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Journal articles on the topic 'Claims database'

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Published: 4 June 2021
Last updated: 25 January 2023

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1

Sato, Daisuke, Takeru Shiroiwa, and Takashi Fukuda. "PP079 The Construction Of Database Using Japanese National Claims Database." International Journal of Technology Assessment in Health Care 33, S1 (2017): 108. http://dx.doi.org/10.1017/s0266462317002501.

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INTRODUCTION:In 2014, the Ministry of Health, Labor and Welfare (MHLW) in Japan began to assume a cost-effectiveness perspective. Some expensive pharmaceutical and medical devices have been regulated, which resulted in a drastic change of the healthcare system.The Japanese National Insurance Claims Database (NDB) is an administrative database based on claims data from Medical Insurance Claims since 2008. The government enacted the Act on Assurance of Medical Care for Elderly People during health care reform in 2008. In 2006, the MHLW commenced discussions on a framework for the optimization of the healthcare expenses, which aimed to evaluate the structure of the increase in healthcare expenditure.The NDB was developed as a tool for investigation and analysis by the MHLW in the context of the Healthcare reform. In addition, the NDB was used for the development of academic research in order to contribute to the implementation and evaluation of healthcare policy management.A major strength of the NDB is its exhaustiveness or completeness of insurance claims. The NDB collects data from all insured people nationwide and covers all medical institutions in Japan.METHODS:We applied to the Expert Meeting on Provision of Medical Insurance Claims to examine the research plan, items extracted, and data management. Inpatient and Outpatient information was extracted on medical procedures and payment. Diagnoses for both inpatients and outpatients are coded according to the International Classification of Diseases Tenth Edition (ICD-10). The coding of treatments and surgeries follow Japan's local procedure and surgical coding, which was specifically developed for insurance claims.RESULTS:We generated any personally traceable patient ID from the “hash ID” generated by patient name, sex, date of birth, and insurer number with the aim of protecting personal identifying information in the NDB. The disease of stroke was defined to analyze the database for cost-effectiveness analysis, and to connect disease information to. The prescription claims information described pharmaceutical names, prescription date, total dose, and number of days.CONCLUSIONS:Our study showed the new standard way of analysis for cost-effectiveness analysis using the Japanese National Insurance Claims Database.
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Park, Jin-Su, and Chan Hee Lee. "Clinical Study Using Healthcare Claims Database." Journal of Rheumatic Diseases 28, no. 3 (July 1, 2021): 119–25. http://dx.doi.org/10.4078/jrd.2021.28.3.119.

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Ruslawati Nik Mustapa, Nik, Najihan Awang Ali, Nurul Husna Jamian, Hussin Abdul Hamid, Syadatul Syaeda Mat Saleh, and Roziana Baharain. "Personal Injury Claims (PIC) Database Modeling in Malaysia." International Journal of Engineering & Technology 7, no. 4.33 (December 9, 2018): 106. http://dx.doi.org/10.14419/ijet.v7i4.33.23510.

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Road accident often leads to claims for personal injury by aggrieved parties. In Malaysia, courts have been using multiplier-multiplicand approach. This approach seems to be outdated and unfair to the claimant. Presently, the approach excludes the claimant's personal condition in the calculation of quantum of damages. Hence, this study uses the Ogden Table as introduced in the United Kingdom as benchmarking guidelines, by taking into account of all aspect of claimant's personal condition for the purpose of such calculation. This study aim is to build upon a proposed data modeling system known as Entity Relationship Diagram (ERD) and the created process modeling known as data flow diagram (DFD). In so doing, the claimants will insert his input data, run it through the first process, and store the information in the claim injury part database. They can also edit and store to claim injury part database on their own. This will generate a report with the information in claim injury part database and can be viewed by claimant, court and lawyer as target users. It is hoped that it will facilitate the calculation of injury claim which would serve justice and accuracy of personal injury in road accidents.
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Landis, Sarah H., Beth L. Nordstrom, Leah B. Sansbury, Sumitra Shantakumar, Samantha A. St Laurent, Kathy H. Fraeman, and Jeanenne J. Nelson. "Disruptions in Liver Function among Cancer Patients and Patients Treated with Tyrosine Kinase Inhibiting Drugs: Comparisons of Two Population-Based Databases." Journal of Cancer Epidemiology 2013 (2013): 1–11. http://dx.doi.org/10.1155/2013/358285.

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Liver toxicity is a recognized adverse event associated with small molecule tyrosine kinase inhibitors (TKIs). Electronic Medical Record (EMR) databases offer the most precise data to investigate the rate of liver function test (LFT) elevations; however, they can be limited in sample size and costly to access and analyze. Health insurance claims databases often contain larger samples sizes but may lack key health information. We evaluated the feasibility of utilizing a large claims database to calculate incidence rates (IRs) of LFT elevations among a general cohort of cancer patients and a cohort of patients treated with TKIs by comparing the results to a “gold standard” oncology-specific EMR database. IRs for the TKI cohorts were very similar between the two databases; however, IRs were higher in the EMR database for the cancer cohorts. Possible explanations for these differences include lack of specificity when defining a cancer case, poor capture of laboratory data, or inaccurate assessment of person-time in the insurance claims database. This study suggests that insurance claims data may provide reliable results when investigating liver toxicities associated with oncology drug exposure; however, there are limitations when assessing laboratory outcomes for cohorts defined solely by disease status.
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Tabner, Andrew, Nicholas Tilbury, Michael Jones, Apostolos Fakis, Nicola Evans, and Graham Johnson. "Trends in emergency department litigation within the NHS: a retrospective database analysis." Medico-Legal Journal 90, no. 1 (February 14, 2022): 5–12. http://dx.doi.org/10.1177/00258172211057000.

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The objectives of this study are to examine trends in litigation related to emergency department care within the NHS. The study is based on retrospective database analysis. NHS Resolution databases of litigation activity pertaining to Type I emergency departments within the NHS are used. The main outcome measures were number of claims, number of successful claims, costs associated with litigation and costs per claim, all in comparison to patterns of ED attendance numbers and inflation. The results showed that the annual cost of litigation relating to emergency department care within the NHS has increased from £25.5 million in 2005/6 to £161.9 million in 2017/18. Mean cost per claim has increased from £58,252 in 2005/6 to £168,966 in 2017/18. The number of claims received has increased significantly; the proportion of these which were successful has remained constant. Therefore, it was concluded that the costs of litigation are increasing disproportionately to inflation and attendance numbers. Multiple potential causes are discussed, with significant implications for clinical practice.
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Schaefer, Eric, Evangelos Messaris, Christopher Hollenbeak, and Audrey Kulaylat. "Truven Health Analytics MarketScan Databases for Clinical Research in Colon and Rectal Surgery." Clinics in Colon and Rectal Surgery 32, no. 01 (January 2019): 054–60. http://dx.doi.org/10.1055/s-0038-1673354.

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AbstractThe MarketScan databases are a family of administrative claims databases that contain data on inpatient and outpatient claims, outpatient prescription claims, clinical utilization records, and healthcare expenditures. The three main databases available for use are each composed of a convenience sample for one of the following patient populations: (1) patients with employer-based health insurance from contributing employers, (2) Medicare beneficiaries who possess supplemental insurance paid by their employers, and (3) patients with Medicaid in one of eleven participating states. Eleven supplemental databases are available, which are utilized to overcome the limited clinical data available in the core MarketScan databases. There are several limitations to this database, primarily related to the fact that individuals or their family members within two of the core databases mandatorily possess some form of employer-based health insurance, which prevents the dataset from being nationally representative. Nonetheless, this database provides detailed and rigorously maintained claims data to identify healthcare utilization patterns among this cohort of patients.
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Yonekura, Hiroshi, Yusuke Mazda, Shohei Noguchi, Hironaka Tsunobuchi, and Motomu Shimaoka. "Current Epidemiology of the General Anesthesia Practice for Cesarean Delivery Using a Nationwide Claims Database in Japan: A Descriptive Study." Journal of Clinical Medicine 11, no. 16 (August 17, 2022): 4808. http://dx.doi.org/10.3390/jcm11164808.

