Search

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. Physical inactivity is the fourth-leading cause of global mortality and is prevalent among people with lower extremity osteoarthritis. Lower extremity osteoarthritis is the most common arthritis type afflicting older adults, and total joint arthroplasty (TJA) performed to address the condition is Medicare's largest annual expense. Despite TJA intervention to address the disabling effects of osteoarthritis, physical activity (PA) level remains stable 6 months after TJA; however, the effect of TJA on long-term PA ([greater than or equal to]2 y) in a representative sample of older adults is unknown. The purpose of this study was to test the hypothesis that PA would remain stable in the long term. Methods. In this longitudinal observational study, a probability-weighted difference-in-differences analysis was conducted to observe the predictive margins of nontraumatic hip or knee TJA on levels of vigorous and moderate PA after 2 years. A combined Health and Retirement Study data set of community-dwelling adults who were >55 years old, had symptomatic osteoarthritis, and were in need of TJA between 2008 and 2018 (N = 4652) was used. Results. TJA was not associated with vigorous PA ([delta] = 2.37; SE = 5.23) or moderate PA ([delta] = -2.84; SE = 7.76) after 2 years. Conclusion. TJA was not associated with increased long-term PA in older adults with osteoarthritis. Impact. Physical therapists should not assume that there will be a natural increase in PA after functional recovery from TJA procedures. Older adults with lower extremity osteoarthritis may benefit from PA screening and promotion practices in physical therapy services. Lay Summary. Receiving a total joint replacement does not lead to increased physical activity levels 2 years after surgery. Keywords: Physical Activity, Preventive Health Services, Total Joint Arthroplasty, Introduction Lower extremity (hip or knee) osteoarthritis is the most prevalent joint disorder, a leading cause of chronic pain and disability in older adults, and a significant barrier to physical [...]