TY - JOUR
T1 - Using claims data for epidemiologic research
T2 - The concordance of claims-based criteria with the medical record and patient survey for identifying a hypertensive population
AU - Quam, Lois
AU - Ellis, Lynda B.M.
AU - Venus, Pat
AU - Clouse, Jon
AU - Taylor, Cynthia G.
AU - Leatherman, Sheila
PY - 1993/6
Y1 - 1993/6
N2 - In this study, a method was developed to identify health plan members with hypertension from insurance claims, using medical records and a patient survey for validation. A sample of 2,079 patients from two study sites with medical service or pharmacy claims indicating a diagnosis of essential hypertension were surveyed, and the medical records of 182 of the 1,275 survey respondents were reviewed. Where the criteria to identify hypertensive patients used both the medical and pharmacy claims, there was 96% agreement with either the medical record or the patient survey. Where the criteria relied on medical claims alone, the agreement rate decreased to 74% with the medical record and 64% with the patient survey. Where the criteria relied on the pharmacy claims alone, the agreement rate was 67% with the medical record and 75% with the patient survey. Combined evidence from medical service and pharmacy claims yielded a high level of agreement with alternative, more costly sources of data in identifying patients with essential hypertension. As it is more thoroughly investigated, claims data should become a more widely accepted resource for epidemiologic research.
AB - In this study, a method was developed to identify health plan members with hypertension from insurance claims, using medical records and a patient survey for validation. A sample of 2,079 patients from two study sites with medical service or pharmacy claims indicating a diagnosis of essential hypertension were surveyed, and the medical records of 182 of the 1,275 survey respondents were reviewed. Where the criteria to identify hypertensive patients used both the medical and pharmacy claims, there was 96% agreement with either the medical record or the patient survey. Where the criteria relied on medical claims alone, the agreement rate decreased to 74% with the medical record and 64% with the patient survey. Where the criteria relied on the pharmacy claims alone, the agreement rate was 67% with the medical record and 75% with the patient survey. Combined evidence from medical service and pharmacy claims yielded a high level of agreement with alternative, more costly sources of data in identifying patients with essential hypertension. As it is more thoroughly investigated, claims data should become a more widely accepted resource for epidemiologic research.
KW - Health surveys
KW - Hypertension
KW - Insurance claim review
KW - Medical chart review
KW - Reproducibility of results
UR - http://www.scopus.com/inward/record.url?scp=0027616341&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0027616341&partnerID=8YFLogxK
U2 - 10.1097/00005650-199306000-00003
DO - 10.1097/00005650-199306000-00003
M3 - Article
C2 - 8501997
AN - SCOPUS:0027616341
SN - 0025-7079
VL - 31
SP - 498
EP - 507
JO - Medical care
JF - Medical care
IS - 6
ER -