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The current status of general anesthesia practice for cesarean delivery in Japan remains unknown. Therefore, using a nationwide claims database, we aimed to investigate general anesthesia use for cesarean delivery over a period of 15 years, and to analyze the general anesthesia practice in Japan. Patients who claimed the Japanese general anesthesia claim code (L008) for cesarean delivery between 1 January 2005, and 31 March 2020, were analyzed. Primary endpoint was the prevalence of general anesthesia use. We used two definitions of general anesthesia: L008 code only (insurance definition) and combination of the L008 code with muscle relaxant use (clinical definition). The general anesthesia claim cohort (L008) included 10,972 cesarean deliveries at 1111 institutions from 2005 to 2020. Muscle relaxants were used in 27.3% of L008 claims cases. The rate of general anesthesia use for cesarean delivery ranged from 3.9% in clinical definition to 14.4% in insurance definition of all cesarean deliveries. We observed a temporal trend of gradual decrease in general anesthesia use, regardless of its definition (p for trend < 0.001). We recommend the clinical definition of general anesthesia as the combination of L008 code and muscle relaxant use in a claims-based approach.
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Marshall, E. "METABOLIC RESEARCH: Canadian Group Claims 'Unique' Database." Science 315, no. 5812 (February 2, 2007): 583b—584b. http://dx.doi.org/10.1126/science.315.5812.583b.

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Ooba, Nobuhiro, Soko Setoguchi, Takashi Ando, Tsugumichi Sato, Takuhiro Yamaguchi, Mayumi Mochizuki, and Kiyoshi Kubota. "Claims-Based Definition of Death in Japanese Claims Database: Validity and Implications." PLoS ONE 8, no. 5 (May 31, 2013): e66116. http://dx.doi.org/10.1371/journal.pone.0066116.

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10

Gupta, Ashwin, Ashley Snyder, Allen Kachalia, Scott Flanders, Sanjay Saint, and Vineet Chopra. "Malpractice claims related to diagnostic errors in the hospital." BMJ Quality & Safety 27, no. 1 (August 9, 2017): 53–60. http://dx.doi.org/10.1136/bmjqs-2017-006774.

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BackgroundLittle is known about the incidence or significance of diagnostic error in the inpatient setting. We used a malpractice claims database to examine incidence, predictors and consequences of diagnosis-related paid malpractice claims in hospitalised patients.MethodsThe US National Practitioner Database was used to identify paid malpractice claims occurring between 1 January 1999 and 31 December 2011. Patient and provider characteristics associated with paid claims were analysed using descriptive statistics. Differences between diagnosis-related paid claims and other paid claim types (eg, surgical, anaesthesia, medication) were assessed using Wilcoxon rank-sum and χ2 tests. Multivariable logistic regression was used to identify patient and provider factors associated with diagnosis-related paid claims. Trends for incidence of diagnosis-related paid claims and median annual payment were assessed using the Cochran-Armitage and non-parametric trend test.Results13 682 of 62 966 paid malpractice claims (22%) were diagnosis-related. Compared with other paid claim types, characteristics significantly associated with diagnosis-related paid claims were as follows: male patients, patient aged >50 years, provider aged <50 years and providers in the northeast region. Compared with other paid claim types, diagnosis-related paid claims were associated with 1.83 times more risk of disability (95% CI 1.75 to 1.91; p<0.001) and 2.33 times more risk of death (95% CI 2.23 to 2.43; p<0.001) than minor injury, after adjusting for patient and provider characteristics. Inpatient diagnostic error accounted for $5.7 billion in payments over the study period, and median diagnosis-related payments increased at a rate disproportionate to other types.ConclusionInpatient diagnosis-related malpractice payments are common and more often associated with disability and death than other claim types. Research focused on understanding and mitigating diagnostic errors in hospital settings is necessary.
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Fonseca, Eileen, Richard T. Silver, Lewis E. Kazis, Sheikh Usman Iqbal, Mathieu Rose, and Nasreen Khan. "Ruxolitinib Discontinuation In Patients With Myelofibrosis: An Analysis From Clinical Practice." Blood 122, no. 21 (November 15, 2013): 2833. http://dx.doi.org/10.1182/blood.v122.21.2833.2833.

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Abstract Introduction The objective of this study is to evaluate the persistence patterns and discontinuation rates from ruxolitinib in clinical practice. Ruxolitinib was the first Janus kinase (JAK) inhibitor approved for treating intermediate-risk or high-risk myelofibrosis, including primary myelofibrosis, post‒polycythemia vera myelofibrosis, and post‒essential thrombocythemia myelofibrosis. Ruxolitinib was investigated in 2 randomized, controlled, phase 3 efficacy trials in patients diagnosed with myelofibrosis (COMFORT-I and COMFORT-II). Methods A retrospective database inception cohort study is developed from 2 large US claims databases, the IMS Health® database containing National Council for Prescription Drug Programs pharmacy-dispensed prescription claims and the MarketScan® database containing patient-level data from approximately 100 health plans (data from active employees, early retirees, COBRA continues, and dependents) and from Medicare Supplemental data. We identify a cohort of myelofibrosis patients who were prescribed ruxolitinib between November 1, 2011 and August 31, 2012 in the IMS database and between November 1, 2011 and June 30, 2012 from the MarketScan database. Patients are followed from the date of the first ruxolitinib claim, defined as the index date, until the last enrollment date or date of last claim recorded if greater than the last enrollment date in the MarketScan database or for a fixed 3- and 6-month period in the IMS database. When analyzing treatment discontinuation, patients with primary or secondary myelofibrosis are required to have ≥1 ruxolitinib dispensed prescription(s) and to have ≥3 months of pre-index data and ≥3 or 6 months of follow-up post-index data. Discontinuation of ruxolitinib was defined as a >30-day gap from the last day of supply from the prior prescription fill. Demographic and ruxolitinib discontinuation rates at 3 and 6 months post-index date for patients in each database are reported in this analysis with the Clopper-Pearson confidence interval. Results In patients prescribed ruxolitinib in the IMS database, mean (SD) age at the index date was 63.4 (13.2) years for patients followed for 3 months (n=183) and 63.3 (13.6) years for patients followed for 6 months (n=115). The MarketScan database inception cohort comprised 161 patients with mean (SD) age of 66.8 (12.2) years. Age was comparable and not substantially different across the 2 databases. Discontinuation rates in the IMS database were 60.9% and 73.0% at 3 and 6 months follow-up, respectively; in the MarketScan database, discontinuation rates were 41.1% and 48.4% for patients with a minimum of 3 and 6 months follow-up, respectively. Conclusions These analyses indicate that the discontinuation rates for patients receiving treatment with ruxolitinib for myelofibrosis are not low and are most pronounced within the first 3 months of treatment. Results suggest the magnitude of unmet need in myelofibrosis and for additional medications that can improve treatment outcomes. Limitations of this study pertain to a traditional claims database inquiry. As patients were identified from 2 distinct databases, there may be some data overlap. Diagnostic information on the basis of claims databases is not always accurate. Future research using rich clinical data from chart reviews is needed to identify clinical determinants of persistence/discontinuation. The discontinuation rates observed from these 2 large representative databases are substantial, reflecting inherent variability of point estimates and differences in data collection for the 2 data sources. Future studies should examine the reasons for discontinuation so that findings may be incorporated into disease/medication adherence management programs. Disclosures: Fonseca: IMS Health - a company that received funds from Sanofi to conduct the study: Employment. Silver:Sanofi : Consultancy, Research Funding. Kazis:Sanofi and IMS: Consultancy. Iqbal:Sanofi: Employment, Equity Ownership. Rose:Sanofi: Employment. Khan:IMS Health: Employment.
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Gu, Tao, Neel Shah, Gaurav Deshpande, Derek H. Tang, Debra F. Eisenberg, and David J. Harrison. "Biologic Cost per Effectively Treated Rheumatoid Arthritis Patient in a Large Managed Care Population: A Retrospective Cohort Study." Journal of Health Economics and Outcomes Research 3, no. 2 (September 17, 2015): 122–31. http://dx.doi.org/10.36469/9830.

