1. Optimal Use of Available Claims to Identify a Medicare Population Free of Coronary Heart Disease.
- Author
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Kent, Shia T., Safford, Monika M., Hong Zhao, Levitan, Emily B., Curtis, Jeffrey R., Kilpatrick, Ryan D., Kilgore, Meredith L., and Muntner, Paul
- Subjects
MEDICARE ,ALGORITHMS ,BLACK people ,CONFIDENCE intervals ,CORONARY disease ,ECONOMIC aspects of diseases ,MYOCARDIAL infarction ,RESEARCH funding ,WHITE people ,HEALTH insurance reimbursement ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
We examined claims-based approaches for identifying a study population free of coronary heart disease (CHD) using data from 8,937 US blacks and whites enrolled during 2003-2007 in a prospective cohort study linked to Medicare claims. Our goal was to minimize the percentage of persons at study entry with self-reported CHD (previous myocardial infarction or coronary revascularization). We assembled 6 cohorts without CHD claims by requiring 6 months, 1 year, or 2 years of continuous Medicare fee-for-service insurance coverage prior to study entry and using either a fixed-window or all-available look-back period. We examined adding CHD-related claims to our "base algorithm," which included claims for myocardial infarction and coronary revascularization. Using a 6-month fixed-window look-back period, 17.8% of participants without claims in the base algorithm reported having CHD. This was reduced to 3.6% using an all-available look-back period and adding other CHD claims to the base algorithm. Among cohorts using all-available look-back periods, increasing the length of continuous coverage from 6 months to 1 or 2 years reduced the sample size available without lowering the percentage of persons with self-reported CHD. This analysis demonstrates approaches for developing a CHD-free cohort using Medicare claims. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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