Abstract:
BACKGROUND:The 3 primary administrative data sets developed by the Centers for Medicare and Medicaid services (CMS) to support the Medicare Part D program implementation represent a valuable source of data for health services researchers. This paper describes the structure of the Medicare Part D program and the related databases, and discusses their utilization for research purposes. RESULTS:The Medicare Part D administrative data include information on plan benefits (integrated into the Health Plan Management System), beneficiary enrollment files, and prescription drug event (PDE) claims-type data. The enrollment data may be of use in investigating the benefits and plan types that appeal to beneficiaries, but their application is limited by the fact that, although individual beneficiaries' enrollment choices are recorded, only summary enrollment data are currently publicly available. PDE data are likely to be of most interest to researchers as they are detailed (including beneficiary identifiers, contract identifiers pharmacy provider information on drugs provided, drug cost, and insurance status), beneficiary-specific (allowing them to be linked to beneficiary characteristics), and an unusual output for a program reimbursed under a capitation-based system. Because PDE data are highly sensitive, only summary data on the number of Part D prescriptions filled are publicly available. CONCLUSIONS:Although the data collected in relation to the Medicare Part D program could be applied to many questions of interest to health services researchers, their utility is limited by the sensitive natures of many of these data, making it difficult currently to obtain access for research purposes.
journal_name
Med Carejournal_title
Medical careauthors
Greenwald LMdoi
10.1097/MLR.0b013e318041385fsubject
Has Abstractpub_date
2007-10-01 00:00:00pages
S9-12issue
10 Supl 2eissn
0025-7079issn
1537-1948pii
00005650-200710002-00004journal_volume
45pub_type
杂志文章相关文献
MEDICAL CARE文献大全abstract:BACKGROUND:Hospitals will increasingly bear the costs for healthcare-acquired conditions such as infection. Our goals were to estimate the costs attributable to healthcare-acquired infection (HAI) and conduct a sensitivity analysis comparing analytic methods. METHODS:A random sample of high-risk adults hospitalized in...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181ef60a2
更新日期:2010-11-01 00:00:00
abstract::The authors of this study examine temporal patterns of medical expenditures by Medicare beneficiaries. A random sample of 204,917 individuals who were alive and in the program from 1974 to 1977 was investigated. Individuals hospitalized in 1974 were found to have twice the rate of hospitalization in 1975, 1976, or 197...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198402000-00005
更新日期:1984-02-01 00:00:00
abstract::Clinical Engineers are currently employed in hospitals to see that the more complex instrumentation is electrically safe and well maintained. Such an objective fails to capitalize on the economic advantages which can be derived from specialist management. This paper proposes that the objective be broadened to cover th...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197707000-00003
更新日期:1977-07-01 00:00:00
abstract::A new technique for identifying inefficient hospitals, Data Envelopment Analysis (DEA), is field tested by application to a group of teaching hospitals. DEA is found to provide meaningful insights into the location and nature of hospital inefficiencies as judged by the opinion of a panel of hospital experts. DEA provi...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198410000-00005
更新日期:1984-10-01 00:00:00
abstract::To study associations between payer and provision of services for patients hospitalized for coronary atherosclerosis, the authors analyzed abstracts of 24,424 discharges from California acute care hospitals during 1989. Services examined included receipt of coronary artery bypass surgery, percutaneous transluminal cor...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199507000-00007
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Research on frequent emergency department (ED) use shows that a subgroup of patients visits multiple EDs. This study characterizes these individuals. OBJECTIVE:The objective of this study was to determine how many frequent ED users seek care at multiple EDs and to identify sociodemographic, clinical, and co...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001228
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:In the United States, data on transplanted and waitlisted patients collected by the Organ Procurement and Transplantation Network (OPTN) have been widely used in transplantation research. Administrative claims data, collected by health plans for reimbursement purposes, are also commonly used in health-service...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3180326121
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:The variability in preferences used in quality-adjusted life-years estimation jeopardizes the comparability of cost-effectiveness analyses and has led the Panel on Cost-Effectiveness in Health and Medicine (the PCEHM) to call for a catalog of "off-the-shelf" preference weights associated with conditions that...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000172050.67085.4f
更新日期:2005-07-01 00:00:00
abstract::This study examines practice mobility among young physicians, based on a large nationwide 1987 survey of physicians under age 40 years and in their second through fifth years of practice. Averaged across all physicians, there is a 10% to 12% chance of changing practices for each of the first 3 years, and about one in ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199110000-00004
更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:The challenges facing healthcare in the 21st century frequently seem intractable and insurmountable. Systemic problems impair the quality and continuity of care and caregivers' quality of life. For over 25 years, the Clinical Practice Model Resource Center (CPMRC) in Grand Rapids, MI, has focused on transfor...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3182239331
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Community-acquired pneumonia (CAP) is the most common infectious cause of death in the United States. To understand the effect of efforts to improve quality and efficiency of care in CAP, we examined the trends in mortality and costs among hospitalized CAP patients. METHODS:Using the National Inpatient Samp...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181f38006
更新日期:2010-12-01 00:00:00
abstract::The techniques of cost-effectiveness are employed to simplify resource allocation decisions concerned with the use of land and air transport systems in the health services of a developing country. Outcome classifications are produced for patients seen by mobile and fixed primary care units. The mobile services examine...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197704000-00001
更新日期:1977-04-01 00:00:00
abstract:OBJECTIVES:Use of antepartum tests of fetal well-being is widespread even though effectiveness in preventing fetal damage or stillbirth has not been established. The study objective was to examine whether aggressive use of these tests might contribute to increased rates of other birth outcomes, including low birth weig...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199701000-00002