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Background: Until recently, the lack of clinical outcomes information for rheumatoid arthritis (RA) in administrative claims databases limited their use in comparative effectiveness research. A validated claims-based algorithm has been developed to estimate the effectiveness of biologics for RA, allowing for estimation of cost and effectiveness in the same database. Objectives: To implement a validated claims-based effectiveness algorithm in a US managed care claims database to compute the 1-year biologic cost per effectively treated patient among first-line biologics approved for moderate-to-severe RA (abatacept, adalimumab, certolizumab pegol, etanercept, golimumab, and infliximab). Methods: This retrospective cohort study used administrative claims data for individuals in the HealthCore Integrated Research Database (HIRDSM). The first claim for a first-line biologic between July 1, 2009, and January 31, 2013, after 6 months of continuous enrollment, was defined as the index event and date. Patients were aged 18-63 years on the index date and had at least one claim for RA in the 6-month pre- index period. Biologic costs included plan and patient paid amounts on claims for the biologic drug and administration. The algorithm defined effectiveness during the 12-month post-index period as achieving all six of the following: high adherence (medication possession ratio ≥80% or infusions consistent with the product label); no increase in biologic dose or decrease in dosing interval; no new biologic; no new nonbiologic disease-modifying antirheumatic drug; no new or increased oral glucocorticoid use; and ≤1 glucocorticoid injection. Cost per effectively treated patient was calculated as the total biologic cost (drug and administration) divided by the number of patients categorized by the algorithm as effectively treated. Results: The cohort comprised 4844 patients (mean age 48.6 years, 76.4% female). Average first-year biologic cost ranged from $14 795 (golimumab) to $19 520 (abatacept). Average first-year biologic cost per effectively treated patient was significantly lower for etanercept ($50 217) than for golimumab ($56 427, p&lt;0.001) adalimumab ($56 879, p&lt;0.001), abatacept ($68 062, p&lt;0.001), certolizumab pegol ($76 427, p&lt;0.001), and infliximab ($95 126, p&lt;0.001). Conclusions: In this application of a validated claims-based algorithm to a large managed care population, etanercept had the lowest 1-year biologic cost per effectively treated patient among first-line biologics.
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Sharma, Dolly, Kathleen L. Deering, Patrick Loustau, Michael D. Culler, Soraya Allas, Blandine Weiss, Deborah M. Mitchell, Danette Astolfi, and Michael Mannstadt. "Clinical Burden and Practice Patterns in Patients With Chronic Hypoparathyroidism in the United States (US): A Claims Data Analysis Using Diagnosis-Based Criteria." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A259. http://dx.doi.org/10.1210/jendso/bvab048.526.

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Abstract Objectives: Significant knowledge gaps exist regarding the comorbidities, treatment and lab testing patterns of patients with chronic hypoparathyroidism (cHP). This study describes a large cohort of patients with cHP identified using a diagnosis-based criteria from a claims database. Methods: This retrospective cohort study was conducted using a large (130 million individuals) claims database (HealthVerity Closed Payer Claim Medical and Pharmacy databases: Private Source 20) from Oct 2014 to Dec 2019. Eligible patients had ≥2 diagnosis claims of HP (ICD9/10 codes: E20.0, E20.8, E20.9, 252.1) that were 6–15 months apart, a prescription claim for either active vitamin D, calcium, PTH or thyroid replacement therapy between the first qualifying HP claim and within 30 days of the second HP claim, and continuous enrollment for one year before the index date (the date of the first of two qualifying HP diagnosis claims) and ≥16 months after. Patients were followed up to two years after the index date. Patient characteristics, comorbidities, lab testing and treatment patterns were descriptively analyzed. Results: Out of 43,640 patients with a diagnosis claim for HP, 4,118 patients met the eligibility criteria. The mean age of the cohort was 56.5 years + 18.6 (SD), and 76.4% were females, similar to data from other large cohort studies. The most common comorbidities during the 1-year follow-up were hypertension (56.0%), hypocalcemia (38.7%), cancer (30.5%, of which 24% were thyroid cancers), diabetes (29.4%), chronic pulmonary disease (24.1%), cardiac arrhythmias (17.4%), CKD stage 3–5 (17.0%), osteoporosis (9.6%) and neuropsychiatric disorders, including depressive disorders (22.0%), anxiety (21.6%), and sleep-wake disorders (18.4%). During the 1-year follow up, commonly monitored lab tests included serum calcium (89.9%), eGFR/creatinine (85.7%), 25-hydroxy vitamin D (61.1%), and intact PTH (43.9%). Remarkably, serum phosphorous (36.3%), serum magnesium (35.4%), and 24h-urine calcium (10.5%) were much less often monitored. In addition, BMD was measured in 10.9% patients. Also during the 1-year follow-up, 67.1% of patients had a prescription claim for thyroid replacement therapy, 60.5% for calcitriol, 15.7% for ergocalciferol, and 3.4 % for PTH. Conclusion: Findings from this study highlight the high comorbidity burden in cHP patients which aligns with the monitoring patterns. Kidney function appears to be a key concern and may be important when considering therapeutic intervention. The comorbidities and practice patterns observed in this study are consistent with the results obtained using a surgery-based approach to identify cHP patients in the same claims database. Future studies will also examine the economic burden of cHP.
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OKAMOTO, Etsuji. "3. Legal Bases of the National Claims Database." Japanese Journal of Pharmacoepidemiology/Yakuzai ekigaku 17, no. 2 (2013): 117–34. http://dx.doi.org/10.3820/jjpe.17.117.

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15

Piecoro, Lance T., Lorinda S. Wang, Wanda S. Dixon, and Robert J. Crovo. "Creating a computerized database from administrative claims data." American Journal of Health-System Pharmacy 56, no. 13 (July 1, 1999): 1326–29. http://dx.doi.org/10.1093/ajhp/56.13.1326.

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VanderBeek, Brian L. "Oral Fluoroquinolones, Retinal Detachments, and Claims Database Studies." JAMA Ophthalmology 134, no. 4 (April 1, 2016): 422. http://dx.doi.org/10.1001/jamaophthalmol.2016.0240.

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Tamblyn, Robyn, Gilles Lavoie, Lina Petrella, and Johanne Monette. "The use of prescription claims databases in pharmacoepidemiological research: The accuracy and comprehensiveness of the prescription claims database in Québec." Journal of Clinical Epidemiology 48, no. 8 (August 1995): 999–1009. http://dx.doi.org/10.1016/0895-4356(94)00234-h.

