PMID: 10624032Jan 7, 2000

Identifying persons with diabetes using Medicare claims data

American Journal of Medical Quality : the Official Journal of the American College of Medical Quality
P L HebertA Marshall McBean

Abstract

The objective of this study was to develop and validate a method for identifying Medicare beneficiaries with diabetes by using Medicare claims data. We used self-reports of diabetes status from participants in the Medicare Current Beneficiary Survey to determine disease status, and then we examined these participants' Medicare claims. Using self-reported diabetes status as the "gold standard," we determined the sensitivity, specificity, and reliability of claims data in identifying beneficiaries with diabetes. We found that to construct a method that is adequately sensitive (> or = 70%), highly specific (> or = 97.5%), and reliable (kappa > or = 0.80), researchers must combine information from different types of Medicare claims files, use 2 years of data to identify cases, and require at least 2 diagnoses of diabetes among claims involving ambulatory care. Since these criteria are met by more than one method, the choice of method should be governed by the goals of the research as well as more practical concerns.

References

Oct 1, 1992·Journal of Epidemiology and Community Health·K MidthjellG Lund-Larsen
Apr 15, 1994·American Journal of Epidemiology·R KehoeL T Chylack
Feb 1, 1993·Journal of Clinical Epidemiology·M HeliövaaraO Impivaara
Dec 1, 1996·Archives of Disease in Childhood·D M Hall
Dec 24, 1997·Diabetes Care·T P GilmerW A Rush

