Quantifying under-reporting of pathology tests in Medical Benefits Schedule claims data.
Objective We investigated the completeness of recording of pathology tests in Australian Medical Benefits Schedule (MBS) claims data, using the example of the prostate-specific antigen (PSA) test. With some exceptions, MBS claims data records only the three most expensive pathology items in an episo...
| Publicado en: | Australian Health Review Vol. 37; no. 5; pp. 649 - 654 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
CSIRO Publishing
2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104162606&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104162606 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01565788 HDW jtl: Australian Health Review issn: 01565788 maglogo: N pubinfo: dt: 2013 vid: 37 iid: 5 pid: 1568 pub: CSIRO Publishing place: Canberra ACT, <Blank> artinfo: ui: 104162606 92021236 10.1071/AH13092 NLM24160673 104162606 ppf: 649 ppct: 5 formats: tig: atl: Quantifying under-reporting of pathology tests in Medical Benefits Schedule claims data. aug: au: Trevena, Judy A. Rogers, Kris D. Jorm, Louisa R. Churches, Tim Armstrong, Bruce affil: Biostatistical Officer, NSW Ministry of Health, Locked Mail Bag 961, North Sydney, NSW 2059, Australia sug: subj: Insurance Benefits Australia Billing and Claims Evaluation Reports Evaluation Health Screening Evaluation Quality Assurance Cost Control Evaluation Human Australia Quantitative Studies Prostate-Specific Antigen Analysis Male Prostatic Neoplasms Diagnosis Middle Age Aged Aged, 80 and Over Female Sampling Error Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Objective We investigated the completeness of recording of pathology tests in Australian Medical Benefits Schedule (MBS) claims data, using the example of the prostate-specific antigen (PSA) test. With some exceptions, MBS claims data records only the three most expensive pathology items in an episode of care, and this practice ('episode coning') means that pathology tests can be under-recorded. Methods The analysis used MBS data for male participants in the 45 and Up Study. The number and cost of items in each episode of care were used to determine whether an episode contained a PSA screening test (Item 66655), or could have lacked a record of this item because of episode coning. Results MBS data for 1 070 392 episodes involving a request for a pathology test for 118 074 men were analysed. Of these episodes, 11% contained a request for a PSA test; a further 7.5% may have been missing a PSA request that was not recorded because of episode coning. Conclusions It is important to consider under-reporting of pathology tests as a result of episode coning when interpreting MBS claims data. Episode coning creates uncertainty about whether a person has received any given pathology test. The extent of this uncertainty can be estimated by determining the proportion of episodes in which the test may have been performed but was not recorded due to episode coning. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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