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Noguchi, Yoshihiro, Shunsuke Yoshizawa, Tomoya Tachi, and Hitomi Teramachi. "Effect of Dipeptidyl Peptidase-4 Inhibitors vs. Metformin on Major Cardiovascular Events Using Spontaneous Reporting System and Real-World Database Study." Journal of Clinical Medicine 11, no. 17 (August 25, 2022): 4988. http://dx.doi.org/10.3390/jcm11174988.

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Background: Metformin had been recommended as the first-line treatment for type 2 diabetes since 2006 because of its low cost, high efficacy, and potential to reduce cardiovascular events, and thus death. However, dipeptidyl peptidase-4 (DPP-4) inhibitors are the most commonly prescribed first-line agents for patients with type 2 diabetes in Japan. Therefore, it is necessary to clarify the effect of DPP-4 inhibitors on preventing cardiovascular events, taking into consideration the actual prescription of antidiabetic drugs in Japan. Methods: This study examined the effect of DPP-4 inhibitors on preventing cardiovascular events. The Japanese Adverse Drug Event Report (JADER) database, a spontaneous reporting system in Japan, and the Japanese Medical Data Center (JMDC) Claims Database, a Japanese health insurance claims and medical checkup database, were used for the analysis. Metformin was used as the DPP-4 inhibitor comparator. Major cardiovascular events were set as the primary endpoint. Results: In the analysis using the JADER database, a signal of major cardiovascular events was detected with DPP-4 inhibitors (IC: 0.22, 95% confidence interval: 0.03–0.40) but not with metformin. In the analysis using the JMDC Claims Database, the hazard ratio of major cardiovascular events for DPP-4 inhibitors versus metformin was 1.01 (95% CI: 0.84–1.20). Conclusions: A comprehensive analysis using two different databases in Japan, the JADER and the JMDC Claims Database, showed that DPP-4 inhibitors, which are widely used in Japan, have a non-inferior risk of cardiovascular events compared to metformin, which is used as the first-line drug in the United States and Europe.
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Williams, PhD, MS, Rachel E., Timothy J. Sampson, BS, Linda Kalilani, MBBS, PhD, John I. Wurzelmann, MD, MPH, and Stephen W. Janning, PharmD. "Epidemiology of opioid pharmacy claims in the United States." Journal of Opioid Management 4, no. 3 (January 30, 2018): 145. http://dx.doi.org/10.5055/jom.2008.0019.

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Objective: To describe opioid pharmacy claims patterns in the United States among an insured population.Design: Information was obtained from the US insurance claims database, IMS Lifelink™, between 1997 and 2002. Descriptive statistics of opioid claims patterns were described with stratification by gender, age, and year of use.Results: The prevalence of insured people with opioid claims increased from 17.1 percent in 1997 to 18.4 percent in 2002. Among people with an opioid claim, 24 percent had ≥30 days and 10 percent had ≥90 days of days supplied based on the insurance claims. Prevalence varied by type of opioid; 56 percent of people with a claim received propoxyphene, 43 percent received codeine, 23 percent received oxycodone, and 17 percent received hydrocodone. Sustained-release opioids were found among 6 percent of those with a claim. With respect to the dose of opioids in the pharmacy claims (expressed as morphine equivalent total daily dose), 71 percent had claims for <50 mg, 55 percent had claims for 50-99 mg, and 24 percent had claims for ≥100 mg. Women, individuals with cancer, and older patients had significantly more pharmacy claims as well as claims for higher doses of opioids (p < 0.05). Internal medicine and family practice specialists were responsible for 22.4 percent and 20.9 percent of all opioid claims.Conclusions: Opioid pharmacy claims increased slightly over time. Older patients, women and patients with a cancer diagnosis had significantly more opioid claims and claims for higher doses than the younger patients, men, and those without cancer.
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Ricchetti-Masterson, Kristen, Molly Aldridge, John Logie, Nittaya Suppapanya, and Suzanne F. Cook. "Exploring Methods to Measure the Prevalence of Ménière's Disease in the US Clinformatics™ Database, 2010-2012." Audiology and Neurotology 21, no. 3 (2016): 172–77. http://dx.doi.org/10.1159/000441963.

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Recent studies on the epidemiology of the inner-ear disorder Ménière's disease (MD) use disparate methods for sample selection, case identification and length of observation. Prevalence estimates vary geographically from 17 to 513 cases per 100,000 people. We explored the impact of case detection strategies and observation periods in estimating the prevalence of MD in the USA, using data from a large insurance claims database. Using case detection strategies of ≥1, ≥2 and ≥3 ICD-9 claim codes for MD within a 1-year period, the 2012 prevalence estimates were 66, 27 and 14 cases per 100,000 people, respectively. For ≥1, ≥2 and ≥3 insurance claims within a 3-year observation period, the prevalence estimates were 200, 104 and 66 cases per 100,000 people, respectively. Estimates based on a single claim are likely to overestimate prevalence; this conclusion is aligned with the American Academy of Otolaryngology-Head and Neck Foundation criteria requiring ≥2 definitive episodes for a definite diagnosis, and it has implications for future epidemiologic research. We believe estimates for ≥2 claims may be a more conservative estimate of the prevalence of MD, and multiyear estimates may be needed to allow for adequate follow-up time.
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Rabilloud, M., C. Colin, R. Ecochard, and C. M. Couris. "Two-Phase Study to Assess the Number of Cases Based on Claims Databases: Characteristics of the Validation Data Set." Methods of Information in Medicine 41, no. 04 (2002): 349–56. http://dx.doi.org/10.1055/s-0038-1634393.

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Summary Objective: In a two-phase study design, the characteristics of an external data set were studied for precision and bias of the number of incident or prevalent cases of a disease obtained from claims databases. Methods: In the study population (first phase), incident or prevalent cases were counted whereas external data (second phase) provided sensitivity and specificity estimates to count cases in a claims database. Influence of potential differences in sensitivity and specificity between the two phases were evaluated. This was illustrated for 50-90% sensitivity and 99-99.99% specificity ranges. Results and Conclusions: The impact of differences in sensitivity and specificity depends on the odds of disease in the study population. We provide advice on the choice of adequate data sets to correct claims database estimates.
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Morlion, Bart J., César Margarit, Imane Wild, Ravi Karra, Hiltrud Liedgens, Melanie Sohns, and Gabriele Finco. "Bone fractures in patients using tapentadol or oxycodone: an exploratory US claims database study." Pain Management 11, no. 1 (January 2021): 39–47. http://dx.doi.org/10.2217/pmt-2020-0065.

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Aim: To explore fracture outcomes with tapentadol or oxycodone, two opioids with differing mechanisms of action. Materials & methods: Retrospective cohort pilot study, using MarketScan® Commercial and Medicare Supplemental claims databases, on patients with postoperative pain, back pain, or osteoarthritis and ≥1 claim for tapentadol (n = 16,457), oxycodone (n = 1,356,920), or both (n = 15,893) between June 2009 and December 2015. Results: During 266,826 and 9,007,889 days of tapentadol and oxycodone treatment, patients evidenced 1080 and 72,275 fractures, respectively. Fracture rates per treatment-year were 1.512 for tapentadol and 3.013 for oxycodone. Conclusion: Examination of administrative claims has inherent limitations, but this exploratory analysis indicates a lower fracture rate with tapentadol than oxycodone in the analyzed dataset, which needs confirmation by further clinical trials.
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Takekuma, Yoh, Shungo Imai, and Mitsuru Sugawara. "Clinical Research Using the Large Health Insurance Claims Database." YAKUGAKU ZASSHI 142, no. 4 (April 1, 2022): 331–36. http://dx.doi.org/10.1248/yakushi.21-00178-3.

