对识别超声波增强剂使用的行政要求的验证
Jordan B Strom1,2,3, Yang Song4,5, Wenting Jiang6
1Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, 375 Longwood Avenue, 4th floor, Boston, MA, 02215, USA. jstrom@bidmc.harvard.edu.
Echo research and practice
|February 6, 2024
概括
行政索赔数据准确地识别了超声波增强剂 (UEA) 在门诊患者中的使用,但显著低于住院患者的使用. 这凸显了需要改善住院患者在心声回声学期间给UEA的编码.
科学领域:
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 超声波增强剂 (UEA) 在心声回声学期间改善左心室可视化.
- 之前关于UEA使用的研究受到了国家一级分析所需的验证索赔数据缺乏的限制.
- 准确识别UEA的使用对于了解其利用和影响至关重要.
研究的目的:
- 评估行政索赔数据在识别超声波增强剂 (UEA) 在压力和胸前心声回声 (STE) 期间使用的准确性.
- 为了比较索赔数据与电子医疗记录 (EMR) 的性能,以捕获UEA使用情况.
- 评估住院和门诊之间UEA索赔捕获的变化.
主要方法:
- 这是一项回顾性横截面研究,使用了来自美国30多个卫生系统 (2019-2022) 的链接EMR和全付款人索赔数据.
- 包括在EMR和索赔数据中同一天接受STE的个人.
- 通过当前程序术语 (CPT) 或国家药物规范 (NDC) 在 STE 1 天内识别UEA使用,使用EMR作为黄金标准.
主要成果:
- 关于UEA识别的声明的整体准确性很高 (90.8%),具有良好的灵敏度 (71.1%) 和特异性 (96.8%).
- 然而,相比于门诊患者 (79.7%),住院患者的敏感性明显较低 (6.8%).
- 索赔数据只捕获了16.8%的UEA使用,当它存在于EMR和索赔数据时.
结论:
- 虽然索赔数据通常可靠用于识别UEA使用,但它们显著代表着住院患者的使用情况.
- 从行政声明中得出的已公布的住院UEA使用率可能是不准确的.
- 需要加强住院患者的编码实践,以确保UEA的管理,以确保准确的数据捕获.
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