Identification of cancer patients using claims data from health insurance systems: A real-world comparative study

HFCAS OpenIR

	Identification of cancer patients using claims data from health insurance systems: A real-world comparative study
其他题名	Identification of cancer patients using claims data from health insurance systems: A real-world comparative study
	2019
发表期刊	CHINESE JOURNAL OF CANCER RESEARCH
ISSN	1000-9604
摘要	Objective: To evaluate the accuracy of identifying cancer patients by use of medical claims data in a health insurance system in China, and provide the basis for establishing the claims-based cancer surveillance system in China.
其他摘要	Objective: To evaluate the accuracy of identifying cancer patients by use of medical claims data in a health insurance system in China, and provide the basis for establishing the claims-based cancer surveillance system in China. Methods: We chose Hua County, Henan Province as the study site, and randomly selected 300 and 1,200 qualified inpatient electronic medical records (EMRs) as well as the New Rural Cooperative Medical Scheme (NCMS) claims records for cancer patients in Hua County People’s Hospital (HCPH) and Anyang Cancer Hospital (ACH) in 2017. Diagnostic information for NCMS claims was evaluated on an individual level, and sensitivity and positive predictive value (PPV) were calculated taking the EMRs as the gold standard. Results: The sensitivity of NCMS was 95.2% (93.8%–96.3%) and 92.0% (88.3%–94.8%) in ACH and HCPH, respectively. The PPV of the NCMS was 97.8% (96.7%–98.5%) in ACH and 89.0% (84.9%–92.3%) in HCPH. Overall, the weighted and combined sensitivity and PPV of NCMS in Hua County was 93.1% and 92.1%, respectively. Significantly higher sensitivity and PPV in identifying patients with common cancers than noncommon cancers were detected in HCPH and ACH separately (P<0.01). Conclusions: Identification of cancer patients by use of the NCMS is accurate on individual level, and it is therefore feasible to conduct claims-based cancer surveillance in areas not covered by cancer registries in China.
关键词	MEDICARE CLAIMS CASE ASCERTAINMENT RURAL CHINA SENSITIVITY PROTECTION REGISTRIES ALGORITHM MORTALITY NCMS claims data cancer surveillance sensitivity positive predictive value
收录类别	CSCD
语种	英语
资助项目	[National Natural Science Foundation of China] ; [National Key R&D Program of China] ; [Digestive Medical Coordinated Development Center of Beijing Hospitals Authority] ; [Science Foundation of Peking University Cancer Hospital] ; [Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education/Beijing]
CSCD记录号	CSCD:6562418
引用统计
文献类型	期刊论文
条目标识符	http://ir.hfcas.ac.cn:8080/handle/334002/65186
专题	中国科学院合肥物质科学研究院
推荐引用方式 GB/T 7714	. Identification of cancer patients using claims data from health insurance systems: A real-world comparative study[J]. CHINESE JOURNAL OF CANCER RESEARCH,2019,31.
APA	(2019).Identification of cancer patients using claims data from health insurance systems: A real-world comparative study.CHINESE JOURNAL OF CANCER RESEARCH,31.
MLA	"Identification of cancer patients using claims data from health insurance systems: A real-world comparative study".CHINESE JOURNAL OF CANCER RESEARCH 31(2019).