Abstract:
OBJECTIVES:Assess the validity of Medicare claims for identifying myocardial infarction (MI). METHODS:We used data from 9951 Medicare beneficiaries 65 years and above in the Reasons for Geographic And Racial Differences in Stroke study. Between 2003 and 2012, 669 participants had an MI identified and adjudicated through study procedures (ie, the gold standard), and 552 had an overnight inpatient claim with a code for MI (ICD-9 code 410.x0 or 410.x1) in any discharge diagnosis position. RESULTS:Using Medicare claims with a discharge diagnosis code for MI in any position, the positive predictive value (PPV) was 84.3% [95% confidence interval (CI), 80.9%-87.3%] and the sensitivity was 49.0% (95% CI, 44.9%-53.1%). Sensitivity was lower for men (45.8%) versus women (55.1%), microsize MIs (13.7%) versus other MIs (64.7%), type 2 (30.9%), and 4-5 MIs (11.1%) versus type 1 MIs (76.6%), and MIs occurring in-hospital (28.8%) versus out-of-hospital (66.7%). Using Medicare claims with a code for MI in the primary discharge diagnosis position, the PPV was 89.7% (95% CI, 86.3%-92.5%) and sensitivity was 40.1% (95% CI, 36.1%-44.2%). The sensitivity of claims with a code for MI in the primary discharge diagnosis position was lower for microsize versus other MIs, type 2 and 4-5 MIs versus type 1 MIs and MIs occurring in-hospital versus out-of-hospital. Hazard ratios for MI associated with participant characteristics were similar using adjudicated MIs identified through study procedures or claims for MI without further adjudication. CONCLUSIONS:Medicare claims have a high PPV but low sensitivity for identifying MI and can be used to investigate individual-level characteristics associated with MI.
journal_name
Med Carejournal_title
Medical careauthors
Colantonio LD,Levitan EB,Yun H,Kilgore ML,Rhodes JD,Howard G,Safford MM,Muntner Pdoi
10.1097/MLR.0000000000001004subject
Has Abstractpub_date
2018-12-01 00:00:00pages
1051-1059issue
12eissn
0025-7079issn
1537-1948journal_volume
56pub_type
杂志文章相关文献
MEDICAL CARE文献大全abstract:BACKGROUND:Breast cancer missed on diagnostic mammography may contribute to delayed diagnoses, whereas false-positive results may lead to unnecessary invasive procedures. Whether accuracy of diagnostic mammography at facilities serving vulnerable women differs from other facilities is unknown. OBJECTIVE:To compare the...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181f380e0
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:Building on Andersen's behavioral model for the utilization of health care services, we examined factors associated with utilization of physician and hospital services among adults in Canada and the United States, with a focus on socioeconomic status (enabling resources in Andersen's framework). METHODS:Usi...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181adcbe9
更新日期:2009-11-01 00:00:00
abstract::This study examines evidence of market segmentation on the basis of patients' insurance status, demographic characteristics, and medical condition in selected local markets in California in the years 1983 and 1989. Substantial differences exist in the probability patients may be admitted to particular hospitals based ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199301000-00004
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Approximately 2.5 million Americans are admitted to the hospital after traumatic physical injury each year. Few investigations have elicited patients' perspectives regarding posttraumatic outcomes. OBJECTIVE:To identify and categorize physically injured trauma survivors' posttraumatic concerns. RESEARCH DE...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-200104000-00004
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Adherence is a factor in the outcome of medical treatment, but the strength and moderators of the adherence-outcome association have not been systematically assessed. OBJECTIVES:A quantitative review using meta-analysis of three decades of empirical research correlating adherence with objective measures of ...
journal_title:Medical care
pub_type: 杂志文章,meta分析
doi:10.1097/00005650-200209000-00009
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Methods to select physicians most likely to benefit from educational interventions to improve the outcome of depression have not been adequately developed. OBJECTIVE:The purpose of this study was to identify a combination of primary care provider (PCP) self-report questions to improve the precision of PCP e...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-200007000-00009
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVES:The author highlights changes in hospital utilization that have occurred in association with restructuring of Ontario hospitals. The basic features of the epidemiology of hospital utilization described link the analysis of the organizational and structural components of hospitals with a more comprehensive ev...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199710001-00012
更新日期:1997-10-01 00:00:00
abstract::The effectiveness of sharing medical records in improving physician-older patient communication was evaluated in 203 ambulatory chronically ill older patients (mean age, 70.1 years) by a randomized controlled trial. Ninety-five experimental group patients received copies of their physicians' progress notes 1 week afte...
journal_title:Medical care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005650-198604000-00004
更新日期:1986-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of standardized, patient-centered label (PCL) instructions to improve comprehension of prescription drug use compared with typical instructions. METHODS:A total of 500 adult patients recruited from 2 academic and 2 community primary care clinics in Chicago, IL and Shreveport, LA...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181f38174
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Traumatic brain injury (TBI) is a serious public health problem in the United States. Each year, TBIs substantially contribute to health care costs, which vary by severity. This is important to consider given the variability in recovery time by severity. RESEARCH DESIGN:This study quantifies the annual incr...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001511
更新日期:2021-01-28 00:00:00
abstract:BACKGROUND:Variance reduction is sometimes considered as a goal of clinical quality improvement. Variance among physicians, hospitals, or health plans has been evaluated as the proportion of total variance (or intraclass correlation, ICC) in a quality measure; low ICCs have been interpreted to indicate low potential fo...
