Validation of an indirect linkage algorithm to combine registry data with Medicare claims. 2022

Jialin Mao, and Kayla O Moore, and Jesse A Columbo, and Kunal S Mehta, and Philip P Goodney, and Art Sedrakyan
Department of Population Health Sciences, Weill Cornell Medicine, New York, NY. Electronic address: jim2012@med.cornell.edu.

The linkage of registries to Medicare claims data can help extend follow-up for patients receiving medical devices. In the present study, we tested and validated an algorithm that does not require patient identifiers to link data from a national vascular registry and Medicare claims data. We used data from the Vascular Quality Initiative (VQI), a registry capturing data from >600 centers for several different vascular procedures, and Medicare claims from 2003 to 2018. We restricted the study to patients aged ≥65 years who had fee-for-service entitlement at their procedure. We performed an indirect linkage to combine the VQI and Medicare data at the patient level using a sequential algorithm based on the patient's date of birth, sex, zip code, procedure date, and procedure facility. We compared the indirectly linked cohort against a reference standard of a cohort directly linked using Social Security numbers. We calculated the matching rate and accuracy overall and before and after October 2015 when the International Classification of Diseases, 10th revision (ICD-10) system was adopted in the United States. A total of 144,045 VQI-Medicare-linked patients were in the reference standard cohort. Using the indirect linking algorithm, we matched 133,966 of the 144,045 VQI patients to their Medicare claims with a matching rate of 93.0%. Of the 133,966 patients, 133,104 were correctly matched (matching accuracy, 99.4%). The matching rate was higher when the indirect linkage was implemented using the ICD-10 coded data than using the ICD-9 coded data (94.0% vs 92.2%). The accuracy of the indirect linkage remained high for all procedure modules after the ICD-10 coding change (overall, 99.4%; range, 99.0%-99.7%). In the present study, we successfully used indirect identifiers to link the VQI data to Medicare claims with >90% success and >99% accuracy. When direct linkage of the registry claims data using Social Security numbers is not possible because of availability or confidentiality, or both, our algorithm for indirect linkage provides a suitable alternative. The matching rate and accuracy will help ensure the accuracy of long-term follow-up and the completeness and representativeness of linked databases for relevant research and quality improvement initiatives.

UI MeSH Term Description Entries
D012042 Registries The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers. Parish Registers,Population Register,Parish Register,Population Registers,Register, Parish,Register, Population,Registers, Parish,Registers, Population,Registry
D006278 Medicare Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976) Health Insurance for Aged and Disabled, Title 18,Insurance, Health, for Aged and Disabled,Health Insurance for Aged, Disabled, Title 18,Health Insurance for Aged, Title 18
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000465 Algorithms A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. Algorithm
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D016208 Databases, Factual Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references. Databanks, Factual,Data Banks, Factual,Data Bases, Factual,Data Bank, Factual,Data Base, Factual,Databank, Factual,Database, Factual,Factual Data Bank,Factual Data Banks,Factual Data Base,Factual Data Bases,Factual Databank,Factual Databanks,Factual Database,Factual Databases
D018588 Fee-for-Service Plans Method of charging whereby a physician or other practitioner bills for each encounter or service rendered. In addition to physicians, other health care professionals are reimbursed via this mechanism. Fee-for-service plans contrast with salary, per capita, and prepayment systems, where the payment does not change with the number of services actually used or if none are used. (From Discursive Dictionary of Health Care, 1976) Fee-for-Service, Medical,Reimbursement, Fee-for-Service,Fee for Service,Fees for Service,Fee for Service Plans,Fee for Service, Medical,Fee for Services,Fee-for-Service Plan,Fee-for-Service Reimbursement,Fee-for-Service Reimbursements,Fee-for-Services, Medical,Fees for Services,Medical Fee-for-Service,Medical Fee-for-Services,Plan, Fee-for-Service,Plans, Fee-for-Service,Reimbursement, Fee for Service,Reimbursements, Fee-for-Service,Service, Fee for,Service, Fees for,Services, Fee for,Services, Fees for

Related Publications

Jialin Mao, and Kayla O Moore, and Jesse A Columbo, and Kunal S Mehta, and Philip P Goodney, and Art Sedrakyan
March 2013, Surgery,
Jialin Mao, and Kayla O Moore, and Jesse A Columbo, and Kunal S Mehta, and Philip P Goodney, and Art Sedrakyan
June 2009, American heart journal,
Jialin Mao, and Kayla O Moore, and Jesse A Columbo, and Kunal S Mehta, and Philip P Goodney, and Art Sedrakyan
September 1994, Epidemiology (Cambridge, Mass.),
Jialin Mao, and Kayla O Moore, and Jesse A Columbo, and Kunal S Mehta, and Philip P Goodney, and Art Sedrakyan
May 1995, Epidemiology (Cambridge, Mass.),
Jialin Mao, and Kayla O Moore, and Jesse A Columbo, and Kunal S Mehta, and Philip P Goodney, and Art Sedrakyan
May 2014, Circulation. Cardiovascular quality and outcomes,
Jialin Mao, and Kayla O Moore, and Jesse A Columbo, and Kunal S Mehta, and Philip P Goodney, and Art Sedrakyan
December 2004, Health services research,
Jialin Mao, and Kayla O Moore, and Jesse A Columbo, and Kunal S Mehta, and Philip P Goodney, and Art Sedrakyan
June 2019, The Journal of arthroplasty,
Jialin Mao, and Kayla O Moore, and Jesse A Columbo, and Kunal S Mehta, and Philip P Goodney, and Art Sedrakyan
January 2012, Circulation. Cardiovascular quality and outcomes,
Jialin Mao, and Kayla O Moore, and Jesse A Columbo, and Kunal S Mehta, and Philip P Goodney, and Art Sedrakyan
October 2015, Journal of hospital medicine,
Jialin Mao, and Kayla O Moore, and Jesse A Columbo, and Kunal S Mehta, and Philip P Goodney, and Art Sedrakyan
January 2016, Frontiers in oncology,
Copied contents to your clipboard!