报告中的一些州的医院 医疗补助退院数量在成本报告中 数据数据
Kelsey Chalmers1, Omkar Waghmare1, Valérie Gopinath1
1Lown Institute, Needham, Massachusetts, USA.
Health services research
|September 8, 2025
概括
在CMS医院成本报告信息系统 (HCRIS) 和T-MSIS分析文件 (TAF) 数据之间存在Medicaid医院出院数据的不一致. HCRIS可能无法准确地捕捉管理护理的医疗补助病人的数量,影响政策和研究.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生政策分析 卫生政策分析
- 医疗保健数据分析数据分析
背景情况:
- 对医院出院的可靠数据对于医疗服务研究和政策至关重要.
- 两种广泛使用的数据来源,CMS医院成本报告信息系统 (HCRIS) 和T-MSIS分析文件 (TAF),用于此目的.
- 之前的研究还没有充分调查这两种系统之间医疗补助患者出院报告的潜在差异.
研究的目的:
- 调查和量化HCRIS和TAF之间的Medicaid注册人的医院出院数据中的差异.
- 为了确定这些数据不一致的医院的模式和特征.
- 评估这些差异对卫生政策和研究的影响.
主要方法:
- 采用了一种描述性研究设计,比较来自HCRIS和TAF的住院出院数据.
- 分析了2020-2021年普通医院的数据.
- 对总和卫生维护组织 (HMO) 资助的医疗补助退院和患者日的HCRIS数据与相应的TAF住院病人的档案进行了比较.
主要成果:
- 在25个州观察到差异,一些医院报告TAF出院数量高于HCRIS.
- 在加利福尼亚州,纽约州和德克萨斯州,对HMO资助的医疗补助退院和HCRIS患者日的不一致报告被注意到.
- 20个州显示了类似的值,其中9个州在综合管理护理计划中医疗补助人口不到5%的州.
结论:
- CMS医院成本报告信息系统 (HCRIS) 可能无法可靠地捕获医疗补助患者的医院出院量,特别是那些由管理护理资助的患者.
- 数据报告中的不一致性可能导致错误的政策决策和对医院绩效的不准确评估.
- 研究人员和决策者在使用HCRIS进行Medicaid出院计数时应谨慎使用HCRIS,并考虑使用TAF或其他补充数据源.
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