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Impact of Claims Data Research on Clinical Practice

Published online by Cambridge University Press:  10 March 2009

Earl P. Steinberg
Affiliation:
The Johns Hopkins Medical Institutions
Jeffrey Whittle
Affiliation:
The Johns Hopkins Medical Institutions
Gerard F. Anderson
Affiliation:
The Johns Hopkins Medical Institutions

Abstract

Despite their potential utility, clinicians are skeptical about claims data as a substrate for clinical research. Clinicians' concerns are centered on two issues—the quality of the data and the fairness of comparisons that are made. To increase the impact of claims data research on clinical practice, several strategies should be pursued.

Type
Special Section: Measuring Health Care Effectiveness: Use of Large Data Bases for Technology and Quality Assessments
Copyright
Copyright © Cambridge University Press 1990

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References

REFERENCES

1Barry, M. J., Mulley, A. G. Jr, Fowler, F. J., & Wennberg, J. E.Watchful waiting vs. immediate transurethral resection for symptomatic prostatism: The importance of patients' preferences. Journal of the American Medical Association, 1988, 259, 3010–17.CrossRefGoogle ScholarPubMed
2Chassin, M. R., Brook, R. H., Park, R. E. et al. , Variations in the use of medical and surgical services by the Medicare population. New England Journal of Medicine, 1986, 313, 285–90.CrossRefGoogle Scholar
3Demlo, L. K., & Campbell, P. M.Improving hospital discharge data: Lessons from the National Hospital Discharge Survey. Medical Care 1981, 19, 1030–40.CrossRefGoogle ScholarPubMed
4Feinstein, A. R.Methodologic problems and standards in case-control research. Journal of Chronic Diseases, 1979, 32, 3541.CrossRefGoogle ScholarPubMed
5Feinstein, A. R., & Horwitz, R. I.Double standards, scientific methods, and epidemiologic research. New England Journal of Medicine, 1982, 307, 1611–17.CrossRefGoogle ScholarPubMed
6Feinstein, A. R.ICD, POR, and DRG: Unsolved scientific problems in the nosology of clinical medicine. Archives of Internal Medicine, 1988. 148, 2269–74.CrossRefGoogle ScholarPubMed
7Hsia, D. C., Krushat, W. M., Fagan, A. B. et al. , Accuracy of diagnostic coding for Medicare patients under the prospective payment system. New England Journal of Medicine, 1988, 318, 352–55.CrossRefGoogle ScholarPubMed
8Institute of Medicine. Reliability of National Hospital Discharge Survey Data, Washington, DC: National Academy of Sciences, 1980.Google Scholar
9Jencks, S. F., Williams, D. K., & Kay, T. L.Assessing hospital-associated deaths from discharge data: The role of length of stay and comorbidities. Journal of the American Medical Association, 1988, 260, 2240–46.CrossRefGoogle ScholarPubMed
10Mullin, R. L.Diagnosis-related groups and severity: ICD-9-CM, the real problem. Journal of the American Medical Association. 1985, 254, 1208–10.CrossRefGoogle ScholarPubMed
11Roos, N. P., & Ramsey, E. W.A population-based study of prostatectomy: Outcomes associated with differing surgical approaches. Journal of Urology, 1987, 137, 1184–88.CrossRefGoogle ScholarPubMed
12Roos, N. P., Wennberg, J. E., Malenka, D. J. et al. , Mortality and reoperation after open and transurethral resection of the prostate for benign prostatic hyperplasia. New England Journal of Medicine, 1989, 320, 1120–24.CrossRefGoogle ScholarPubMed
13Sackett, D. L.Bias in analytic research. Journal of Chronic Diseases, 1979, 32, 5163.CrossRefGoogle ScholarPubMed
14Steinwachs, D. M., Weiner, J. P., & Shapiro, S. Management information systems and quality. In Goldfield, N. & Nash, D. (eds.), Providing quality care—The challenge to clinicians. Philadelphia, PA: American College of Physicians, 1989, 160–82.Google Scholar
15Wennberg, J., & Gittelsohn, A.Small area variations in health care delivery. Science, 1973, 182, 1102–08.CrossRefGoogle ScholarPubMed
16Wennberg, J. E.Dealing with medical practice variations: A proposal for action. Health Affairs, 1984, 3, 632.CrossRefGoogle ScholarPubMed
17Wennberg, J. E., Mulley, A. G. Jr, Hanley, D. et al. , An assessment of prostatectomy for benign urinary tract obstruction. Geographic variations and the evaluation of medical care outcomes. Journal of the American Medical Association, 1988, 259, 3027–30.CrossRefGoogle ScholarPubMed
18Winslow, C. M., Solomon, D. H., Chassin, M. R. et al. , The appropriateness of carotid endarterectomy. New England Journal of Medicine, 1988, 318, 721–27.CrossRefGoogle ScholarPubMed