scholarly journals Characteristics and Trends of the Hospital Standardized Readmission Ratios for Pneumonia: A Retrospective Observational Study Using Japanese Administrative Claims Data from 2010 to 2018

2021 ◽  
Vol 18 (14) ◽  
pp. 7624
Author(s):  
Ryo Onishi ◽  
Yosuke Hatakeyama ◽  
Kunichika Matsumoto ◽  
Kanako Seto ◽  
Koki Hirata ◽  
...  
Keyword(s):  
Observational Study ◽  
Claims Data ◽  
Retrospective Observational Study ◽  
Administrative Claims ◽  
Optimal Care ◽  
Administrative Claims Data ◽  
Consecutive Period ◽  
Long Term Trends

Previous studies indicated that optimal care for pneumonia during hospitalization might reduce the risk of in-hospital mortality and subsequent readmission. This study was a retrospective observational study using Japanese administrative claims data from April 2010 to March 2019. We analyzed data from 167,120 inpatients with pneumonia ≥15 years old in the benchmarking project managed by All Japan Hospital Association. Hospital-level risk-adjusted ratios of 30-day readmission for pneumonia were calculated using multivariable logistic regression analyses. The Spearman’s correlation coefficient was used to assess the correlation in each consecutive period. In the analysis using complete 9-year data including 54,756 inpatients, the hospital standardized readmission ratios (HSRRs) showed wide variation among hospitals and improvement trend (r = −0.18, p = 0.03). In the analyses of trends in each consecutive period, the HSRRS were positively correlated between ‘2010–2012’ and ‘2013–2015’ (r = 0.255, p = 0.010), and ‘2013–2015’ and ‘2016–2018’ (r = 0.603, p < 0.001). This study denoted the HSRRs for pneumonia could be calculated using Japanese administrative claims data. The HSRRs significantly varied among hospitals with comparable case-mix, and could relatively evaluate the quality of preventing readmission including long-term trends. The HSRRs can be used as yet another measure to help improve quality of care over time if other indicators are examined in parallel.

scholarly journals Patterns of Long-Term Prescription Opioid Use Among Older Adults in the United States: A Study of Medicare Administrative Claims Data

2020 ◽  
Vol 1;24 (1;1) ◽  
pp. 31-40
Keyword(s):  
Older Adults ◽  
Claims Data ◽  
The United States ◽  
Prescription Opioid ◽  
Administrative Claims ◽  
Medicare Beneficiaries ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Administrative Claims Data

BACKGROUND: Long-term opioid therapy was prescribed with increasing frequency over the past decade. However, factors surrounding long-term use of opioids in older adults remains poorly understood, probably because older people are not at the center stage of the national opioid crisis. OBJECTIVES: To estimate the annual utilization and trends in long-term opioid use among older adults in the United States. STUDY DESIGN: Retrospective cohort study. SETTING: Data from Medicare-enrolled older adults. METHODS: This study utilized a nationally representative sample of Medicare administrative claims data from the years 2012 to 2016 containing records of health care services for more than 2.3 million Medicare beneficiaries each year. Medicare beneficiaries who were 65 years of age or older and who were enrolled in Medicare Parts A, B, and D, but not Part C, for at least 10 months in a year were included in the study. We measured annual utilization and trends in new long-term opioid use episodes over 4 years (2013–2016). We examined claims records for the demographic characteristics of the eligible individuals and for the presence of chronic non-cancer pain (CNCP), cancer, and other comorbidities. RESULTS: From 2013 to 2016, administrative claims of approximately 2.3 million elderly Medicare beneficiaries were analyzed in each year with a majority of them being women (~56%) and white (~82%) with a mean age of approximately 75 years. The proportion of all eligible beneficiaries with at least one new opioid prescription increased from 6.64% in 2013, peaked at 10.32% in 2015, and then decreased to 8.14% in 2016. The proportion of individuals with long-term opioid use among those with a new opioid prescription was 12.40% in 2013 and 10.20% in 2016. Among new long-term opioid users, the proportion of beneficiaries with a cancer diagnosis during the study years increased from 13.30% in 2013 to 15.67% in 2016, and the proportion with CNCP decreased from 30.25% in 2013 to 27.36% in 2016. Across all years, long-term opioid use was consistently high in the Southern states followed by the Midwest region. LIMITATIONS: This study used Medicare fee-for-service administrative claims data to capture prescription fill patterns, which do not allow for the capture of individuals enrolled in Medicare Advantage plans, cash prescriptions, or for the evaluation of appropriateness of prescribing, or the actual use of medication. This study only examined long-term use episodes among patients who were defined as opioid-naive. Finally, estimates captured for 2016 could only utilize data from 9 months of the year to capture 90-day long-term-use episodes. CONCLUSIONS: Using a national sample of elderly Medicare beneficiaries, we observed that from 2013 to 2016 the use of new prescription opioids increased from 2013 to 2014 and peaked in 2015. The use of new long-term prescription opioids peaked in 2014 and started to decrease from 2015 and 2016. Future research needs to evaluate the impact of the changes in new and long-term prescription opioid use on population health outcomes. KEY WORDS: Long-term, opioids, older adults, trends, Medicare, chronic non-cancer pain, cancer, cohort study