journal_title:Medical care
pub_type: 杂志文章,多中心研究
doi:10.1097/MLR.0b013e3181c15a6e
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Failure to rescue (FTR), the rate of death in patients suffering 1 of 6 in-hospital complications, is an Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicator calculated from administrative data. OBJECTIVE:: We sought to assess the accuracy of the AHRQ FTR algorithm. METHODS:We underto...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000250226.33094.d4
更新日期:2007-04-01 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:OBJECTIVE:To examine the association of drug users' outpatient patterns of care with subsequent intensity of antiretroviral therapy (ART). MATERIALS AND METHODS:Annual types of ART in 8897 New York State Medicaid drug users who were prescribed ART for > or =6 months in 1996 or 1997 were determined. From pharmacy claim...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-200210000-00014
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Providing collaborative mental health treatment within primary care settings improves depression outcomes and may improve detection of mental disorders. Few studies have assessed the effect of collaborative mental health treatment programs on diagnosis of mental disorders in primary care populations. In 2008...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181e5792b
更新日期:2010-09-01 00:00:00
abstract::Broken appointments have been a major problem at the Anthony L. Jordan Health Center since it opened in 1968. In an earlier 6-month study of broken appointments at the center the authors found 48% of pediatric appointments and 43% of medicine appointments to be broken. Daily broken appointment rates were correlated be...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198409000-00005
更新日期:1984-09-01 00:00:00
abstract:INTRODUCTION/OBJECTIVES:The engagement of patients and other stakeholders is a critical element in the design of patient-centered outcomes research studies. However, methodology for scalable engagement in research management particularly activities such as operationalization of principles and setting of priorities is n...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000790
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Medication error occurring during the care of HIV-infected patients may lead to treatment failure, drug toxicity, or even death. OBJECTIVE:The objective of this study was to ascertain and confirm 5 categories of medication error in the care of HIV-infected patients. RESEARCH DESIGN:This study was a retrosp...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000175622.81335.4d
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Although the life expectancy for the US population has increased, a high proportion of this population has lived with ≥1 chronic conditions. We have quantified the burden of disease associated with 15 chronic conditions and combinations of conditions by estimating quality-adjusted life years (QALYs) for olde...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000943
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:The relative performance of three widely used generic health status measures (EQ-5D, a modified HUI3 [mHUI3], and SF-12) was compared within a general population sample. MATERIALS AND METHODS:Data were taken from a cohort of persons identified from the patient list of a large general practice in York, UK. T...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.MLR.0000044901.57067.19
更新日期:2003-02-01 00:00:00
abstract::This article summarizes tests of the appropriateness of aggregating specific categories of physical capacities and limitations into aggregate functional status indexes. Self-administered questionnaires were used to gather data from 4,603 people between 14 and 66 years of age. Cumulative indexes defining ranked levels ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198105000-00001
更新日期:1981-05-01 00:00:00
abstract::Earlier studies have established substantial gender differences in the likelihood of obtaining a psychotropic drug prescription, and a correlation, especially among women, with such family characteristics as family responsibilities, marital separation, divorce or widowhood, and the presence of family stressors such as...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199004000-00001
更新日期:1990-04-01 00:00:00
abstract:BACKGROUND:Medicare's Nonpayment Program of 2008 (hereafter called Program) withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs). Little is known whether a hospital's Medicare patient load [quantified by the hospital's Medicare utilization ratio (MUR), which is the proportion of inp...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000680
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Latinos make up the largest group of minority children in the United States. Despite great diversity among Latino children, studies have traditionally treated them as a monolithic group. Few studies have examined patterns and determinants of access to and use of health care for different subgroups of Latino ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318190d9e4
更新日期:2009-06-01 00:00:00
abstract::The effect of a greater volume of patients with similar conditions being treated at a hospital on the outcomes achieved is studied using a variety of categories of patients, 15 surgical and 2 medical, and involving 550,000 patients treated in over 1,200 nonfederal United States acute care hospitals. After demonstratin...
journal_title:Medical care
pub_type: 杂志文章
doi:
更新日期:1984-02-01 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::Sequential analysis can be used as an early warning system about potential unintended consequences of health policy decisions, generating follow-up investigations, but it should not be used as causal evidence. ...
journal_title:Medical care
pub_type: 评论,杂志文章
doi:10.1097/MLR.0000000000000896
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Information is limited regarding the effects of processes of care on cardiac surgical outcomes. Correspondingly, many recommended cardiac surgical processes of care are derived from animal experiments or clinical judgment. This report from the VA Cooperative Study in Health Services, "Processes, Structures, ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000102295.08379.57
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:The Medicare Part D benefit is complicated and may be costly, especially for vulnerable low-income populations where lack of resources and limited English proficiency may be barriers to optimal plan selection. OBJECTIVES:To identify vulnerable Medicare beneficiaries and lower their expected annual out-of-po...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318202a9f2
更新日期:2011-04-01 00:00:00
abstract::Adherence to the medical regimen continues to rank as a major clinical problem in the management of patients with essential hypertension, as in other conditions treated with drugs and life-style modification. This article reviews the psychometric properties and tests the concurrent and predictive validity of a structu...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198601000-00007
更新日期:1986-01-01 00:00:00