Optimal Use of Available Claims to Identify a Medicare Population Free of Coronary Heart Disease

被引:22
作者
Kent, Shia T. [1 ]
Safford, Monika M. [3 ]
Zhao, Hong [1 ]
Levitan, Emily B. [1 ]
Curtis, Jeffrey R. [4 ]
Kilpatrick, Ryan D. [5 ]
Kilgore, Meredith L. [2 ]
Muntner, Paul [1 ]
机构
[1] Univ Alabama Birmingham, Sch Publ Hlth, Dept Epidemiol, Birmingham, AL 35294 USA
[2] Univ Alabama Birmingham, Sch Publ Hlth, Hlth Care Org & Policy, Birmingham, AL 35294 USA
[3] Univ Alabama Birmingham, Sch Med, Dept Med, Div Prevent Med, Birmingham, AL 35294 USA
[4] Univ Alabama Birmingham, Sch Med, Dept Med, Div Clin Immunol & Rheumatol, Birmingham, AL 35294 USA
[5] Baxalta US Inc, Dept Global Drug Safety, Cambridge, MA USA
基金
美国国家卫生研究院;
关键词
algorithms; bias (epidemiology); coronary disease; epidemiologic methods; Medicare; REPORTED CARDIOVASCULAR-DISEASE; MYOCARDIAL-INFARCTION; ADMINISTRATIVE DATA; RISK; STROKE; AGE; HYPERTENSION; ADJUSTMENT; AGREEMENT; DATABASES;
D O I
10.1093/aje/kwv116
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
We examined claims-based approaches for identifying a study population free of coronary heart disease (CHD) using data from 8,937 US blacks and whites enrolled during 2003-2007 in a prospective cohort study linked to Medicare claims. Our goal was to minimize the percentage of persons at study entry with self-reported CHD (previous myocardial infarction or coronary revascularization). We assembled 6 cohorts without CHD claims by requiring 6 months, 1 year, or 2 years of continuous Medicare fee-for-service insurance coverage prior to study entry and using either a fixed-window or all-available look-back period. We examined adding CHD-related claims to our "base algorithm," which included claims for myocardial infarction and coronary revascularization. Using a 6-month fixed window look-back period, 17.8% of participants without claims in the base algorithm reported having CHD. This was reduced to 3.6% using an all-available look-back period and adding other CHD claims to the base algorithm. Among cohorts using all-available look-back periods, increasing the length of continuous coverage from 6 months to 1 or 2 years reduced the sample size available without lowering the percentage of persons with self-reported CHD. This analysis demonstrates approaches for developing a CHD-free cohort using Medicare claims.
引用
收藏
页码:808 / 819
页数:12
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