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Walshe, K. "National claims database belongs to NHS as a whole." BMJ 321, no. 7269 (November 4, 2000): 1157. http://dx.doi.org/10.1136/bmj.321.7269.1157.

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Cziraky, Mark J., Vincent J. Willey, James M. McKenney, Siddhesh A. Kamat, Maxine D. Fisher, John R. Guyton, Terry A. Jacobson, and Michael H. Davidson. "Statin Safety: An Assessment Using an Administrative Claims Database." American Journal of Cardiology 97, no. 8 (April 2006): S61—S68. http://dx.doi.org/10.1016/j.amjcard.2005.12.011.

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Subramanyam, Rajeev, Vidya Chidambaran, Lili Ding, Charles M. Myer, and Senthilkumar Sadhasivam. "Anesthesia- and opioids-related malpractice claims following tonsillectomy in USA: LexisNexis claims database 1984-2012." Pediatric Anesthesia 24, no. 4 (January 13, 2014): 412–20. http://dx.doi.org/10.1111/pan.12342.

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Kim, JaYoung, Munsin Kim, Ji-Hye Ha, Junghoon Jang, Myungsil Hwang, Byung Koo Lee, Myeon Woo Chung, Tae Moo Yoo, and Myung Jung Kim. "Signal detection of methylphenidate by comparing a spontaneous reporting database with a claims database." Regulatory Toxicology and Pharmacology 61, no. 2 (November 2011): 154–60. http://dx.doi.org/10.1016/j.yrtph.2011.03.015.

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Takahashi, Sayumi, Taku Obara, Yoichi Kakuta, Yusuke Shimoyama, Takeo Naito, Rintaro Moroi, Masatake Kuroha, Hisashi Shiga, Yoshitaka Kinouchi, and Atsushi Masamune. "Validity of Diagnostic Algorithms for Inflammatory Bowel Disease in Japanese Hospital Claims Data." International Journal of Environmental Research and Public Health 19, no. 13 (June 28, 2022): 7933. http://dx.doi.org/10.3390/ijerph19137933.

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Inflammatory bowel disease (IBD) diagnoses are increasing in Japan. Some patients have symptoms that are difficult to control, and further research on IBD is needed. Claims databases, which have a large sample size, can be useful for IBD research. However, it is unclear whether the International Classification of Diseases, Tenth Revision (ICD-10) codes alone can correctly identify IBD. We aimed to develop algorithms to identify IBD in claims databases. We used claims data from the Department of Gastroenterology, Tohoku University Hospital from 1 January 2016 to 31 December 2020. We developed 11 algorithms by combining the ICD-10 code, prescription drug, and workup information. We had access to the database which contains all the information for Crohn’s disease and ulcerative colitis patients who visited our department, and we used it as the gold standard. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value for each algorithm. We enrolled 19,384 patients, and among them, 1012 IBD patients were identified in the gold standard database. Among 11 algorithms, Algorithm 4 (ICD-10 code and ≥1 prescription drugs) showed a strong performance (PPV, 94.8%; sensitivity, 75.6%). The combination of an ICD-10 code and prescription drugs may be useful for identifying IBD among claims data.
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Al-Ani, Haya H., Anandita Devi, Helen Eyles, Boyd Swinburn, and Stefanie Vandevijvere. "Nutrition and health claims on healthy and less-healthy packaged food products in New Zealand." British Journal of Nutrition 116, no. 6 (August 9, 2016): 1087–94. http://dx.doi.org/10.1017/s0007114516002981.

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AbstractNutrition and health claims are displayed to influence consumers’ food choices. This study assessed the extent and nature of nutrition and health claims on the front-of-pack of ‘healthy’ and ‘less-healthy’ packaged foods in New Zealand. Foods from eight categories, for which consumption may affect the risk of obesity and diet-related chronic diseases, were selected from the 2014 Nutritrack database. The internationally standardised International Network for Food and Obesity/Non-Communicable Diseases Research, Monitoring and Action Support (INFORMAS) taxonomy was used to classify claims on packages. The Nutrient Profiling Scoring Criterion (NPSC) was used to classify products as ‘healthy’ or ‘less healthy’. In total, 7526 products were included, with 47 % (n 3557) classified as ‘healthy’. More than one-third of products displayed at least one nutrition claim and 15 % featured at least one health claim on the front-of-pack. Claims were found on one-third of ‘less-healthy’ products; 26 % of those products displayed nutrition claims and 7 % featured health claims. About 45 % of ‘healthy’ products displayed nutrition claims and 23 % featured health claims. Out of 7058 individual claims, the majority (69 %) were found on ‘healthy’ products. Cereals displayed the greatest proportion of nutrition and health claims (1503 claims on 564 products), of which one-third were displayed on ‘less-healthy’ cereals. Such claims could be misleading consumers’ perceptions of nutritional quality of foods. It needs to be explored how current regulations on nutrition and health claims in New Zealand could be further strengthened (e.g. using the NPSC for nutrition claims, including general health claims as per the INFORMAS taxonomy) to ensure consumers are protected and not misled.
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Hindman, Bradley J., John P. Palecek, Karen L. Posner, Vincent C. Traynelis, Lorri A. Lee, Paul D. Sawin, Trent L. Tredway, Michael M. Todd, and Karen B. Domino. "Cervical Spinal Cord, Root, and Bony Spine Injuries." Anesthesiology 114, no. 4 (April 1, 2011): 782–95. http://dx.doi.org/10.1097/aln.0b013e3182104859.

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Background The aim of this study was to characterize cervical cord, root, and bony spine claims in the American Society of Anesthesiologists Closed Claims database to formulate hypotheses regarding mechanisms of injury. Methods All general anesthesia claims (1970-2007) in the Closed Claims database were searched to identify cervical injuries. Three independent teams, each consisting of an anesthesiologist and neurosurgeon, used a standardized review form to extract data from claim summaries and judge probable contributors to injury. Results Cervical injury claims (n = 48; mean ± SD age 47 ± 15 yr; 73% male) comprised less than 1% of all general anesthesia claims. When compared with other general anesthesia claims (19%), cervical injury claims were more often permanent and disabling (69%; P &lt; 0.001). In addition, cord injuries (n = 37) were more severe than root and/or bony spine injuries (n = 10; P &lt; 0.001), typically resulting in quadriplegia. Although anatomic abnormalities (e.g., cervical stenosis) were often present, cord injuries usually occurred in the absence of traumatic injury (81%) or cervical spine instability (76%). Cord injury occurred with cervical spine (65%) and noncervical spine (35%) procedures. Twenty-four percent of cord injuries were associated with the sitting position. Probable contributors to cord injury included anatomic abnormalities (81%), direct surgical complications (24% [38%, cervical spine procedures]), preprocedural symptomatic cord injury (19%), intraoperative head/neck position (19%), and airway management (11%). Conclusion Most cervical cord injuries occurred in the absence of traumatic injury, instability, and airway difficulties. Cervical spine procedures and/or sitting procedures appear to predominate. In the absence of instability, cervical spondylosis was the most common factor associated with cord injury.
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Teitelbaum, April H., Dana Evans, Elaine Yu, Robert Morlock, and Stacey DaCosta Byfield. "Treatment patterns and costs in second-line (2L) metastatic colorectal cancer (mCRC)." Journal of Clinical Oncology 31, no. 4_suppl (February 1, 2013): 544. http://dx.doi.org/10.1200/jco.2013.31.4_suppl.544.

