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Objective: To evaluate the quality of a multiyear linkage between the Colorado all-payer claims database (APCD) and the Colorado Central Cancer Registry. Data sources: Secondary 2012-2017 data from the APCD and the Colorado Cancer Registry. Study design: Descriptive analysis of the proportion of cases captured by the linkage in relation to the cases reported by the registry. Data collection/extraction methods: We used probabilistic linkage to combine records from both data sources for all patients diagnosed with cancer. Results: We successfully linked 93% of the 146,884 patients in the registry. Approximately 63% of linked patients were perfect matches on five identifiers. Of partial matches, 81.6% were matched on four identifiers with missing or partial Social Security Numbers. The linkage rate was lower for uninsured patients at diagnosis (74.7%) or patients with private plans (89.4%) but close to 100% for Medicare and Medicaid enrollees. Most of the 29% of patients who did not have claims at the time of diagnosis were covered by private plans that may not submit claims. Conclusions: APCD-registry linkages are a promising source of data to conduct population-based research from multiple payers. However, not all payers submit claims, and the quality of the data may vary by state. KEYWORDS all-payer claims databases, cancer, linkage, longitudinal, registry What is known on this topic * Health services research on cancer care and outcomes has benefited from linkages between claims databases and cancer registries, but these linkages are limited to a single payer, health system, or population. * Many states have developed all-payer claims databases, but each state has different rules regarding claims submission and not all payers are required to submit claims. * The quality of all-payer claims databases for cancer health services research is unknown. What this study adds * We linked most patients (93.0%) in the Colorado Cancer Registry with the Colorado all-payer claims databases, with high linkage rates of 98.6% for Medicare and 99.2% for Medicaid, and similar linkages rates by race and urban/rural residence (89.3%-94.8%). * Although we were able to link 93% of patients in the registry, nearly 30% of patients did not have claims at the time of diagnosis, either due to uninsurance or coverage from private plans that do not submit claims. * Even though nearly 30% of linked patients did not have claims data at the time of diagnosis, claims available in the linkage after diagnosis could be valuable in some study designs (e.g., survivorship studies) and baseline characteristics for these patients are available from the registry., 1 | INTRODUCTION Cancer health services research has benefited from the availability of claims data linked to cancer registry data; the most well-known example is Surveillance, Epidemiology, and End Results [...]

Objective. To determine if a tiered hospital benefit and safety incentive shifted the distribution of admissions toward safer hospitals. Data Sources/Study Setting. A large manufacturing company instituted the hospital safety incentive (HSI) for union employees. The HSI gave union patients a financial incentive to choose hospitals that met the Leapfrog Group's three patient safety "leaps." The analysis merges data from four sources: claims and enrollment data from the company, the American Hospital Association, the AHRQ HCUP-SID, and a state Office of the Insurance Commissioner. Study Design. Changes in hospital admissions' patterns for union and nonunion employees using a difference-in-difference design. We estimate the probability of choosing a specific hospital from a set of available alternatives using conditional logistic regression. Principal Findings. Patients affiliated with the engineers' union and admitted for a medical diagnosis were 2.92 times more likely to select a hospital designated as safer in the postperiod than in the preperiod, while salaried nonunion (SNU) patients (not subject to the financial incentive) were 0.64 times as likely to choose a compliant hospital in the post- versus preperiod. The difference-in-difference estimate, which is based on the predictions of the conditional logit model, is 0.20. However, the machinists' union was also exposed to the incentive and they were no more likely to choose a safer hospital than the SNU patients. The incentive did not have an effect on patients admitted for a surgical diagnosis, regardless of union status. All patients were averse to travel time, but those union patients selecting an incentive hospital were less averse to travel time. Conclusions. Patient price incentives and quality/safety information may influence hospital selection decisions, particularly for medical admissions, though the optimal incentive level for financial return to the plan sponsor is not clear. Key Words. Tiered hospital benefits, patient safety, Leapfrog Group, hospital choice, centers of excellence, Recent innovations in health insurance products and health financing mechanisms are attempting to address the escalation of health costs and the mounting evidence of problems with health care quality and [...]

Objective. To estimate the costs, effectiveness, and cost-effectiveness of prevention interventions for out-of-treatment substance abusers at risk for HIV. This is the first cost-effectiveness study of an AIDS intervention that [...]

Objective. To assess whether the covariates that explain expectations of nursing home entry are consistent with the characteristics of those who enter nursing homes. Data Sources. Waves 1 and 2 [...]