Accuracy and completeness of Medicare claims data for surgical treatment of breast cancer

Xianglin Du, Jean L. Freeman, Joan L. Warren, Ann B. Nattinger, Dong Zhang, James Goodwin

Research output: Contribution to journalArticle

95 Citations (Scopus)

Abstract

BACKGROUND. Although a number of studies have used Medicare claims data to study trends and variations in breast cancer treatment, the accuracy and completeness of information on surgical treatment for breast cancer in the Medicare data have not been validated. OBJECTIVES. This study assessed the accuracy and completeness of Medicare claims data for breast cancer surgery to determine whether Medicare claims can serve as a source of data to augment information collected by cancer registries. METHODS. We used the Surveillance, Epidemiology and End Results (SEER) Cancer Registry-Medicare data and compared Medicare claims on surgery with the surgery recorded by the SEER registries for 23,709 women diagnosed with breast cancer at ≥65 years of age from 1991 through 1993. RESULTS. More than 95% of women having mastectomies according to the Medicare data were confirmed by SEER. For breast-conserving surgery, 91% of cases were confirmed by SEER. The Medicare physician services claims and inpatient claims were approximately equal in accuracy on type of surgery. The Medicare outpatient claims were less accurate for breast-conserving surgery. In terms of completeness, when the 3 claims sources were combined, 94% of patients receiving breast cancer surgery according to SEER were identified by Medicare. CONCLUSIONS. The combined Medicare claims database, which includes the inpatient, outpatient, and physician service claims, provides valid information on surgical treatment among women known to have breast cancer. The claims are a rich source of data to augment the information collected by tumor registries and provide information that can be used to follow long-term outcomes of Medicare beneficiaries.

Original languageEnglish (US)
Pages (from-to)719-727
Number of pages9
JournalMedical Care
Volume38
Issue number7
StatePublished - Jul 2000

Fingerprint

Medicare
surgery
cancer
Breast Neoplasms
epidemiology
surveillance
Epidemiology
Registries
Therapeutics
Segmental Mastectomy
Information Storage and Retrieval
physician
Inpatients
Physicians
Neoplasms
Mastectomy
Ambulatory Care
Outpatients
trend
Databases

Keywords

  • Breast cancer
  • Breast conserving surgery
  • Mastectomy
  • Medicare
  • SEER

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nursing(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Du, X., Freeman, J. L., Warren, J. L., Nattinger, A. B., Zhang, D., & Goodwin, J. (2000). Accuracy and completeness of Medicare claims data for surgical treatment of breast cancer. Medical Care, 38(7), 719-727.

Accuracy and completeness of Medicare claims data for surgical treatment of breast cancer. / Du, Xianglin; Freeman, Jean L.; Warren, Joan L.; Nattinger, Ann B.; Zhang, Dong; Goodwin, James.

In: Medical Care, Vol. 38, No. 7, 07.2000, p. 719-727.

Research output: Contribution to journalArticle

Du, X, Freeman, JL, Warren, JL, Nattinger, AB, Zhang, D & Goodwin, J 2000, 'Accuracy and completeness of Medicare claims data for surgical treatment of breast cancer', Medical Care, vol. 38, no. 7, pp. 719-727.
Du X, Freeman JL, Warren JL, Nattinger AB, Zhang D, Goodwin J. Accuracy and completeness of Medicare claims data for surgical treatment of breast cancer. Medical Care. 2000 Jul;38(7):719-727.
Du, Xianglin ; Freeman, Jean L. ; Warren, Joan L. ; Nattinger, Ann B. ; Zhang, Dong ; Goodwin, James. / Accuracy and completeness of Medicare claims data for surgical treatment of breast cancer. In: Medical Care. 2000 ; Vol. 38, No. 7. pp. 719-727.
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abstract = "BACKGROUND. Although a number of studies have used Medicare claims data to study trends and variations in breast cancer treatment, the accuracy and completeness of information on surgical treatment for breast cancer in the Medicare data have not been validated. OBJECTIVES. This study assessed the accuracy and completeness of Medicare claims data for breast cancer surgery to determine whether Medicare claims can serve as a source of data to augment information collected by cancer registries. METHODS. We used the Surveillance, Epidemiology and End Results (SEER) Cancer Registry-Medicare data and compared Medicare claims on surgery with the surgery recorded by the SEER registries for 23,709 women diagnosed with breast cancer at ≥65 years of age from 1991 through 1993. RESULTS. More than 95{\%} of women having mastectomies according to the Medicare data were confirmed by SEER. For breast-conserving surgery, 91{\%} of cases were confirmed by SEER. The Medicare physician services claims and inpatient claims were approximately equal in accuracy on type of surgery. The Medicare outpatient claims were less accurate for breast-conserving surgery. In terms of completeness, when the 3 claims sources were combined, 94{\%} of patients receiving breast cancer surgery according to SEER were identified by Medicare. CONCLUSIONS. The combined Medicare claims database, which includes the inpatient, outpatient, and physician service claims, provides valid information on surgical treatment among women known to have breast cancer. The claims are a rich source of data to augment the information collected by tumor registries and provide information that can be used to follow long-term outcomes of Medicare beneficiaries.",
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N2 - BACKGROUND. Although a number of studies have used Medicare claims data to study trends and variations in breast cancer treatment, the accuracy and completeness of information on surgical treatment for breast cancer in the Medicare data have not been validated. OBJECTIVES. This study assessed the accuracy and completeness of Medicare claims data for breast cancer surgery to determine whether Medicare claims can serve as a source of data to augment information collected by cancer registries. METHODS. We used the Surveillance, Epidemiology and End Results (SEER) Cancer Registry-Medicare data and compared Medicare claims on surgery with the surgery recorded by the SEER registries for 23,709 women diagnosed with breast cancer at ≥65 years of age from 1991 through 1993. RESULTS. More than 95% of women having mastectomies according to the Medicare data were confirmed by SEER. For breast-conserving surgery, 91% of cases were confirmed by SEER. The Medicare physician services claims and inpatient claims were approximately equal in accuracy on type of surgery. The Medicare outpatient claims were less accurate for breast-conserving surgery. In terms of completeness, when the 3 claims sources were combined, 94% of patients receiving breast cancer surgery according to SEER were identified by Medicare. CONCLUSIONS. The combined Medicare claims database, which includes the inpatient, outpatient, and physician service claims, provides valid information on surgical treatment among women known to have breast cancer. The claims are a rich source of data to augment the information collected by tumor registries and provide information that can be used to follow long-term outcomes of Medicare beneficiaries.

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