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544 Background: Administrative claims databases are an important data source to examine treatment (tx) patterns, costs and outcomes, but are subject to limitations. This study included a chart review to assess a claims-based algorithm for identifying 2L mCRC patients (pts). Tx patterns and costs were compared between mCRC pts treated with bevacizumab (BEV) or cetuximab (CET). Methods: 2LmCRC pts were identified from a US commercial insurance claims database (1/2008-6/2011). Initial identification required pts to have ≥2 claims ≥30 d apart for colon or rectal cancer and metastatic (met) disease. Continuous enrollment for ≥6 mo before and after the date of 1st met claim, ≥2 lines of therapy (LOT), and 2L tx with BEV or anti-EGFR was required. 2L was defined as addition of any new agent ≥28 d after start of 1st LOT. Charts from 92 pts were abstracted and used to refine and corroborate the algorithm. Generalized Linear Models (GLM) were used to assess differences in healthcare costs between patients on BEV or CET during 2L. Results: The match rate of claims identified mCRC pts treated with multiple lines of therapy confirmed by chart abstraction ranged from 85% to 97%. Applying the final algorithm to the overall claims data resulted in the identification of 569 pts: 450 pts receiving BEV and 119 pts receiving CET. A total of 38 panitumumab patients were excluded from analysis due to small sample size. Pt characteristics were similar; mean age was 61 years and 58% were males. In 2L, BEV was commonly used with 5FU or capecitabine-based regimens (81%) and CET with irinotecan-based regimens (73%). BEV pts had significantly lower all-cause healthcare costs (adjusted difference: –$12,239, p=0.02), and medical costs (–$13,672, p=0.01) during 2L. While on second-line therapy, BEV pts also had lower average monthly all-cause and medical costs than CET pts. Sensitivity analysis using variations of the case finding algorithm yield similar results. Conclusions: The use of BEV during second line treatment of mCRC was found to be associated with significantly lower healthcare costs relative to the use of CET from a large US healthcare claims database.
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Domino, Karen B., T. Andrew Bowdle, Karen L. Posner, Pete H. Spitellie, Lorri A. Lee, and Frederick W. Cheney. "Injuries and Liability Related to Central Vascular Catheters." Anesthesiology 100, no. 6 (June 1, 2004): 1411–18. http://dx.doi.org/10.1097/00000542-200406000-00013.

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Background To assess changing patterns of injury and liability associated with central venous or pulmonary artery catheters, the authors analyzed closed malpractice claims for central catheter injuries in the American Society of Anesthesiologists Closed Claims database. Methods All claims for which a central catheter (i.e., central venous or pulmonary artery catheter) was the primary damaging event for the injury were compared with the rest of the claims in the database. Central catheter complications were defined as being related to vascular access or catheter use or maintenance. Statistical analysis was performed using the chi-square test, Fisher exact test, or Z test (proportions) and the Kolmogorov-Smirnov test (payments). Results The database included 110 claims for injuries related to central catheters (1.7% of 6,449 claims). Claims for central catheter injuries had a higher severity of injury, with an increased proportion of death (47%) compared with other claims in the database (29%, P &lt; 0.01). The most common complications were wire/catheter embolus (n = 20), cardiac tamponade (n = 16), carotid artery puncture/cannulation (n =16), hemothorax (n =15), and pneumothorax (n =14). Cardiac tamponade, hemothorax, and pulmonary artery rupture had a higher proportion of death (P &lt; 0.05) compared with the rest of the central catheter injures. The proportion of claims for vascular access injury increased (47% to 84%) and use/maintenance injury decreased (53% to 16%) in 1994-1999 compared with 1978-1983 (P &lt; 0.05). Conclusions Claims related to central catheters had a high severity of patient injury. The most common complications causing injury were wire/catheter embolus, cardiac tamponade, carotid artery puncture/cannulation, hemothorax, and pneumothorax.
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Liu, Zhimei, Peter Sun, Michael Kohrman, and John Bissler. "Prevalence of angiomyolipoma among patients with tuberous sclerosis complex: A U.S. Healthcare Claims Database study." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e12042-e12042. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e12042.

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e12042 Background: Angiomyolipoma (AML) are common benign neoplasm in the kidney, and are associated with tuberous sclerosis complex (TSC). The objectives of this study were to examine AML prevalence among TSC patients in a real world setting, and to explore the relationship between AML prevalence and ages, genders, or residential regions. Methods: A retrospective cohort study was conducted based on a large US commercial healthcare claims database. Patients with a TSC claim between 2000 and 2009 and with continuous 12-month enrollment after their first TSC claim were selected for the study. AML patients were identified based on ICD-9CM code (223.0X). Patients’ genders, residential regions, and age on their first TSC/or AML claim (if they had AML) were derived respectively from enrollment files and healthcare claims. Two-sample t tests and Chi-square tests were used to explore the relationships between AML prevalence, genders, residential regions and the age groups. Results: The study included 2,767 TSC patients with a mean age of 28.5 years on their first TSC claims, and 55.3% were female. AML prevalence among TSC patients was 7.8% in their first observed post-TSC year, and could be 78% at the end of the 10th observed post-TSC year if AML incidence rate (701.1 per 10,000 TSC patient years) remains constant. Associations between AML prevalence and age groups, genders, or residential regions were statistically significant (all p<0.05); and variations of AML prevalence by genders (Male: 5.6 vs. Female: 9.7%), residential regions (6.2-9.4%) and age groups at the first TSC claim (3.9% for age<1 year, 5.2% for age 1-5 years, 10.6% for 6-10 years, 8.4% for age 11-18 years, 13.6% for age 19-25 years, and 6.9% for age 26 years or more) were observed. Conclusions: In a real world setting AML occurred in 7.8% TSC patients in the first post-TSC year, and could increase to 78% within 10 years if the incidence rate remained at 701.1 per 10,000 TSC patient years. AML prevalence was associated with age, gender and residential regions, and varied significantly by ages, genders and residential regions. Further research is needed to explore the factors that resulted into these associations.
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Zhong, Wenjun, Xinyue Liu, Katrina Mott, and Zaina Qureshi. "316 Comorbidities among medically diagnosed insomnia patients: A MarketScan database study." Sleep 44, Supplement_2 (May 1, 2021): A127. http://dx.doi.org/10.1093/sleep/zsab072.315.

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Abstract Introduction A large proportion of patients with insomnia frequently suffer from comorbid medical conditions. Literature on the relationship between insomnia and associated comorbidities is severely limited due to challenges of generalizability, focus on a specific comorbidity and concerns of information biases. We conducted a comprehensive secondary database analysis to describe comorbidities among medically diagnosed insomnia patients. Methods All patients in the MarketScan database in 2018 with a full year of enrollment were included. Insomnia patients were identified using ICD-10-CM diagnosis codes (at least 2 outpatient claims or 1 inpatient claim of insomnia in 2018), along with their comorbidities recorded in that year. The frequencies of comorbidities among patients with insomnia were estimated. For comorbidities with prevalence &gt; 1%, we further grouped them when appropriate to reduce the number of comorbidities. Results Among 20,209,292 enrollees, 259,035 (1.3%) had insomnia in 2018. Patients with insomnia had a median of 2 (IQR: 1–3) insomnia claims. The mean age of these insomnia patients was 49.3 years (std: 15.7), most of them were female (62.5%). About 172 comorbidities with &gt;1% were found in this patient population, and 35 comorbidities had a frequency greater than 10%. The common comorbidities among these insomnia patients included 1): common physical disorders among middle aged and older adults: hyperlipidemia (39%), hypertension (39%), skin diseases (37%), back pain 35%; 2):common mental health disorders such as anxiety disorder (41%), depression (28%); and 3): other diseases such as GERD and thyroid diseases also had high frequencies among insomnia patients (18% and 18.7%, respectively). Conclusion Using claims data, we provided a quantitative assessment of comorbidities among patients with medically diagnosed insomnia. These results could help clinicians become aware of the most frequently occurring comorbidities and assist in integrating management of the insomnia. Support (if any):
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Al Dallal, Sara Ahmad Mohammad, Mohamed Farghaly, Ahmed Ghorab, Mostafa Elaassar, Hammam Haridy, Nancy Awad, Badarinath Chickballapur Ramachandrachar, and Ashok Natarajan. "Real-world evaluation of costs of illness for pneumonia in adult patients in Dubai—A claims database study." PLOS ONE 16, no. 9 (September 1, 2021): e0256856. http://dx.doi.org/10.1371/journal.pone.0256856.

