Assessing the Quality of SK&A’s Office-Based Physician Database for Identifying Oncologists

Health services research increasingly uses commercial databases that capture provider practice characteristics. Little is known about how these data sets compare along other dimensions with publicly available data. We assess the quality of one of the most commonly used commercial databases, SK&A’s office-based physician database, for capturing oncologists who bill the Medicare fee-for-service program. Using 2017 data, we find that nearly 74% of the oncologists in Medicare claims can be found in the SK&A data. Weighted by patients, service volume, or spending, match rates increase to 77%, 96%, and 92%, respectively. Matched oncologists have a high concordance (above 95%) on subspecialty as well as contact information other than street address. Oncologists who appear only in Medicare tend to have low service volumes and spending relative to those who are matched while over half of oncologists who appear only in SK&A have a pediatric subspecialty.

TERRITORIALIZAÇÃO DE POLÍTICAS PÚBLICAS: APONTAMENTOS SOBRE A COVID-19 E O CÓDIGO DE ENDEREÇAMENTO POSTAL NAS FAVELAS CARIOCAS

Em tempos de crise humanitária, provocada pela Pandemia do novo coronavírus, debates sobre o uso inteligente dos recursos públicos ocupam os tabloides com a opinião dos especialistas. No conjunto da sociedade brasileira, a fratura da desigualdade social ficou ainda mais exposta, e com isso a discussão em torno de políticas públicas e o papel do Estado diante do delicado momento ganhou espaço na esfera pública. Nesta direção, cabe referenciar a existência de contingentes populacionais significativos vivendo em localidades que não possuem o acesso adequado a serviços públicos básicos, que não gozam do direito à Cidade, e que são sistematicamente invisibilizados, inclusive no plano da estatística pública. São localidades sem CEP (Código de Endereçamento Postal), importantes não apenas para o serviço essencial de recebimento de cartas e encomendas pelos Correios, mas para atribuição de endereço aos indivíduos em contato com as malhas do Estado. Não ter endereço com CEP, por logradouro, significa ter a existência -espacialmente falando - atrelada a outro lugar que não é onde se vive, e por consequência, com danos ao exercício da cidadania plena. O enfrentamento ao Covid-19 depreende uma ação do Poder Público de forma eficaz, de políticas públicas articuladas, devidamente financiadas, transparentes e, não menos importante, territorializadas.Palavras Chave: Favelas. Covid-19. Políticas PúblicasTERRITORIALIZATION OF PUBLIC POLICIES: NOTES ABOUT COVID-19 AND THE POSTAL ADDRESS CODE IN RIO FAVELASIn times of humanitarian crisis, caused by the Pandemic of the new coronavirus, debates about the intelligent use of public resources occupy the tabloids with the opinion of experts. In Brazilian society as a whole, the fracture of social inequality was even more exposed, and with this the discussion around public policies and the role of the State in the face of this delicate moment gained space in the public sphere. In this sense, it is worth mentioning the existence of significant population contingents living in locations that do not have adequate access to basic public services, that do not enjoy the right to the City, and that are systematically made invisible, including in terms of public statistics. They are locations without CEP (Postal Address Code), important not only for the essential service of receiving letters and parcels by the Post Office, but for assigning addresses to individuals in contact with the state's networks. Not having a postal address, by street address, means having one's existence - spatially speaking - linked to another place that is not where one lives, and consequently, with damage to the exercise of full citizenship. The confrontation with Covid-19 implies an effective government action, articulated public policies, duly financed, transparent and, not least, territorialized.Keywords: Favelas. Covid-19. Public policy

Using Web-Based Pin-Drop Maps to Capture Activity Spaces Among Young Adults Who Use Drugs in Rural Areas: Cross-Sectional Survey

Background Epicenters of harmful drug use are expanding to US rural areas, with rural young adults bearing a disproportionate burden. A large body of work suggests that place characteristics (eg, spatial access to health services) shape vulnerability to drug-related harms among urban residents. Research on the role of place characteristics in shaping these harms among rural residents is nascent, as are methods of gathering place-based data. Objective We (1) analyzed whether young rural adults who used drugs answered self-administered Web-based mapping items about locations where they engaged in risk behaviors and (2) determined the precision of mapped locations. Methods Eligible individuals had to report recently using opioids to get high; be aged between 18 and 35 years; and live in the 5-county rural Appalachian Kentucky study area. We used targeted outreach and peer-referral methods to recruit participants. The survey asked participants to drop a pin in interactive maps to mark where they completed the survey, and where they had slept most; used drugs most; and had sex most in the past 6 months. Precision was assessed by (1) determining whether mapped locations were within 100 m of a structure and (2) calculating the Euclidean distance between the pin-drop home location and the street address where participants reported sleeping most often. Measures of central tendency and dispersion were calculated for all variables; distributions of missingness for mapping items and for the Euclidean distance variable were explored across participant characteristics. Results Of the 151 participants, 88.7% (134/151) completed all mapping items, and ≥92.1% (>139/151) dropped a pin at each of the 4 locations queried. Missingness did not vary across most participant characteristics, except that lower percentages of full-time workers and peer-recruited participants mapped some locations. Two-thirds of the pin-drop sex and drug use locations were less than 100 m from a structure, as were 92.1% (139/151) of pin-drop home locations. The median distance between the pin-drop and street-address home locations was 2.0 miles (25th percentile=0.8 miles; 75th percentile=5.5 miles); distances were shorter for high-school graduates, staff-recruited participants, and participants reporting no technical difficulties completing the survey. Conclusions Missingness for mapping items was low and unlikely to introduce bias, given that it varied across few participant characteristics. Precision results were mixed. In a rural study area of 1378 square miles, most pin-drop home addresses were near a structure; it is unsurprising that fewer drug and sex locations were near structures because most participants reported engaging in these activities outside at times. The error in pin-drop home locations, however, might be too large for some purposes. We offer several recommendations to strengthen future research, including gathering metadata on the extent to which participants zoom in on each map and recruiting participants via trusted staff.