Citations

Oct 31, 2012·Cancer Causes & Control : CCC·Linda S CookCharles L Wiggins
Mar 21, 2007·Journal of General Internal Medicine·Karin M NelsonGayle E Reiber
Jan 10, 2009·Journal of General Internal Medicine·Usha SubramanianDavid G Marrero
Aug 16, 2011·Journal of General Internal Medicine·Cary P GrossR Scott Braithwaite
Jun 5, 2004·Annals of Epidemiology·Alain G BertoniLynne E Wagenknecht
Feb 26, 2005·Journal of Cardiac Failure·Peter E SandgrenRobert N Foley
Sep 8, 2010·The New England Journal of Medicine·Krista L LentineDaniel C Brennan
Apr 14, 2009·Population Health Management·Timothy M DallShiping Zhang
Feb 8, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Karminder GillBrian D Bradbury
Sep 7, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Julie M YabuDolly B Tyan
May 26, 2004·Journal of Public Health Management and Practice : JPHMP·Lynn M MarshallMelvin A Kohn
Jun 21, 2005·Journal of General Internal Medicine·Raz GrossMyrna M Weissman
Apr 28, 2006·Journal of General Internal Medicine·Chin-Lin TsengLeonard M Pogach
Sep 1, 2009·BMC Medical Research Methodology·Shabnam AsghariAlain Vanasse
Jan 22, 2013·BMC Public Health·Baylah Tessier-ShermanMark R Cullen
Aug 2, 2011·BMC Medical Informatics and Decision Making·Mohammed KhaliliaMihail Popescu
Jan 5, 2011·BMC Health Services Research·Mary Jo PughLewis E Kazis
Jan 8, 2009·Implementation Science : IS·Monika M SaffordLeonard M Pogach
Jul 20, 2012·Arthritis Research & Therapy·Christie M BartelsMaureen A Smith
Jan 21, 2014·BMC Pregnancy and Childbirth·Caitlin A KnoxAlmut G Winterstein
Feb 5, 2014·Journal of General Internal Medicine·Heather M JohnsonMaureen A Smith
Apr 4, 2014·BMC Health Services Research·Joseph W SakshaugLauren Hersch Nicholas
Oct 29, 2003·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·T-Christian H MixAllan J Collins
Oct 1, 2013·Journal of the American Medical Informatics Association : JAMIA·Danning HeSusan Hutfless
Sep 13, 2013·Journal of the American Medical Informatics Association : JAMIA·Rachel L RichessonSusan E Spratt
Nov 10, 2013·Journal of the American Medical Informatics Association : JAMIA·Chaitanya ShivadeAlbert M Lai
Sep 15, 2001·Journal of General Internal Medicine·C L VojtaD A Asch
Jul 25, 2006·Medical Care·Usha SambamoorthiLeonard M Pogach
May 12, 2007·The Review of Diabetic Studies : RDS·Frank A SloanMark N Feinglos
Mar 7, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Edward H ColeJohn S Gill
Apr 4, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Krista L LentineDaniel C Brennan
Apr 4, 2008·Journal of the American Society of Nephrology : JASN·Olwyn JohnstonJohn S Gill
Apr 18, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Krista L LentineBertram L Kasiske
Nov 21, 2008·Journal of the American Society of Nephrology : JASN·Areef IshaniAllan J Collins
Jan 30, 2009·Cerebrovascular Diseases·Nancy PandhiMichael D Finch
Mar 25, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Tomasz P SrokowskiSharon H Giordano
May 9, 2009·Journal of the American Society of Nephrology : JASN·Jon J Snyder, Allan J Collins
Jun 23, 2009·Clinical Journal of the American Society of Nephrology : CJASN·Krista L LentineDaniel C Brennan
Aug 8, 2009·Critical Care Medicine·Mercedes FalcigliaMarta L Render
May 28, 2011·Medical Care·Carolyn T ThorpeMaureen A Smith
Mar 1, 2012·Journal of the American Society of Nephrology : JASN·Eric D WeinhandlAllan J Collins
Jun 13, 2012·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·R ChlebowskiDavid M Euhus
Oct 16, 2013·Journal of Hypertension·Heather M JohnsonMaureen A Smith
Mar 5, 2005·American Journal of Epidemiology·Chin-Lin TsengMonika M Safford
Feb 15, 2011·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·David GilbertsonAllan J Collins
Jun 15, 2007·Current Medical Research and Opinion·Elbert S HuangWillard Manning
Mar 16, 2007·Current Medical Research and Opinion·Eric J StanekMark J Cziraky
Jul 3, 2013·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·David GilbertsonAllan J Collins
May 2, 2013·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Thomas J ArnesonWendy L St Peter
Apr 20, 2013·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Eric D WeinhandlWendy L St Peter
Nov 13, 2009·Kidney International·Jiannong LiuAllan J Collins
Oct 9, 2003·Kidney International. Supplement·Allan J CollinsCharles A Herzog
Jun 18, 2004·Kidney International·Wendy L St PeterAllan J Collins
Mar 20, 2012·Seminars in Arthritis and Rheumatism·Christie M BartelsMaureen A Smith
Mar 1, 2012·Advances in Chronic Kidney Disease·Brian D BradburyRyan D Kilpatrick
Sep 21, 2011·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Bertram L KasiskeAjay K Israni
Dec 28, 2010·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Suying LiWendy L St Peter
Nov 30, 2010·Economics and Human Biology·Lauren Hersch Nicholas
Sep 3, 2010·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Laurel A CopelandAlexander L Miller
Feb 2, 2010·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Lih-Wen MauAllan J Collins
Jan 1, 2010·Mayo Clinic Proceedings·Ann M SheehyMaureen A Smith
Oct 27, 2009·The Journal of Thoracic and Cardiovascular Surgery·Gautam R ShroffCharles A Herzog
Mar 3, 2009·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Allan J CollinsRobert N Foley
Mar 25, 2009·Revue D'épidémiologie Et De Santé Publique·A J Koné PéfoyoC Laurier
