Increasing Methodological Transparency and Openness in Rehabilitation-Related Health Services Research Using Claims Data: A Case Example.

Abstract

Health insurance claims are a rich source of information for health services researchers and can provide evidence to understand issues related to access, efficiency, and effectiveness of care. While numerous studies have examined rehabilitation utilization using Medicare, Medicaid, and/or private insurance claims data, these studies typically lack detail on approaches used to identify rehabilitation services. The primary objectives of this perspective are: (1) to raise awareness of the need for and importance of methodological transparency and openness in rehabilitation-related health services research using claims data and (2) to provide a case example by sharing the details of a method for identifying community-based physical and occupational therapy in Medicare claims. General decisions made in claims-based analyses are discussed and then are illustrated with the approach used for identifying community-based therapy claims within the context of a secondary analysis of data from a large, multicenter pragmatic clinical trial. Specific decisions made and challenges encountered are discussed and recommendations are made for future work in this area. Sharing methodological details, data when possible, and metadata on approaches for conducting rehabilitation-related health services research can enhance its validity, rigor, and-ultimately-overall value. Rehabilitation health services researchers are encouraged to make greater efforts to share information on their methodological approaches using claims data and other data relevant to health services research.