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Background Pneumonia is a significant cause of morbidity and mortality among adults globally. This retrospective cohort analysis assessed the pneumonia burden and related healthcare resource utilization and costs in the at-risk (low, medium, and high-risk) adult patients in Dubai, United Arab Emirates (UAE). Methods The claims data from January 1, 2014 to June 30, 2019 were extracted from the Dubai Real-World Claims Database for patients, aged ≥18 year, having at least 1 pneumonia claim. Data for the inpatient, outpatient and emergency visits were assessed for 12-months, before (pre-index) and after (follow-up) a pneumonia episode. Healthcare costs were calculated based on dollar value of 2020. Results Total 48,562 records of eligible patients were analyzed (mean age = 39.9 years; low [62.1%], medium [36.2%] and high [1.7%] risk cohorts). Mean all-cause healthcare costs were approximately >45% higher in the follow-up period (1,947 USD/patient) versus pre-index period (1,327 USD/patient). During follow-up period, the mean annual pneumonia incidence rate was 1.3 episodes, with a similar pattern across all cohorts. Overall, mean claims and costs (USD) per patient (all-cause) were highest in the high-risk cohort in the follow-up period (claims: overall, 11.6; high-risk, 22.0; medium-risk, 13.9; low-risk, 9.9; costs: high-risk, 14,184; medium-risk, 2,240; low-risk, 1,388). Similarly, the mean pneumonia-related costs (USD) per patient were highest for the high-risk cohort (overall: 1,305; high-risk, 10,207; medium-risk, 1,283; low-risk, 882), however, the claims were similar across cohorts (claims/patient: overall: 2.0; high-risk, 1.9; medium-risk, 2.2; low-risk, 1.9). Most all-cause and pneumonia-related costs were due to inpatient visits (4,901 and 4,818 USD respectively), while outpatient (1,232 and 166 USD respectively) and emergency visits (347 and 206 USD respectively) contributed significantly lesser. Conclusions Pneumonia imposes a significant healthcare burden in the UAE, especially in the high-risk patients with severe comorbidities. These findings would guide clinicians and policy makers to make informed decisions.
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Myers, Laura C., Lisa Heard, and Elizabeth Mort. "Lessons Learned From Medical Malpractice Claims Involving Critical Care Nurses." American Journal of Critical Care 29, no. 3 (May 1, 2020): 174–81. http://dx.doi.org/10.4037/ajcc2020341.

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Background Medical malpractice data can be used to improve patient safety. Objective To describe the types of harm events involving nurses that lead to malpractice claims and to compare claims among intensive care units (ICUs), emergency departments, and operating rooms. Methods Malpractice claims closed between 2007 and 2016 were extracted from a national database. Claims with a nurse as the primary provider were identified and then compared by location of the harm event: ICU, emergency department, or operating room. Multivariable regression was used to determine predictors of claims payment. Results Of 54 699 claims, 314 involved ICU nurses as the primary provider. The majority (59%) of claims involving ICU nurses resulted in death or permanent injury. The most common allegation of claims involving ICU nurses was failure to monitor (47%), which was higher than among claims against nurses in the emergency department (9%) or the operating room (4%) (P &lt; .001). The most common diagnosis in claims involving ICU nurses was decubitus ulcers (26%). Despite equivalent numbers of defendants per claim, the median indemnity for paid claims involving ICU nurses was higher ($125 000) than that paid for claims originating in the emergency department ($56 799) or operating room ($43 910) (P &lt; .001). In multivariable regression, 2 variables increased the risk of claim payment: ICU location (odds ratio, 1.79 [95% CI, 1.29-2.48]) and permanent injury (odds ratio, 1.50 [95% CI, 1.07-2.09]). Conclusions Malpractice claims involving ICU nurses were distinct from claims in comparably fast-paced settings. Focusing harm-prevention efforts in the ICU on skin integrity and monitoring of patients would most likely mitigate many highly severe harms involving ICU nurses, which would benefit both patients and nurses.
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Abouleish, Amr E., Donald S. Prough, and Rakesh B. Vadhera. "Influence of the Type of Anesthesia Provider on Costs of Labor Analgesia to the Texas Medicaid Program." Anesthesiology 101, no. 4 (October 1, 2004): 991–98. http://dx.doi.org/10.1097/00000542-200410000-00026.

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Background The Texas Medicaid Program (Medicaid) defines billable time for labor analgesia as face-to-face time; therefore, anesthesia providers determine billed time. The authors' goal was to determine the influence of anesthesia providers on labor analgesia costs billed to Medicaid. Methods Under the Freedom of Information Act, Medicaid provided data on claims paid for 6 months in 2001 for labor analgesia administered during the course of a vaginal delivery. Claims were either time based (codes 00946 or 00955) or a flat fee (codes 26311 or 26319). Using modifiers, the authors grouped time-based claims as either anesthesiologist group or certified registered nurse anesthetist (CRNA) group. The cost to Medicaid was based on the 2001 fee schedule. The conversion factor was 18.21 USD per American Society of Anesthesiologists unit. The flat-fee reimbursement was 152.50 USD. CRNA services were paid at 85% of the fee schedule. Average time per time claim, percent of providers with more than 4 h of billed time, and cost per claim were determined for each group. Providers with more than 120 claims (&gt; 20 claims/month) were considered high-volume. Results The database included 21,378 claims (anesthesiologist group: 12,698 claims from 219 providers; CRNA group: 8,680 claims from 117 providers). For time-based claims, the average time per case was significantly higher in the CRNA group (146 min) than in the anesthesiologist group (105 min). The CRNA group cost to Medicaid (225.11 USD) was 19% more per claim than the anesthesiologist group (189.26 USD). The difference in cost per claim was greater among high-volume providers--213.10 USD for the CRNA group versus 168.76 USD for the anesthesiologist group. If a flat-fee program were instituted using the average cost per claim for all groups (203.81 USD), the Texas Medicaid program would save more than 500,000 USD annually. Conclusions The costs of labor analgesia billed to Texas Medicaid were 19% to 26% less per patient when provided by anesthesiologists than by CRNAs, despite lower per-unit reimbursement of CRNAs.
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Domino, Karen B., Karen L. Posner, Robert A. Caplan, and Frederick W. Cheney. "Awareness during Anesthesia." Anesthesiology 90, no. 4 (April 1, 1999): 1053–61. http://dx.doi.org/10.1097/00000542-199904000-00019.

