Clinical InvestigationOutcomes, Health Policy, and Managed CareLinking inpatient clinical registry data to Medicare claims data using indirect identifiers
Section snippets
Data sources and patient populations
We used 2 inpatient databases in this study, neither of which made direct patient identifiers available. First, we used data from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) registry.5 This registry contains information on eligible hospitalizations from hospitals that participated voluntarily in the OPTIMIZE-HF quality improvement program. Eligible hospitalizations included those for which heart failure was the primary cause
Discussion
Although previous work has been done to link different databases to Medicare claims data,6, 7, 8 these efforts required direct identifiers like patient name or Social Security number. In this article, we describe and demonstrate a method that enables researchers to identify a high proportion of clinical registry database hospitalizations in 100% Medicare inpatient claims data without direct patient identifiers. We found that using combinations of nonunique fields commonly available in both
Conclusions
In the absence of direct identifiers, it is possible to create a high-quality link between inpatient clinical registry data and Medicare claims data. The method allows researchers to leverage existing data to create a linked claims-clinical database that capitalizes on the strengths of both types of data sources. Combined databases such as these are important at a time when there is otherwise little infrastructure to answer important safety, efficacy, and other clinical questions for large
Acknowledgements
We thank Damon M. Seils, MA, Duke University, Durham, NC, for assistance with the manuscript preparation. Mr Seils did not receive compensation for his assistance apart from his employment at the institution where the study was conducted.
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This work was supported by grant U18HS10548 from the Agency for Healthcare Research and Quality (Rockville, MD) and a research agreement between GlaxoSmithKline (Research Triangle Park, NC) and Duke University (Durham, NC). Dr Hernandez is a recipient of an American Heart Association Pharmaceutical Roundtable grant (0675060N). Drs Curtis and Schulman were supported in part by grants U01HL066461 from the National Heart, Lung, and Blood Institute and R01AG026038 from the National Institute on Aging. Dr Fonarow is supported by the Ahmanson Foundation (Beverly Hills, CA) and the Corday Family Foundation (Los Angeles, CA). The OPTIMIZE-HF registry is registered at clinicaltrials.gov as study number NCT00344513.
David J. Cohen, MD, MSc served as guest editor on this manuscript.