Use of Medicare data in international comparisons

This paper provides a detailed description of the statistical systems of the U.S. Medicare program and discusses how these data bases can be used for health policy analyses and for international comparisons of health systems at the microeconomic level. First, the Medicare program in the context of the entire U.S. health care financing and delivery system is described. Second, the Medicare data collection process and the detailed data elements collected as part of the various Medicare administrative and research data bases are discussed in detail. Third, the use of these microdata for international comparisons of medical effectiveness, incentive effects of alternative reimbursement systems, technology assessment, service use by consumers, and industry impacts is suggested. International comparisons of health systems based on microdata are essential for understanding the underlying dynamics of health systems as well as for attributing performance to specific features or policies.