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Healthcare accrediting organizations and insurers increasingly require reporting of clinical data, and cancer treatment is one area of enhanced scrutiny. OBJECTIVES:To compare rates of received versus reported adjuvant breast cancer treatments, and to assess barriers to measuring and reporting treatments to...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3182422f7b
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:The Veterans Health Administration does not routinely collect and document sexual orientation and gender identity (SOGI) data, despite existing health disparities among sexual and gender minority Veterans. Because of the legacy of previous Department of Defense (DoD) policies that prohibited disclosure of se...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000744
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVES:To assess the likely effects of the 1996 Health Insurance Portability and Accessibility Act (HIPAA), based on small firms' experiences under state small group insurance reforms that were similar in design to HIPAA. METHODS:Data on 17,818 small businesses (range, 2-50 employees) nationwide from the 1994 Nati...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199907000-00009
更新日期:1999-07-01 00:00:00
abstract::The authors describe a new model for classifying hospitalized patients with acquired immunodeficiency syndrome (AIDS) according to their severity of illness. In the first phase of the project, a clinical model indicating the relative severity of AIDS complications was formulated, based on the clinical literature and e...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198904000-00009
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND:With the goal of improving clinical efficiency and effectiveness, programs to enhance care coordination are a major focus of health care reform. OBJECTIVE:To examine whether "care density"--a claims-based measure of patient sharing by office-based physicians--is associated with measures of quality. Care den...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000319
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Current health care reform efforts are focused on reorganizing health care systems to reduce waste in the US health care system. OBJECTIVE:To compare rates of overuse in different health care systems and examine whether certain systems of care or insurers have lower rates of overuse of health care services....
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/MLR.0b013e31828dbafe
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to identify hospital organizational characteristics consistently associated with adherence to multiple clinical practice guidelines (CPGs). We examined the relationship between organizational and patient population characteristics and adherence to three screening CPGs implemented...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-200212000-00005
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Most health insurance plans monitor ambulatory care quality using the Healthcare Effectiveness Data and Information Set (HEDIS), publicly reporting results at the plan level. Plan-level comparisons obscure the influence of patients served or settings where care is delivered. Mental illness, substance abuse, ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318190db45
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:In the setting of declining U.S. literacy, new policies include use of clear communication and low-literacy accessibility practices with all patients. Reliable methods for adapting health information to meet such criteria remain a pressing need. OBJECTIVES:To report method validation (study 1) and method re...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318249d6c8
更新日期:2012-04-01 00:00:00
abstract::The purpose of this paper is to provide a systematic explanation of the use of traditional medicine among the native American population living in the San Francisco Bay area. Several hypotheses concerning the factors associated with this behavior are tested. These include tribal grouping, socioeconomic and sociocultur...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197511000-00004
更新日期:1975-11-01 00:00:00
abstract:OBJECTIVES:The economic impact of trauma in older persons is a matter of increasing concern to public health practitioners and planners, yet it is an issue that has not been widely studied. Available evidence does suggest, however, that falls are the costliest category of injury among older persons. METHODS:This study...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199808000-00006
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:Patients with multiple chronic conditions (MCCs) are a critical but undefined group for quality measurement. We present a generally applicable systematic approach to defining an MCC cohort of Medicare fee-for-service beneficiaries that we developed for a national quality measure, risk-standardized ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000853
更新日期:2018-02-01 00:00:00
abstract::Research indicates that approximately one in five hospital admissions is unnecessary or inappropriate, based on accepted clinical criteria. Various cost-containment approaches have been initiated to reduce unnecessary hospital care. Among these approaches, hospital utilization review (UR) has shown promise as a cost-c...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198906000-00006
更新日期:1989-06-01 00:00:00
abstract::It is well-documented that ratings of medical care received personally (personal referent) yield more favorable responses than ratings of care received by people in general (general referent). Hence general items are useful in achieving greater variation in responses to satisfaction surveys. However, the validity of g...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198606000-00006
更新日期:1986-06-01 00:00:00
abstract::Disparities by economic status are observed in the health status and health outcomes of Medicare beneficiaries. For health services and health policy researchers, one barrier to addressing these disparities is the ability to use Medicare data to ascertain information about an individual's income level or poverty, beca...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000606
更新日期:2017-12-01 00:00:00
abstract:PURPOSE:Healthcare organizations have undergone major change efforts in the past decade. Sustained change is related to continued alignment among organizational participants and may fail with incongruent perceptions of change. This study identifies factors contributing to the alignment in perceptions of organizational ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000220692.39762.bf
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Continuity of the relationship between patients and primary care providers (PCPs) is an important component of care from the consumer perspective that may be affected by variation in cost containment strategies within managed care. OBJECTIVE:To evaluate the effects of cost containment strategies on the cont...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-200110000-00005
更新日期:2001-10-01 00:00:00