Using Web-Based Pin-Drop Maps to Capture Activity Spaces Among Young Adults Who Use Drugs in Rural Areas: Cross-Sectional Survey (Preprint)

BACKGROUND Epicenters of harmful drug use are expanding to US rural areas, with rural young adults bearing a disproportionate burden. A large body of work suggests that place characteristics (eg, spatial access to health services) shape vulnerability to drug-related harms among urban residents. Research on the role of place characteristics in shaping these harms among rural residents is nascent, as are methods of gathering place-based data. OBJECTIVE We (1) analyzed whether young rural adults who used drugs answered self-administered Web-based mapping items about locations where they engaged in risk behaviors and (2) determined the precision of mapped locations. METHODS Eligible individuals had to report recently using opioids to get high; be aged between 18 and 35 years; and live in the 5-county rural Appalachian Kentucky study area. We used targeted outreach and peer-referral methods to recruit participants. The survey asked participants to drop a pin in interactive maps to mark where they completed the survey, and where they had slept most; used drugs most; and had sex most in the past 6 months. Precision was assessed by (1) determining whether mapped locations were within 100 m of a structure and (2) calculating the Euclidean distance between the pin-drop home location and the street address where participants reported sleeping most often. Measures of central tendency and dispersion were calculated for all variables; distributions of missingness for mapping items and for the Euclidean distance variable were explored across participant characteristics. RESULTS Of the 151 participants, 88.7% (134/151) completed all mapping items, and ≥92.1% (>139/151) dropped a pin at each of the 4 locations queried. Missingness did not vary across most participant characteristics, except that lower percentages of full-time workers and peer-recruited participants mapped some locations. Two-thirds of the pin-drop sex and drug use locations were less than 100 m from a structure, as were 92.1% (139/151) of pin-drop home locations. The median distance between the pin-drop and street-address home locations was 2.0 miles (25th percentile=0.8 miles; 75th percentile=5.5 miles); distances were shorter for high-school graduates, staff-recruited participants, and participants reporting no technical difficulties completing the survey. CONCLUSIONS Missingness for mapping items was low and unlikely to introduce bias, given that it varied across few participant characteristics. Precision results were mixed. In a rural study area of 1378 square miles, most pin-drop home addresses were near a structure; it is unsurprising that fewer drug and sex locations were near structures because most participants reported engaging in these activities outside at times. The error in pin-drop home locations, however, might be too large for some purposes. We offer several recommendations to strengthen future research, including gathering metadata on the extent to which participants zoom in on each map and recruiting participants via trusted staff.

Industrial News Became Modern

This chapter traces the evolution U.S. news, from the American realism of the nineteenth century to the advent of online media in the twenty-first century. It discusses how the spider of digital media sent images on paper into retreat, leaving printing and paper manufacturing industries in disarray. It details how newspaper stories grew in length from the 1880s to the 2010s. These longer stories reflected changes in content and visual presentation, which changed how news presented people, events, and places. The impact of longer news on content was also counterintuitive. Instead of “human interest” growing, ordinary and working-class people disappeared from news, replaced by groups, officials, and experts. Although audiences presumably preferred local stories, locations moved away from the street address, as references to faraway places expanded. Moreover, news no longer aimed to report events-as-they-happened for the public to process. It explained larger problems or tried to make sense of issues, aiming to interpret events.

Abstract P150: Linkage Program to Identify Siblings from a CARDIAC Risk Factor Registry

Introduction: The Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) Project gathers anthropometric, BP and lipid data from fifth graders in West Virginia in the past 18 y. 60,403 children had LDL cholesterol and we found 5259 sets of siblings by direct match on mothers first and last name. The suggestion that more sibships could be identified prompted evaluation of Link Plus software from Centers for Disease Control (CDC) to improve matching. Methods: LinkPlus generates potential matches via a probabilistic algorithm that allows relative weighting of multiple factors such as first and last name. For our purposes the deduplication rather than matching algorithm was run using mother’s first and last name using the NYSIIS (New York State Identification and Intelligence System) phonetic schema to avoid creating multiple many-to-many relationships that were difficult to analyze. Additional variables considered included county, street address, telephone, fathers first and last name, school. Subject last name was used as a blocking variable. Results: 7602 matched siblings were generated by the program that determined a probability score ranging from 61.3 to cut off at 15; few matches were observed below this level. The figure demonstrates exponential decay beginning at a probability score of 26 with 95% accuracy at 25.5. 6827 pairs were included at that level including 6824 matched pairs and only 3 false positive pairs. Partial matches (n = 61) likely are half sibs including exact match of telephone and/or street but only one parent matching. Child surname was not used in the algorithm. Typographical errors were accounted by Link Plus. Lipid correlations were similar to those found with excel but more robust. Conclusion: The Link Plus record matching program from CDC is able to successfully determine sibships with increased sensitivity compared with a direct match from a sorted excel file. The program was able to identify likely sibs and half-sibs plus avoid non-match due to minor typo errors in the analyzed fields.