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Background Awareness during general anesthesia is a frightening experience, which may result in serious emotional injury and post-traumatic stress disorder. We performed an in-depth analysis of cases from the database of the American Society of Anesthesiologists Closed Claims Project to explore the contribution of intraoperative awareness to professional liability in anesthesia. Methods The database of the Closed Claims Project is composed of closed US malpractice claims that have been collected in a standardized manner. All claims for intraoperative awareness were reviewed by the reviewers to identify patterns of causation and standard of care. Logistic regression analysis was used to identify independent patient and anesthetic factors associated with claims for recall during general anesthesia compared to other general anesthesia malpractice claims. Results Awareness claims accounted for 79 (1.9%) of 4,183 claims in the database, including 18 claims for awake paralysis, i.e., the inadvertent paralysis of an awake patient, and 61 claims for recall during general anesthesia, ie., recall of events while receiving general anesthesia. The majority of awareness claims involved women (77%), younger than 60 yr of age (89%), American Society of Anesthesiologists physical class I-II (68%), who underwent elective surgery (87%). Most (94%) claims for awake paralysis represented substandard care involving errors in labeling and administration, whereas care was substandard in only 43% of the claims for recall during general anesthesia (P &lt; 0.001). Claims for recall during general anesthesia were more likely to involve women (odds ratio [OR] = 3.08, 95% confidence interval [CI] = 1.58, 6.06) and anesthetic techniques using intraoperative opioids (OR = 2.12, 95% CI = 1.20, 3.74), intraoperative muscle relaxants (OR = 2.28, 95% CI = 1.22, 4.25), and no volatile anesthetic (OR = 3.20, 95% CI = 1.88, 5.46). Conclusions Deficiencies in labeling and vigilance were common causes for awake paralysis. Claims for recall during general anesthesia were more likely in women and with nitrous-narcotic-relaxant techniques.
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Lenert, Aleksander, GYeon Oh, Michael J. Ombrello, and Sujin Kim. "Clinical characteristics and comorbidities in adult-onset Still’s disease using a large US administrative claims database." Rheumatology 59, no. 7 (January 21, 2020): 1725–33. http://dx.doi.org/10.1093/rheumatology/kez622.

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Abstract Objectives We aimed to describe clinical characteristics, treatment patterns and major comorbidities of a US-based adult-onset Still’s disease (AOSD) cohort. Methods Administrative claims data from Truven MarketScan were collected from 2009 to 2015. An AOSD case was defined as ≥1 M06.1 International Classification of Diseases 10th revision (ICD-10) medical claim code. We extracted data for the AOSD cohort (n = 106) and 1:5 matched controls (n = 530) without AOSD. Outcomes of interest and a novel claims-based set of Yamaguchi criteria were identified by relevant ICD 9th revision (ICD-9) and ICD-10 codes. Bivariate descriptive analyses were conducted on all variables. Comorbidity rates and rate ratios were calculated in AOSD cases and matched controls. Statistical significance of cohort differences was determined to compare AOSD cases and matched controls. Results The AOSD cohort, with a mean age of 43.08 (standard deviation, s.d. 13.9) years and with female predominance (68.9%) was observed over a mean of 750.12 (637.6) days. A total of 35.9% of AOSD patients fulfilled claims-based Yamaguchi criteria compared with 0.4% matched controls (P&lt; 0.05). We identified severe AOSD-related complications, including macrophage activation syndrome (4.7%) and acute respiratory distress syndrome (12.3%). Treatment commonly involved systemic glucocorticoids (62.2%), MTX (51%) and anakinra (24.5%). Compared with matched controls, serious infections were significantly increased (rate ratio 2.58, 95% CI: 1.53, 4.37, P = 0.0004), while hyperlipidaemia (0.54, 95% CI: 0.35, 0.85; P = 0.008) and obesity (0.30, 95% CI: 0.15, 0.62; P = 0.001) were significantly decreased in AOSD patients. Conclusion We characterized a first US-based AOSD cohort using a large national administrative claims database, and identified key complications, treatments and comorbidities.
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Miura, Masayoshi, Keiko Sato, Hisao Muto, Kusuma Gopala, and Katsiaryna Holl. "Intussusception in Japanese infants: Analysis of health insurance claims database." Open Journal of Pediatrics 03, no. 04 (2013): 311–16. http://dx.doi.org/10.4236/ojped.2013.34056.

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Shahin, Maryam, Spencer Smith, Jung U. Yoo, and Won Hyung A. Ryu. "193. Management of C1 fractures: analysis of national claims database." Spine Journal 22, no. 9 (September 2022): S102. http://dx.doi.org/10.1016/j.spinee.2022.06.212.

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Duarte, Gleison Vieira, André Vicente Esteves de Carvalho, Ricardo Romiti, Antonio Gaspar, Thaís Gomes de Melo, Cinara Prata Soares, and Anna Rita Aguirre. "Generalized pustular psoriasis in Brazil: A public claims database study." JAAD International 6 (March 2022): 61–67. http://dx.doi.org/10.1016/j.jdin.2021.12.001.

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Horvath, Margaret C., Rebecca Wurtz, Beth A. Virnig, Nicole Engel-Nitz, Lincy S. Lal, Caitlin Elliott, and Stacey DaCosta Byfield. "Investigating hospice utilization for oncology patients using a claims database." Journal of Clinical Oncology 36, no. 15_suppl (May 20, 2018): 6570. http://dx.doi.org/10.1200/jco.2018.36.15_suppl.6570.

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Al-Sabah, Sheikh Sabah Jaber Ali, Sami M. Fereig, and David J. Hoare. "A database management system to document and analyse construction claims." Advances in Engineering Software 34, no. 8 (August 2003): 477–91. http://dx.doi.org/10.1016/s0965-9978(03)00044-9.

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Truter, I. "Cost Analysis of Anti-Migraine Prescribing Using a Claims Database." Value in Health 16, no. 7 (November 2013): A619. http://dx.doi.org/10.1016/j.jval.2013.08.1807.

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46

Wu, EQ, HG Birnbaum, M. Cifaldi, G. Colice, and Y. Kang. "PC03 DEVELOPMENT OF A COPD SEVERITY SCORE IN CLAIMS DATABASE." Value in Health 7, no. 6 (November 2004): 684–85. http://dx.doi.org/10.1016/s1098-3015(10)65781-6.

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47

Manack, Aubrey, Stephen P. Motsko, Judith K. Jones, Arliene Ravelo, Cornelia Haag-Molkenteller, and Roger R. Dmochowski. "EPIDEMIOLOGY OF NEUROGENIC BLADDER PATIENTS IN A US CLAIMS DATABASE." Journal of Urology 181, no. 4S (April 2009): 160. http://dx.doi.org/10.1016/s0022-5347(09)60461-4.

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48

Forooghian, Farzin. "The importance of validation in ophthalmic medical claims database research." Canadian Journal of Ophthalmology 52, no. 2 (April 2017): 143–44. http://dx.doi.org/10.1016/j.jcjo.2016.12.005.

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49

David, Guy, Candace L. Gunnarsson, Heidi C. Waters, Ruslan Horblyuk, and Harold S. Kaplan. "Economic Measurement of Medical Errors Using a Hospital Claims Database." Value in Health 16, no. 2 (March 2013): 305–10. http://dx.doi.org/10.1016/j.jval.2012.11.010.

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50

Lee, Paul P., Leonard A. Levin, John G. Walt, Tina H. Chiang, John J. Doyle, Lee S. Stern, and Margarita Dolgitser. "The Impact of Glaucoma Coding in a Large Claims Database." American Journal of Ophthalmology 143, no. 5 (May 2007): 867–70. http://dx.doi.org/10.1016/j.ajo.2006.12.034.

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