Jul 14, 2012·Ophthalmic Surgery, Lasers & Imaging : the Official Journal of the International Society for Imaging in the Eye·Stephen S FemanThomas E Burroughs
Dec 10, 2015·The Psychiatric Quarterly·Chen-Hsiang SuChun-Jen Huang
Apr 29, 2008·Journal of Vascular and Interventional Radiology : JVIR·Kazim SheikhClaudia M Bullock
Apr 17, 2008·Journal of Diabetes and Its Complications·Edward F TierneyMichael M Engelgau
Apr 26, 2008·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Fabienne DobbelsBertram L Kasiske
Jul 18, 2008·Primary Care Diabetes·Usha SubramanianEve A Kerr
Dec 20, 2007·Journal of Renal Nutrition : the Official Journal of the Council on Renal Nutrition of the National Kidney Foundation·Wadi N Suki, Dialysis Clinical Outcomes Revisited Investigators
Oct 24, 2007·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Eric D WeinhandlBrian J G Pereira
Mar 24, 2007·Clinical Therapeutics·Chaitanya A SarawateScott L Charland
Jan 7, 2014·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Akeem A YusufWendy L St Peter
Sep 27, 2005·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Krista L LentineDaniel C Brennan
Feb 26, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Allan J CollinsDavid Gilbertson
Sep 27, 2014·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Seungyoung HwangJoseph J Gallo
Aug 31, 2004·Health Services Research·Frank A SloanPaul P Lee
May 20, 2003·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Robert S WoodwardDaniel C Brennan
Mar 27, 2003·Journal of the American Geriatrics Society·James X ZhangMarshall H Chin
Apr 6, 2006·Health Services Research·Elizabeth F O KernLeonard M Pogach
Jan 3, 2007·Journal of the American Geriatrics Society·Cary P GrossMary E Tinetti
Aug 13, 2011·Psycho-oncology·Ravishankar JayadevappaJoseph J Gallo
Mar 21, 2012·Journal of the American Geriatrics Society·Carolyn T ThorpeMaureen A Smith
Mar 19, 2011·Health Services Research·Bruce C StuartJennifer T Lloyd
Jul 27, 2015·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Michelle M O'Shaughnessy, Kevin F Erickson
Jan 19, 2012·Health Services Research·Jeph HerrinDavid J Ballard
Feb 10, 2011·Arthritis and Rheumatism·Christie M BartelsMaureen A Smith
Jun 7, 2014·Pharmacoepidemiology and Drug Safety·Eric D WeinhandlRobert N Foley
Jan 1, 2014·Pharmacoepidemiology and Drug Safety·Ronac MamtaniJames D Lewis
Jul 18, 2008·Transplantation Reviews·Roy D Bloom, Michael F Crutchlow
Dec 16, 2004·Journal of Cardiac Failure·Charles A HerzogAllan J Collins
Nov 27, 2015·Pharmacoepidemiology and Drug Safety·David GilbertsonKenneth J Rothman
Aug 29, 2006·Diabetes Research and Clinical Practice·Janice C ZgiborLinda M Siminerio
Oct 2, 2015·BMC Public Health·Elizabeth Mokyr Horner, Mark R Cullen
Jun 10, 2014·Journal of Gastroenterology and Hepatology·Salman WaheedHsin-Chieh Yeh
Apr 24, 2015·Pharmacoepidemiology and Drug Safety·Karminder GillBrian D Bradbury
Jul 11, 2015·British Journal of Cancer·J LuoKaren L Margolis
May 16, 2012·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Amy DavidoffJ Samantha Shoemaker
Jul 17, 2015·American Journal of Public Health·David C LeeBrian Elbel
Mar 4, 2015·Rheumatology·Christie M BartelsMaureen A Smith
May 10, 2015·Cancer Causes & Control : CCC·Gregory S CalipDenise M Boudreau
Feb 7, 2015·Annals of Epidemiology·Anna E PrizmentKristin E Anderson
Oct 8, 2014·Research in Social & Administrative Pharmacy : RSAP·Carolyn T ThorpeMaureen A Smith
Feb 15, 2011·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Robert S WoodwardDaniel C Brennan
Nov 7, 2014·Journal of General Internal Medicine·Heather M JohnsonMaureen A Smith
Apr 26, 2011·Diabetes Research and Clinical Practice·Chun-Jen HuangHerng-Chia Chiu
Mar 29, 2001·Annual Review of Public Health·Beth A Virnig, Marshall McBean
Feb 28, 2004·Diabetes Care·Alain G BertoniDavid C Goff
Oct 26, 2007·Diabetes Care·Mercedes R CarnethonMartha L Daviglus
Nov 25, 2003·Diabetes Care·A Marshall McBeanDorothea Musgrave
Nov 28, 2002·Diabetes Care·David R ArdayDavid A Nicewander
May 29, 2002·Diabetes Care·Sarah L KreinEve A Kerr
Mar 5, 2002·Diabetes Care·Alain G BertoniFrederick L Brancati
Jan 28, 2003·Diabetes Care·Eric A FinkelsteinRonald Manderscheid
Oct 28, 2003·Diabetes Care·James S WrobelLeonard M Pogach
Oct 1, 2008·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Bertrand L JaberFREEDOM Study Group
Oct 8, 2016·BMC Health Services Research·Sophia Miryam Schüssler-Fiorenza RoseMargaret G Stineman
Nov 11, 2016·MMWR. Morbidity and Mortality Weekly Report·Mary Jo PughRosemarie Kobau
Apr 6, 2017·International Journal of Cancer. Journal International Du Cancer·Jie LinKangmin Zhu
Apr 25, 2017·Medical Care·Sundar S ShresthaGiuseppina Imperatore
Jun 10, 2008·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality· Suying LiAllan J Collins
Nov 11, 2005·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Priscilla A HollanderDavid J Ballard
Oct 27, 2009·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Susan M FrayneTerence M Keane
Nov 10, 2004·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Ann M BorzeckiDan R Berlowitz
Mar 24, 2004·Medical Care Research and Review : MCRR·Judy MouchawarW William Schluter
Jun 13, 2003·Medical Care Research and Review : MCRR·Mary Jo PughDan R Berlowitz
Jul 23, 2013·Medical Care Research and Review : MCRR·Christine M EverettMaureen A Smith
