癌症注册表的准确性 主要付款人信息和对政策研究的影响
Amy J Davidoff1, Lindsey Enewold1, Courtney P Williams1,2
1Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD.
在诊断时的主要付款人 (PPDx) 的癌症注册表数据经常错误地报告医疗保险和医疗补助入学. 通过客观的入学数据改善PPDx对于准确的癌症政策影响评估至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 癌症流行病学 癌症流行病学
- 卫生政策分析 卫生政策分析
背景情况:
- 癌症登记处使用"诊断时的主要付款人" (PPDx) 数据来评估保险对癌症护理的影响.
- 在捕获医疗补助和医疗保险入学时,PPDx的准确性仍然在很大程度上是未知的.
研究的目的:
- 评估PPDx数据在代表癌症患者的医疗保险和医疗补助入学时的准确性.
- 在PPDx数据中识别影响医疗补助和医疗保险入学报告不足的因素.
主要方法:
- 将国家癌症研究所的注册数据与美国医疗保险和医疗补助服务中心 (CMS) 的注册记录联系起来,记录了2007-2011年间诊断的19-64岁成年人的注册记录.
- 进行双变量分析,将PPDx付款人信息与实际CMS入学情况进行比较,根据患者特征和国家政策评估报告不足率.
主要成果:
- 与CMS记录相比,PPDx数据显示医疗保险 (7.8%) 和医疗补助 (10.1%) 的入学率更高 (5.5%的医疗保险,10.4%的医疗补助).
- 对PPDx的积极预测值为Medicaid的65.3%,Medicare的75.4%,报告不足 (52.0%的Medicaid,Medicare的33.8%).
- 报告不足因贫困程度,性别,医疗补助资格途径和州管理护理入学人数而异.
结论:
- 登记处报告的PPDx数据不足以捕捉医疗补助和医疗保险的入学情况,可能会偏见与保险相关的政策影响研究.
- 将客观招生数据集成到PPDx中可以减少测量错误和偏差,提高癌症护理政策评估的有效性.
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