Faculty Collaboration Database

Creation of state-level Medicare database for healthcare evaluation applications. Proc Annu Symp Comput Appl Med Care 1993:663-7

Date

01/01/1993

Pubmed ID

8130558

Pubmed Central ID

PMC3203557

Scopus ID

2-s2.0-0027747911 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

The Health Care Quality Improvement Initiative (HCQII) of the Health Care Financing Administration (HCFA) calls for Professional Review Organizations (PROs) to undertake pattern analysis of large administrative datasets for the purposes of quality of care assessment. The limitations of such administrative databases (primarily the MEDPAR file and derivatives thereof) include impoverished information regarding clinical attributes of Medicare enrollees and the process and outcome of their healthcare. This paper describes preliminary efforts to address this problem by the creation of a database, the PRO Concatenated Database (PCD), from the pooled implicit judgment review data of four Peer Review Organizations (PROs). The data elements comprising the PCD were carefully selected to provide important information regarding quality and appropriateness of care. Preliminary inter-state comparative studies employing the PCD are discussed. A method is also described by which the analytical power of state-level databases may be enhanced by linkage to state-level Modeled MEDPAR data which are issued by HCFA and contain patient-level risk-adjusted mortality data. This approach to the acquisition of data whose clinical content is enriched may prove to be particularly useful to the PRO community during the pattern analysis phase of the HCQII. Such analyses will evolve into more detailed studies involving primary data collection followed by dissemination of the results to local healthcare providers. In this manner, the PCD may facilitate rapid feedback regarding the effectiveness of healthcare delivery to the local community.

Author List

Pates RD, Lundberg MT, Hennen J, Boymel C, Webber A, Wright G, Hayes RP, Simpson PM, Lynch GW, Merwin E

Author

Pippa M. Simpson PhD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Angioplasty, Balloon, Coronary
Coronary Artery Bypass
Databases, Factual
Hospital Mortality
Humans
Medicare
Professional Review Organizations
Quality Assurance, Health Care
United States
Virginia