Jan 9, 2014·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Jeph HerrinDavid J Ballard
Dec 10, 2016·Journal of Diabetes Science and Technology·Rina KagawaKazuhiko Ohe
Nov 25, 2003·Southern Medical Journal·Marshall H ChinPaul J Rathouz
Feb 2, 2018·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Monica V DragomanMary E Gaffield
Apr 25, 2018·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Christie M BartelsMaureen A Smith
Apr 4, 2014·The Journal of Head Trauma Rehabilitation·Mary Jo PughJordan H Grafman
Sep 14, 2006·Clinical Transplantation·Mathew KiberdBryce A Kiberd
Jan 19, 2007·Movement Disorders : Official Journal of the Movement Disorder Society·Katia NoyesAndrew W Dick
Apr 25, 2007·Transplantation·Thomas E BurroughsMark A Schnitzler
Nov 10, 2015·Obstetrics and Gynecology·Steven W ChampalouxDenise J Jamieson
Jun 16, 2006·Journal of the American Society of Nephrology : JASN·Jon J SnyderRoss Maclean
Dec 24, 2004·Journal of the American Society of Nephrology : JASN·Krista L LentineMark A Schnitzler
Oct 26, 2013·Journal of the American Society of Nephrology : JASN·Deidra C CrewsDeveloping Evidence to Inform Decisions about Effectiveness (DEcIDE) Patient Outcomes in End Stage Renal Disease Study Inves
Mar 3, 2007·Journal of the American Society of Nephrology : JASN·Jay L XueAllan J Collins
Oct 19, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Debasish BanerjeeCharles A Herzog
Aug 21, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Krista L LentineDaniel C Brennan
Aug 21, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Michael F Crutchlow, Roy D Bloom
Aug 19, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Thomas E BurroughsMark A Schnitzler
Jun 12, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Krista L LentineMark A Schnitzler
Sep 28, 2013·Clinical Journal of the American Society of Nephrology : CJASN·Krista L Lentine, Dorry L Segev
Feb 6, 2014·Menopause : the Journal of the North American Menopause Society·Jody M JacksonKaren L Margolis
May 3, 2014·Obstetrics and Gynecology·Naomi K TepperKathryn M Curtis
Mar 30, 2017·The Journal of Ambulatory Care Management·Anna M AfonsoToyosi O Morgan
Oct 1, 2019·The Journal of Head Trauma Rehabilitation·Alicia A SwanChronic Effects of Neurotrauma Consortium
Mar 26, 2014·JAAPA : Official Journal of the American Academy of Physician Assistants·Christine M EverettMaureen A Smith
Jan 11, 2020·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Prasad L GawadeBrian D Bradbury
Nov 19, 2015·Plastic and Reconstructive Surgery. Global Open·Elham MahmoudiKevin C Chung
Jan 7, 2017·Annals of Surgery·Jason T WisemanK Craig Kent
Feb 24, 2004·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Edward F EllerbeckSamuel J Markello
Feb 27, 2003·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Bertram L KasiskeArthur J Matas
Jul 15, 2015·Menopause : the Journal of the North American Menopause Society·Shannon K Laughlin-TommasoElizabeth A Stewart
Apr 15, 2018·Preventing Chronic Disease·Jennifer L St SauverWalter A Rocca
Sep 26, 2018·Statistics in Medicine·Rebecca A HubbardYong Chen
Jul 16, 2019·Journal of the American Medical Informatics Association : JAMIA·Ying XiongJun Yan
May 19, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Bertram L KasiskeChangchun Wang
May 29, 2018·Neurourology and Urodynamics·Ravishankar JayadevappaAlan J Wein
Dec 6, 2018·International Journal of Public Health·Sonsoles FuentesCONSTANCES-Diab Group
Jun 15, 2019·Journal of the American Medical Informatics Association : JAMIA·V G Vinod VydiswaranNalingna Yuan
Jul 5, 2011·Journal of Diabetes Science and Technology·Wen-Jan TuanMaureen A Smith
Mar 20, 2012·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Sara H OlsonElena B Elkin

Related Concepts

Diabetes Mellitus
Insurance, Health, for Aged and Disabled
Health Surveys
Insurance Claim Reporting
Longitudinal Survey

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Synthetic Genetic Array Analysis

Synthetic genetic arrays allow the systematic examination of genetic interactions. Here is the latest research focusing on synthetic genetic arrays and their analyses.

Congenital Hyperinsulinism

Congenital hyperinsulinism is caused by genetic mutations resulting in excess insulin secretion from beta cells of the pancreas. Here is the latest research.

Neural Activity: Imaging

Imaging of neural activity in vivo has developed rapidly recently with the advancement of fluorescence microscopy, including new applications using miniaturized microscopes (miniscopes). This feed follows the progress in this growing field.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Epigenetic Memory

Epigenetic memory refers to the heritable genetic changes that are not explained by the DNA sequence. Find the latest research on epigenetic memory here.

Cell Atlas of the Human Eye

Constructing a cell atlas of the human eye will require transcriptomic and histologic analysis over the lifespan. This understanding will aid in the study of development and disease. Find the latest research pertaining to the Cell Atlas of the Human Eye here.

Femoral Neoplasms

Femoral Neoplasms are bone tumors that arise in the femur. Discover the latest research on femoral neoplasms here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.