综合管理护理数据的完整性和质量,与2001年至2019年国家医疗补助申请中的服务费数据相比
Hillary Samples1,2, Kristen Lloyd1, Radha Ryali1
1Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey, USA.
Health services research
|January 3, 2025
概括
国家研究档案中的医疗补助综合管理护理 (CMC) 数据在完整性和质量方面与服务费用 (FFS) 数据在很大程度上相似. 随着时间的推移,数据质量和完整性得到了改善,支持其在研究中的使用.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生数据分析
- 医疗保健政策评估 医疗保健政策评估
背景情况:
- 医疗补助综合管理护理 (CMC) 是医疗补助计划的一个重要组成部分.
- 了解CMC数据的完整性和质量对于准确的研究和政策分析至关重要.
- 国家MAX/TAF研究档案对于研究医疗补助人口至关重要.
研究的目的:
- 评估国家MAX/TAF研究档案中的医疗补助综合管理护理 (CMC) 数据的完整性和质量.
- 将CMC数据特征与服务费用 (FFS) 数据进行比较.
- 评估随着时间的推移数据完整性和质量的趋势.
主要方法:
- 一项观察性研究比较了CMC和FFS注册数据从医疗补助MAX/TAF住院,门诊和药房档案 (2001-2019).
- 数据的完整性以每名登记者的索赔和平均索赔比例来衡量.
- 用诊断,程序和与药物相关的代码和填充信息来评估数据质量,将CMC与FFS基准进行比较 (平均 ± 2标准偏差).
主要成果:
- 在891个状态年中,CMC数据在住院,门诊和药房索赔的完整性和质量标准方面与FFS数据在很大程度上可比.
- 在≥10%CMC入学率的州年度中,CMC数据符合大多数完整性 (79.6%-86.5%) 和质量 (83.1%-97.8%) 标准.
- 到2019年,总体数据的完整性 (92.3%) 和质量 (84.6%) 显著改善.
结论:
- 医疗补助综合管理护理数据的完整性和质量在很大程度上与服务费用数据相美.
- 随着时间的推移,越来越多的国家年度数据满足了数据质量和完整性标准.
- 进一步的研究应检查具体研究应用的计划类型,状态和时间的数据完整性和质量的变化.
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