scholarly journals Characterization of Bariatric Surgery and Outcomes using Administrative Claims Data in the Research Network of a Nationwide Commercial Health Plan (Preprint)

2019 ◽  
Author(s):  
Qinli Ma ◽  
Michael Mack ◽  
Sonali Shambhu ◽  
Kathleen McTague ◽  
Kevin Haynes
Keyword(s):  
Bariatric Surgery ◽  
Health Systems ◽  
Claims Data ◽  
Incidence Rates ◽  
Research Network ◽  
Hospital Death ◽  
Administrative Claims ◽  
Long Term Outcomes ◽  
Administrative Claims Data

BACKGROUND Administrative claims data could facilitate longitudinal ascertainment of health outcomes across multiple health systems during defined enrollment periods within health plans. As a result, the supplementation of electronic health records data with administrative claims data may be used to capture outcome events more comprehensively in longitudinal comparative effectiveness observational studies. OBJECTIVE To investigate the utility of administrative claims data to identify and capture outcomes across health systems using a comparative effectiveness study of different types of bariatric surgery as a model. METHODS This observational cohort study identified Anthem members who had bariatric surgery between 01/01/2007 and 12/31/2015 within the HealthCore Anthem Research Network (HCARN) database in the National Patient-Centered Clinical Research Network (PCORnet) common data model. Using HCARN bariatric claims, we identified patients whose procedures were performed in a member facility of one of the health systems affiliated with PCORnet Clinical Research Networks (CRNs). The main short-term adverse event outcome of interest was a composite of venous thromboembolism, reintervention, failure of discharge from the hospital, and death within 30 days after bariatric surgery. The long-term outcomes included all-cause hospitalization, abdominal operation or intervention, and in-hospital death up to 5 years after the procedure. Events were classified as occurring within or outside PCORnet CRN health systems by linking facility identifiers and events from all available CRNs and claims data. RESULTS We identified 4,899 patients who had bariatric surgery in one of the PCORnet CRN health systems. For 30-day composite adverse events, the inclusion of HCARN multi-site claims data marginally increased the incidence rate based only on HCARN single-site claims data for PCORnet CRN health systems from 3.9% to 4.2%. During the 5-year follow-up period, 56.8% of all-cause hospitalizations, 31.2% major abdominal operations or interventions, and 32.3% of in-hospital deaths occurred outside PCORnet CRN health systems. Incidence rates for long-term outcomes (events per 100 patient-years) were significantly lower when based on claims from a single PCORnet CRN health system only compared to using claims from all health systems in the HCARN across all outcomes: all-cause hospitalization, 12.5 (95% Confidence Interval [CI]: 11.9, 13.2) to 25.3 (95% CI: 24.4, 26.3); abdominal operation or intervention, 4.4 (95% CI: 4.0, 4.8) to 6.1 (95% CI: 5.7, 6.6); in-hospital death, 0.2 (95% CI: 0.12, 0.29) to 0.3 (95% CI: 0.19, 0.38). CONCLUSIONS Short-term inclusion of multi-site claims data only marginally increased the incidence rate computed from single-site claims data alone. Longer term follow up captured a notable number of events outside of PCORnet CRN health systems. The incidence rates for long-term outcomes were significantly lower when derived from claims from a single PCORnet CRN health system compared all claims. CLINICALTRIAL Not applicable

scholarly journals Monitoring and evaluating the quality of cancer care in Japan using administrative claims data

2015 ◽  
Vol 107 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Momoko Iwamoto ◽  
Fumiaki Nakamura ◽  
Takahiro Higashi
Keyword(s):  
Cancer Care ◽  
Claims Data ◽  
Administrative Claims ◽  
Administrative Claims Data
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