在健康结果研究中使用开放索赔与封闭索赔
Onur Baser1,2,3, Gabriela Samayoa4, Nehir Yapar4
1City University of New York, New York, NY, USA.
Journal of health economics and outcomes research
|September 11, 2023
概括
尽管存在潜在的重复,但开放索赔数据为医疗保健结果研究提供了更大的样本规模和更快的信息. 这项研究发现,与已关闭的索赔相比,使用率估计类似,这表明了它的价值.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
- 医疗信息学 医疗信息学
背景情况:
- 关闭索赔数据是结果研究中的标准.
- 开放索赔数据提供更快,更大规模的信息,但面临缺失数据和重复数据的挑战.
- 之前的研究由于数据完整性问题,未充分利用开放索赔.
研究的目的:
- 为了比较关闭和开放的索赔数据之间的医疗保健利用指标.
- 评估开放数据中缺少的索赔是否会在估计中引入下行偏差.
- 验证开放索赔数据在医学研究中的有用性.
主要方法:
- 使用2022年的数据,比较了18种疾病,来自两个封闭索赔 (MarketScan®,PharMetrics® Plus) 和一个开放索赔 (Kythera) 数据库.
- 应用了一种重复删除算法来打开索赔数据.
- 分析了住院,急诊室,门诊利用率和停留时间,使用标准化差异比较中位数.
主要成果:
- 开放索赔数据集是封闭索赔数据集的10-65倍.
- 在所有疾病中,在开放和关闭的索赔数据之间,医疗保健利用率的估计是相似的,并且在统计学上是微不足道的.
- 在开放索赔数据估计中没有发现显著的下行偏差.
结论:
- 开放索赔数据在医疗保健结果研究中提供了显著的优势,因为样本规模更大,信息更为最新.
- 开放索赔数据可以加速研究时间表,特别是在新药和罕见疾病方面.
- 与开放索赔相关的数据完整性问题可以减轻,使其成为一个有价值的研究资源.
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