Use of Medicare Administrative Claims to Identify a Population at High Risk for Adverse Drug Events and Hospital Use for Quality Improvement

Journal of Managed Care & Specialty Pharmacy
Rachel DigmannJane Brock

Abstract

A system using administrative claims to monitor medication use patterns and associated adverse events is not currently available. Establishment of a standardized method to identify Medicare beneficiaries at high risk for adverse events, by assessing Medicare Part D medication claim patterns and associated outcomes, including outpatient adverse drug events (ADEs) and hospital use, enhances prevention efforts and monitoring for quality improvement efforts. To (a) demonstrate that Medicare claims data can be used to identify a population of beneficiaries at high risk for adverse events for quality improvement and (b) define trends associated with adverse health outcomes in identified high-risk beneficiaries for quality improvement opportunities. We used Medicare fee-for-service Part D claims data to identify a population at high risk for adverse events by evaluating medication use patterns. This population was taking at least 3 medications, 1 of which was an anticoagulant, an opioid, or an antidiabetic agent. Next, we used associated Part A claims to calculate rates of outpatient ADEs, looking for specific ICD-9-CM or ICD-10-CM codes in the principal diagnosis code position. Rates of hospital use (inpatient hospitalization, observ...Continue Reading

References

Mar 8, 2003·JAMA : the Journal of the American Medical Association·Jerry H GurwitzDavid W Bates
Apr 25, 2006·Pharmacoepidemiology and Drug Safety·Daniel S Budnitz, Peter M Layde
Apr 3, 2008·BMC Endocrine Disorders·Adit A GindeCarlos A Camargo
May 13, 2008·Journal of Clinical Epidemiology·Charles E LeonardJoshua P Metlay
Jul 14, 2010·Pharmacoepidemiology and Drug Safety·Florence T BourgeoisKenneth D Mandl
Sep 15, 2010·Archives of Internal Medicine·Jennifer Brennan BradenMark D Sullivan
Nov 25, 2011·The New England Journal of Medicine·Daniel S BudnitzChesley L Richards
Jan 1, 2012·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Fabio SalviAntonio Cherubini
Jan 1, 2012·Medicare & Medicaid Research Review·Michael TaitelIan Duncan

❮ Previous
Next ❯

Citations

Oct 1, 2020·Journal of Managed Care & Specialty Pharmacy·Lt Lauren HertzogLaura E Happe

❮ Previous
Next ❯

Related Concepts

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.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

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.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation 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.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Canadian Family Physician Médecin De Famille Canadien
Imaan BayoumiAnne Holbrook
Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine
Ann M SheehyAmy J H Kind
Pharmacoepidemiology and Drug Safety
Kevin HaynesJoshua P Metlay
© 2022 Meta ULC. All rights reserved