requires that researchers take special care in using them. The 10 PORTs using Medicare claims provided information on their approach to several key issues in working with these data, including: 1) identifying the index cases or patient cohorts to be studied; 2) defining the length of the episode; and 3) measuring outcomes. This paper reports the experience and knowledge gained by these PORTs in using these claims to create and analyze episodes of care.
医疗保险理赔数据库在构建用于结果研究的照护事件方面具有若干优势。它们以人群为基础，获取成本相对较低，包含大量病例，并且可用于长期随访。然而，这些理赔数据库规模庞大，且主要具有行政（而非临床）性质，这就要求研究人员在使用它们时格外谨慎。10个使用医疗保险理赔数据的PORTs提供了有关其处理这些数据时几个关键问题的方法的信息，包括：1）确定要研究的索引病例或患者队列；2）定义事件的时长；3）测量结果。本文报告了这些PORTs在使用这些理赔数据创建和分析照护事件方面所获得的经验和知识。
