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Enriching the American Heart Association COVID-19 Cardiovascular Disease Registry Through Linkage With External Data
Andrew S Oseran1,2, Tianyu Sun1, Rishi K Wadhera1,3
1Richard A. and Susan F. Smith Center for Outcomes Research Beth Israel Deaconess Medical Center Boston MA.
Insights
Linking the American Heart Association Registry with Medicare claims enhances COVID-19 patient data. This creates a generalizable resource for studying long-term health outcomes after hospitalization.
Area of Science:
- Cardiovascular Medicine
- Public Health
- Health Informatics
Background:
- The American Heart Association (AHA) Registry collects data on hospitalized COVID-19 patients.
- The registry lacks social determinants of health and long-term outcome information.
- Linking registry data with external sources can address these limitations.
Purpose of the Study:
- To link the AHA Registry with Medicare fee-for-service (FFS) claims and other data sources.
- To assess the representativeness of linked AHA Registry patients compared to the broader Medicare FFS population hospitalized with COVID-19.
Main Methods:
- Adults aged ≥65 years from the AHA Registry (March 2020-September 2021) were linked to Medicare FFS claims using a deterministic algorithm.
- Additional linkage was performed with the American Hospital Association Annual Survey, Rural-Urban Commuting Area codes, and the Social Vulnerability Index.
- Linked and unlinked Medicare FFS beneficiaries hospitalized with COVID-19 were compared to evaluate representativeness.
Main Results:
- A total of 10,010 (47.0%) AHA Registry records were successfully linked to Medicare FFS claims.
- Linked and unlinked beneficiaries showed similarities in age, sex, race, dual-eligibility status, and comorbidity burden.
- Differences were observed in geographic location (Northeast, urban/metropolitan areas) and hospital characteristics, but in-hospital outcomes like mortality and discharge disposition were similar.
Conclusions:
- Linking the AHA Registry with Medicare FFS claims and other databases creates a valuable, generalizable dataset.
- This integrated resource enables comprehensive evaluation of long-term health outcomes following COVID-19 hospitalization.
Abstract:
Background The AHA Registry (American Heart Association COVID-19 Cardiovascular Disease Registry) captures detailed information on hospitalized patients with COVID-19. The registry, however, does not capture information on social determinants of health or long-term outcomes. Here we describe the linkage of the AHA Registry with external data sources, including fee-for-service (FFS) Medicare claims, to fill these gaps and assess the representativeness of linked registry patients to the broader Medicare FFS population hospitalized with COVID-19. Methods and Results We linked AHA Registry records of adults ≥65 years from March 2020 to September 2021 with Medicare FFS claims using a deterministic linkage algorithm and with the American Hospital Association Annual Survey, Rural Urban Commuting Area codes, and the Social Vulnerability Index using hospital and geographic identifiers. We compared linked individuals with unlinked FFS beneficiaries hospitalized with COVID-19 to assess the representativeness of the AHA Registry. A total of 10 010 (47.0%) records in the AHA Registry were successfully linked to FFS Medicare claims. Linked and unlinked FFS beneficiaries were similar with respect to mean age (78.1 versus 77.9, absolute standardized difference [ASD] 0.03); female sex (48.3% versus 50.2%, ASD 0.04); Black race (15.1% versus 12.0%, ASD 0.09); dual-eligibility status (26.1% versus 23.2%, ASD 0.07); and comorbidity burden. Linked patients were more likely to live in the northeastern United States (35.7% versus 18.2%, ASD 0.40) and urban/metropolitan areas (83.9% versus 76.8%, ASD 0.18). There were also differences in hospital-level characteristics between cohorts. However, in-hospital outcomes were similar (mortality, 23.3% versus 20.1%, ASD 0.08; home discharge, 45.5% versus 50.7%, ASD 0.10; skilled nursing facility discharge, 24.4% versus 22.2%, ASD 0.05). Conclusions Linkage of the AHA Registry with external data sources such as Medicare FFS claims creates a unique and generalizable resource to evaluate long-term health outcomes after COVID-19 hospitalization.
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