Limits...
Linking individual medicare health claims data with work-life claims and other administrative data.

Mokyr Horner E, Cullen MR - BMC Public Health (2015)

Bottom Line: Chronic diseases were found to have relatively high levels of concordance between employment-based private insurance and subsequent Medicare insurance.Information about patient health prior to receipt of Medicare, including biometric indicators, were found to predict health at age 65.The dataset created by this integration could be useful for research in areas such as social epidemiology and occupational health.

View Article: PubMed Central - PubMed

Affiliation: American Institutes for Research, 2800 Campus Drive, Suite 200, San Mateo, CA, 94403, USA. Elli.Horner@gmail.com.

ABSTRACT

Background: Researchers investigating health outcomes for populations over age 65 can utilize Medicare claims data, but these data include no direct information about individuals' health prior to age 65 and are not typically linkable to files containing data on exposures and behaviors during their worklives. The current paper is a proof-of-concept, of merging employers' administrative data and private, employment-based health claims with Medicare data. Characteristics of the linked data, including sensitivity and specificity, are evaluated with an eye toward potential uses of such linked data. This paper uses a sample of former manufacturing workers from an industrial cohort as a test case. The dataset created by this integration could be useful to research in areas such as social epidemiology and occupational health.

Methods: Medicare and employment administrative data were linked for a large cohort of manufacturing workers (employed at some point during 1996-2008) who transitioned onto Medicare between 2001-2009. Data on work-life health, including biometric indicators, were used to predict health at age 65 and to investigate the concordance of employment-based insurance claims with subsequent Medicare insurance claims.

Results: Chronic diseases were found to have relatively high levels of concordance between employment-based private insurance and subsequent Medicare insurance. Information about patient health prior to receipt of Medicare, including biometric indicators, were found to predict health at age 65.

Conclusions: Combining these data allows for evaluation of continuous health trajectories, as well as modeling later-life health as a function of work-life behaviors and exposures. It also provides a potential endpoint for occupational health research. This is the first harmonization of its kind, providing a proof-of-concept. The dataset created by this integration could be useful for research in areas such as social epidemiology and occupational health.

No MeSH data available.


Related in: MedlinePlus

Early Medicare as a function of earlier data. a: High risk score at age 61 predicts new diagnoses (Sample 3). b: High previous BMI measurement predicts hypertension and diabetes (Sample 4). c: Abnormal lung function associated with asthma/COPD diagnosis (Sample 5)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4590275&req=5

Fig2: Early Medicare as a function of earlier data. a: High risk score at age 61 predicts new diagnoses (Sample 3). b: High previous BMI measurement predicts hypertension and diabetes (Sample 4). c: Abnormal lung function associated with asthma/COPD diagnosis (Sample 5)

Mentions: For those individuals who had private insurance through work at age 61, a risk-score was available (Sample 3). This allowed us to evaluate whether health trajectories from pre-Medicare life predict outcomes for those over the age of 65. Figure 2 presents the ORs from logistic regressions, such that the coefficients are the odds of having a diagnosis of a specific new onset disease given a high risk score divided by the odds for individuals with low risk scores (a value of 1 indicates identical likelihood). As can be seen in Fig. 2a, having a risk score over the median for the subsample predicted new diagnoses of all of the chronic diseases considered. These results suggests that previous health trajectories can be informative about outcomes for individuals on Medicare, and may serve as a valuable tool for analyses that require controlling for prior health status.Fig. 2


Linking individual medicare health claims data with work-life claims and other administrative data.

Mokyr Horner E, Cullen MR - BMC Public Health (2015)

Early Medicare as a function of earlier data. a: High risk score at age 61 predicts new diagnoses (Sample 3). b: High previous BMI measurement predicts hypertension and diabetes (Sample 4). c: Abnormal lung function associated with asthma/COPD diagnosis (Sample 5)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4590275&req=5

Fig2: Early Medicare as a function of earlier data. a: High risk score at age 61 predicts new diagnoses (Sample 3). b: High previous BMI measurement predicts hypertension and diabetes (Sample 4). c: Abnormal lung function associated with asthma/COPD diagnosis (Sample 5)
Mentions: For those individuals who had private insurance through work at age 61, a risk-score was available (Sample 3). This allowed us to evaluate whether health trajectories from pre-Medicare life predict outcomes for those over the age of 65. Figure 2 presents the ORs from logistic regressions, such that the coefficients are the odds of having a diagnosis of a specific new onset disease given a high risk score divided by the odds for individuals with low risk scores (a value of 1 indicates identical likelihood). As can be seen in Fig. 2a, having a risk score over the median for the subsample predicted new diagnoses of all of the chronic diseases considered. These results suggests that previous health trajectories can be informative about outcomes for individuals on Medicare, and may serve as a valuable tool for analyses that require controlling for prior health status.Fig. 2

Bottom Line: Chronic diseases were found to have relatively high levels of concordance between employment-based private insurance and subsequent Medicare insurance.Information about patient health prior to receipt of Medicare, including biometric indicators, were found to predict health at age 65.The dataset created by this integration could be useful for research in areas such as social epidemiology and occupational health.

View Article: PubMed Central - PubMed

Affiliation: American Institutes for Research, 2800 Campus Drive, Suite 200, San Mateo, CA, 94403, USA. Elli.Horner@gmail.com.

ABSTRACT

Background: Researchers investigating health outcomes for populations over age 65 can utilize Medicare claims data, but these data include no direct information about individuals' health prior to age 65 and are not typically linkable to files containing data on exposures and behaviors during their worklives. The current paper is a proof-of-concept, of merging employers' administrative data and private, employment-based health claims with Medicare data. Characteristics of the linked data, including sensitivity and specificity, are evaluated with an eye toward potential uses of such linked data. This paper uses a sample of former manufacturing workers from an industrial cohort as a test case. The dataset created by this integration could be useful to research in areas such as social epidemiology and occupational health.

Methods: Medicare and employment administrative data were linked for a large cohort of manufacturing workers (employed at some point during 1996-2008) who transitioned onto Medicare between 2001-2009. Data on work-life health, including biometric indicators, were used to predict health at age 65 and to investigate the concordance of employment-based insurance claims with subsequent Medicare insurance claims.

Results: Chronic diseases were found to have relatively high levels of concordance between employment-based private insurance and subsequent Medicare insurance. Information about patient health prior to receipt of Medicare, including biometric indicators, were found to predict health at age 65.

Conclusions: Combining these data allows for evaluation of continuous health trajectories, as well as modeling later-life health as a function of work-life behaviors and exposures. It also provides a potential endpoint for occupational health research. This is the first harmonization of its kind, providing a proof-of-concept. The dataset created by this integration could be useful for research in areas such as social epidemiology and occupational health.

No MeSH data available.


Related in: MedlinePlus