Optimal use of available claims to identify a Medicare population free of coronary heart disease.

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.

journal_name

Am J Epidemiol

authors

Kent ST,Safford MM,Zhao H,Levitan EB,Curtis JR,Kilpatrick RD,Kilgore ML,Muntner P

doi

10.1093/aje/kwv116

subject

Has Abstract

pub_date

2015-11-01 00:00:00

pages

808-19

issue

9

eissn

0002-9262

issn

1476-6256

pii

kwv116

journal_volume

182

pub_type

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