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www.ahrq.gov/sites/default/files/wysiwyg/data/SyH-DR-Getting-Started-Guide.pdfMay 01, 2022 - Synthetic Healthcare Database for Research (SyH-DR) A Synthetic Nationally Representative All-Payer Claims … Claims Files • Commercial Inpatient File • Commercial Outpatient File • Commercial Person-Level File … • All claims that directly identified a newborn were removed, so the SyH-DR cannot be used to study … For example, total charges are not provided for commercial claims. … Therefore, claims for some payer types will never have more than a certain number of codes if the source
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www.ahrq.gov/sites/default/files/wysiwyg/data/SyH-DR-Getting-Started-Guide-072822.pdfJuly 01, 2022 - Synthetic Healthcare Database for Research (SyH-DR) A Synthetic Nationally Representative All-Payer Claims … Claims Files • Commercial Inpatient File • Commercial Outpatient File • Commercial Person-Level File … • All claims that directly identified a newborn were removed, so the SyH-DR cannot be used to study … For example, total charges are not provided for commercial claims. … Therefore, claims for some payer types will never have more than a certain number of codes if the source
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www.ahrq.gov/patient-safety/settings/hospital/resource/qitool/casestudy.htmlDecember 01, 2017 - Angeles were questioning the usefulness of quality measures based on hospital inpatient administrative claims … successful clinical improvement processes already in place, clinicians discounted the accuracy of using a claims-based
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www.ahrq.gov/research/findings/studies/index.html?page=135January 01, 2024 - Medicare claims linked to electronic health record (EHR) data from six Texas hospitals between 2009 and … claims. … Pain management specialists increased Medicare Part D opioid claims by 27.3% to 1,140 mean claims per … Physical medicine and rehabilitation providers increased claims by 16.9% to 511 mean claims per provider … However opioid claims among dentists (+5.6%) and nonphysician providers (+10.2%) increased during this
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www.ahrq.gov/topics/a.htmlApril 30, 2025 - A Access to Care Adverse Drug Events (ADE) Adverse Events Alcohol Use All-Payer Claims
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www.ahrq.gov/sites/default/files/wysiwyg/data/SyH-DR-Getting-Started-Guide-rev-20230303.pdfMarch 01, 2023 - Synthetic Healthcare Database for Research (SyH-DR) A Synthetic Nationally Representative All-Payer Claims … Claims Files • Commercial Inpatient File • Commercial Outpatient File • Commercial Person-Level File … • All claims that directly identified a newborn were removed, so the SyH-DR cannot be used to study … For example, total charges are not provided for commercial claims. … Therefore, claims for some payer types will never have more than a certain number of codes if the source
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Mod02-Business-Case-Worksheet (pdf file)
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module2/mod02-business-case-worksheet.pdfApril 01, 2016 - – Analyze the organization’s frequency of adverse events and malpractice claims to support the rationale … disclose the event – Length of time to complete investigation and analysis of the event – Number of claims … asserted – Number of law suits filed compared to the claims settled or dismissed for <$500 – Proportion … calculate the projected costs of harm events in terms of reimbursement loss, penalties, risk management claims -
www.ahrq.gov/research/findings/studies/index.html?page=474January 01, 2024 - deterministic record linkage using multiple indirect personal identifiers: linking a large registry to claims … Keywords: Critical Care, Mortality, Diabetes Thacker EL , Muntner P , Zhao H Claims-based … The researchers sought to develop claims-based algorithms to identify individuals at high risk for coronary … Claims-based algorithms for identifying Medicare beneficiaries at high estimated risk for coronary heart … The researchers found that their claims-based hierarchical coding algorithm of spine-related medical
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Does Medical Error Disclosure Violate the Medical Malpractice Insurance Cooperation Clause? (pdf file)
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Banja.pdfJanuary 01, 2004 - “The insured shall not, except at his own cost, make any payment, admit any liability, settle any claims … policies usually provide that an admission of the insured of error voids coverage for the related claims … the Lexington facility placed in the top 25 percent of VA hospitals in the number of malpractice claims … and, therefore, an increase in an insurer’s claims-handling costs, if that policy nevertheless results … Factors that prompted families to file medical malpractice claims following perinatal injuries. -
