Issues and biases in matching Medicaid pregnancy episodes to vital records data: the Arkansas experience.
Objectives This study examines the extent of selection biases identified in the process of linking Medicaid claims with evidence of pregnancy to vital records. Methods Two years of Medicaid claims were scanned to identify pregnancy-related diagnoses and procedures. Information on 55,764 Medicaid rec...
| Publicado en: | Maternal & Child Health Journal Vol. 13; no. 2; pp. 250 - 260 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Mar2009
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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=105450401&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105450401 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10927875 N9J jtl: Maternal & Child Health Journal issn: 10927875 maglogo: N pubinfo: dt: Mar2009 vid: 13 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 105450401 2010191497 10.1007/s10995-008-0347-z NLM18449631 105450401 ppf: 250 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Issues and biases in matching Medicaid pregnancy episodes to vital records data: the Arkansas experience. aug: au: Bronstein J Lomatsch C Fletcher D Wooten T Lin TM Nugent R Lowery C sug: subj: Billing and Claims Medicaid Prenatal Care Utilization Selection Bias Adult Demography Descriptive Statistics Female Funding Source Health Resource Utilization International Classification of Diseases Marital Status Pregnancy Race Factors Record Review Wilcoxon Rank Sum Test Human Adult: 19-44 years Female ab: Objectives This study examines the extent of selection biases identified in the process of linking Medicaid claims with evidence of pregnancy to vital records. Methods Two years of Medicaid claims were scanned to identify pregnancy-related diagnoses and procedures. Information on 55,764 Medicaid recipients was provided to the Division of Health Statistics, which linked the information to vital records data on a range of identifying characteristics. Claims were then clustered by date and then into episodes of care surrounding the birth date of the infant. We identified 38,222 pregnancy episodes matched to vital records; 8,474 episodes unmatched to vital records that appeared to terminate before a delivery; and 5,278 episodes that appeared to include a delivery but did not match to vital records. The characteristics of matched episodes and unmatched episodes and the characteristics of matched episodes with and without delivery claims are compared. Results Unmatched episodes spanned fewer weeks than matched episodes, included more diagnostic indicators of elevated risk, and occurred more frequently in more impoverished populations. Among the matched records, 13% did not include claims for delivery services. These episodes occurred more frequently among Hispanic women, women delivering out of hospitals and women with preterm births and infant deaths. Conclusions The results provide evidence, as other studies have demonstrated, that matching Medicaid claims and vital records data is feasible. However, the matched analytic data set does tend to under-represent the outcomes of high-risk pregnancies. An additional source of selection bias can be avoided by using evidence of pregnancy as the Medicaid index for matching against vital records, rather than using only index cases with evidence of delivery. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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