医疗保险丙型肝炎患者中基于索赔的诊断与开始治疗之间的关系。

IF 3.1 2区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Hao Zhang PhD, Yuhua Bao PhD, Kayla Hutchings MPH, Martin F. Shapiro MD PhD, Shashi N. Kapadia MD
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引用次数: 0

摘要

目的:开发一种基于索赔的算法,以确定疾病诊断的环境:开发一种基于理赔的算法,以确定疾病诊断的环境:研究设计:我们利用设施指标、收入中心代码和服务场所代码开发了一种基于理赔的算法,以确定首次出现 HCV 诊断的场所。当首次出现在实验室时,我们尝试将 HCV 诊断与随后的临床就诊联系起来。数据收集/提取方法:数据收集/提取方法:纳入新诊断为丙型肝炎病毒并连续参加传统医疗保险 A、B 和 D 部分的患者(诊断前 12 个月和诊断后 6 个月):在 104,454 名 18-64 岁和 66,726 名≥65 岁的患者中,分别有 70.1% 和 69% 是在门诊确诊的,20.2% 和 22.7% 是在实验室或未知场所确诊的。逻辑回归显示,在急诊科/急诊室、医院、实验室或未分类场所确诊后开始治疗的几率明显低于在门诊就诊的几率:该算法确定了大多数病例的 HCV 诊断环境,并发现了与开始治疗之间的重要关联,表明这种方法可用于未来基于索赔的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Association between claims-based setting of diagnosis and treatment initiation among Medicare patients with hepatitis C

Association between claims-based setting of diagnosis and treatment initiation among Medicare patients with hepatitis C

Objective

To develop a claims-based algorithm to determine the setting of a disease diagnosis.

Data Sources and Study Setting

Medicare enrollment and claims data from 2014 to 2019.

Study Design

We developed a claims-based algorithm using facility indicators, revenue center codes, and place of service codes to identify settings where HCV diagnosis first appeared. When the first appearance was in a laboratory, we attempted to associate HCV diagnoses with subsequent clinical visits. Face validity was assessed by examining association of claims-based diagnostic settings with treatment initiation.

Data Collection/Extraction Methods

Patients newly diagnosed with HCV and continuously enrolled in traditional Medicare Parts A, B, and D (12 months before and 6 months after index diagnosis) were included.

Principal Findings

Among 104,454 patients aged 18–64 and 66,726 aged ≥65, 70.1% and 69%, respectively, were diagnosed in outpatient settings, and 20.2% and 22.7%, respectively in laboratory or unknown settings. Logistic regression revealed significantly lower odds of treatment initiation after diagnosis in emergency departments/urgent cares, hospitals, laboratories, or unclassified settings, than in outpatient visits.

Conclusions

The algorithm identified the setting of HCV diagnosis in most cases, and found significant associations with treatment initiation, suggesting an approach that can be adapted for future claims-based studies.

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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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