Utility and Limitations of Claims Data
Authors: Edwin D. Huff
Journal: Annals of Internal Medicine (1994)

Letters15 June 1994Utility and Limitations of Claims DataEdwin D. Huff, PhDEdwin D. Huff, PhDNew Hampshire Foundation for Medical Care; Dover, NH 03820Disclaimer: The conclusions and opinions expressed and the methods used herein are those of the author and are not necessarily Health Care Finance Administration policy. The author assumes full responsibility for the accuracy and completeness of the PRO data used, and no PRO funds were spent in the preparation of this effort.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-12-199406150-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Jollis and colleagues [1] draw conclusions regarding claims versus database discordance that extend beyond their data.First, claims records and their corresponding comorbid diagnostic elements selected on the basis of associated coronary arteriography are not representative of all claims exclusive of coronary arteriography and their associated morbidities. One key reason is that approximately 75% of the indexed claims are accounted for by only three diagnostic-related groups (DRGs). Review of 2 fiscal years of Medicare claims representing 83 503 inpatient admissions in New Hampshire, of which 3173 included coronary arteriography, showed that the three main DRGs and their ...References1. Jollis JG, Ancukiewicz M, DeLong ER, Pryor DB, Muhlbaier LH, Mark DB. Discordance of databases designed for claims payment versus clinical information systems: Implications for outcomes research. Ann Intern Med. 1993; 119:844-50. Google Scholar2. Charlson ME, Pompei P, Ales KL, Mackenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40:373-83. Google Scholar3. Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992; 45:613-9. Google Scholar4. Huff ED. Discontinuity in the health care finance administration's published standardized mortality ratios due to underestimation bias across multiple admissions case selection methods. Clinical Performance and Quality Health Care. 1993; 1:194-8. Google Scholar Author, Article, and Disclosure InformationAffiliations: New Hampshire Foundation for Medical Care; Dover, NH 03820Disclaimer: The conclusions and opinions expressed and the methods used herein are those of the author and are not necessarily Health Care Finance Administration policy. The author assumes full responsibility for the accuracy and completeness of the PRO data used, and no PRO funds were spent in the preparation of this effort. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 June 1994Volume 120, Issue 12Page: 1049-1051KeywordsAcute myocardial infarctionAngiographyCardiac surgeryCoronary heart diseaseDiagnosis related groupsHeart diseasesHospitalizationsMorbidityPeer reviewStable coronary artery disease Issue Published: 15 June 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...