A proposed method for identifying Interfacility transfers in Medicare claims data

IF 3.1 2区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Sayeh Nikpay, Michelle Leeberg, Katy Kozhimannil, Michael Ward, Julian Wolfson, John Graves, Beth A. Virnig
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引用次数: 0

Abstract

ObjectiveTo develop a method of consistently identifying interfacility transfers (IFTs) in Medicare Claims using patients with ST‐Elevation Myocardial Infarction (STEMI) as an example.Data Sources/Study Setting100% Medicare inpatient and outpatient Standard Analytic Files and 5% Carrier Files, 2011–2020.Study DesignObservational, cross‐sectional comparison of patient characteristics between proposed and existing methods.Data Collection/Extraction MethodsWe limited to patients aged 65+ with STEMI diagnosis using both proposed and existing methods.Principal FindingsWe identified 62,668 more IFTs using the proposed method (86,128 versus 23,460). A separately billable interfacility ambulance trip was found for more IFTs using the proposed than existing method (86% vs. 79%). Compared with the existing method, transferred patients under the proposed method were more likely to live in rural (p < 0.001) and lower income (p < 0.001) counties and were located farther away from emergency departments, trauma centers, and intensive care units (p < 0.001).ConclusionsIdentifying transferred patients based on two consecutive inpatient claims results in an undercount of IFTs and under‐represents rural and low‐income patients.
在医疗保险报销数据中识别机构间转移的拟议方法
目标以 STEMI(ST-Elevation 心肌梗死)患者为例,开发一种在医疗保险索赔中持续识别机构间转院(IFT)的方法。数据来源/研究设置2011-2020 年,100% 的医疗保险住院和门诊病人标准分析档案以及 5% 的承保人档案。研究设计对建议方法和现有方法的患者特征进行观察性、横断面比较。数据收集/提取方法我们仅限于使用建议方法和现有方法诊断为 STEMI 的 65 岁以上患者。与现有方法相比,使用建议方法发现的可单独计费的机构间救护车转运次数更多(86% 对 79%)。与现有方法相比,采用建议方法的转院患者更有可能居住在农村(p <0.001)和低收入(p <0.001)县,并且距离急诊科、创伤中心和重症监护室更远(p <0.001)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health Services Research
Health Services Research 医学-卫生保健
CiteScore
4.80
自引率
5.90%
发文量
193
审稿时长
4-8 weeks
期刊介绍: Health Services Research (HSR) is a peer-reviewed scholarly journal that provides researchers and public and private policymakers with the latest research findings, methods, and concepts related to the financing, organization, delivery, evaluation, and outcomes of health services. Rated as one of the top journals in the fields of health policy and services and health care administration, HSR publishes outstanding articles reporting the findings of original investigations that expand knowledge and understanding of the wide-ranging field of health care and that will help to improve the health of individuals and communities.
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