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医疗成本核算:利用医疗保险行政数据

Costing medical care: using Medicare administrative data.

作者信息

Lave J R, Pashos C L, Anderson G F, Brailer D, Bubolz T, Conrad D, Freund D A, Fox S H, Keeler E, Lipscomb J

机构信息

Graduate School of Public Health, University of Pittsburgh, PA 15261.

出版信息

Med Care. 1994 Jul;32(7 Suppl):JS77-89.

PMID:8028415
Abstract

This paper describes how the PORTS are using data from the Medicare administrative records systems to study the medical care costs of specific conditions. The general strengths and weaknesses of the Medicare databases for studying cost related issues are discussed, and the relevant data elements are examined in detail. Changes in the nature of the data collected over time are noted. Information is provided on how the PORTS are using these data to estimate the cost to Medicare of treating Medicare beneficiaries with specific conditions and the social (opportunity) cost of treating these patients. Furthermore, information is provided on how data from the Medicare administrative records system can be used to determine the cost of services for patients who have been identified through other large databases (i.e., state hospital discharge tapes) or who have been enrolled in prospective cohort studies.

摘要

本文描述了PORT如何利用医疗保险行政记录系统的数据来研究特定疾病的医疗费用。讨论了医疗保险数据库在研究成本相关问题方面的总体优势和劣势,并详细审查了相关数据元素。记录了随着时间推移所收集数据性质的变化。提供了关于PORT如何利用这些数据来估算治疗患有特定疾病的医疗保险受益人的医疗保险费用以及治疗这些患者的社会(机会)成本的信息。此外,还提供了关于如何利用医疗保险行政记录系统的数据来确定通过其他大型数据库(即州医院出院记录带)识别出的患者或已纳入前瞻性队列研究的患者的服务成本的信息。

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