www.ahrq.gov/research/findings/studies/index.html?page=55January 01, 2024 - Decreases in suppliers across all items and increases in claims per supplier for the majority of items … The purpose of the study was to review Medicaid legacy, Medicaid new generation, and Medicare claims … The study found that new generation Medicare claims had high performance across states and indicators … Medicaid claims outperformed Medicaid legacy claims on several indicators, conducting high-level analysis … In all time periods assessed, most patients' use was reflected only in the EHR, or only in the claims
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www.ahrq.gov/pqmp/publications/1-0-journal-supplement.htmlSeptember 01, 2021 - Identifying Sickle Cell Disease Cases Using Administrative Claims . … Using Medicaid and CHIP Claims Data to Support Pediatric Quality Measurement: Lessons From 3 Centers
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/primary-care/pcp-costs/martsolf2-costs.pdfMay 01, 2015 - For Aim 1, survey and claims data were used to identify a sample of practices that varied in how much … Claims data representing all care delivered to patients were collected for 2 years prior to and 3 years … The claims data were used to calculate each practice’s performance on 13 process measures of the quality … The claims data were also used to calculate total costs per patient per month in each practice and to
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www.ahrq.gov/patient-safety/settings/hospital/candor/demo-program/grants/index.htmlAugust 01, 2022 - Preventing Harm Through Best Practices—Lessons Learned Exploring Alternate Methods of Settling Claims … Exploring Alternate Methods of Settling Claims—Lessons Learned Evaluation Issues Contributions
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Pediatric All-Condition Readmission Measure (pdf file)
www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0129-fullreport.pdfDecember 31, 2015 - Administrative data (e.g claims data). … The measure uses pediatric inpatient claims data. … Hospital claims datasets are widely available. … Use of Claims Data to Measure Readmissions We developed our candidate measure to use inpatient claims … Using claims data alone, one cannot fully case-mix adjust for disease severity. -
PowerPoint Presentation (pdf file)
www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/supln-slides.pdfJanuary 24, 2025 - health plan measures • Data sources – Primarily Medicaid/CHIP administrative data (enrollment and claims … using Health Information Exchange and statewide registry for child health measures not captured in claims … MaineCare claims. … Developmental Screening Rates than Statewide 76 Source: MaineCare Paid claims analyses. … FOR M-CHAT I AUTISM SCREENS FOR CHILDREN AGE ONE AND TWO 77 Source: MaineCare administrative claims -
www.ahrq.gov/research/findings/studies/index.html?page=83January 01, 2024 - antibiotic use and to compare seven models that include these comorbidities and other patient-level claims … Findings showed that adding electronically available patient claims data to facility models consistently … Electronically available patient claims data improve models for comparing antibiotic use across hospitals … A comparison of administrative claims-based risk predictors for pediatric asthma. … This cross-sectional study of deidentified claims data from the Optum Clinformatics Data Mart evaluated
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www.ahrq.gov/patient-safety/capacity/candor/demo-program/grants/index.htmlMay 01, 2016 - Preventing Harm Through Best Practices—Lessons Learned Exploring Alternate Methods of Settling Claims … Exploring Alternate Methods of Settling Claims—Lessons Learned Evaluation Issues Contributions
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www.ahrq.gov/news/newsroom/case-studies/201538.htmlJanuary 01, 2016 - multiple other sources, including large databases containing millions of enrollees and billions of claims … To maintain statistical accuracy, MEPS serves as the basis for the HSCA; the large claims databases are
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www.ahrq.gov/news/newsletters/e-newsletter/863.htmlMay 01, 2023 - The authors analyzed closed malpractice claims from January 2015 to September 2021 for ambulatory care … Of 199 diagnosis-related claims, EHRs were considered a potential contributor to diagnostic errors in … 61 percent of claims. … About 92 percent involved the testing stage, and the most prevalent outcome for claims (71 percent) was
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Eric T. Roberts - Sample Grant Application (pdf file)
www.ahrq.gov/sites/default/files/wysiwyg/funding/training-grants/eric-roberts-draft-application.pdfMay 19, 2021 - Using the Health and Retirement Study linked to Medicare and Medicaid claims, Dr. … Measuring prices in health care markets using commercial claims data. … Related research activities: Aim 1: Measure medication use/adherence in claims and associated … and outpatient facility claims for ED visits. … This data application is now under review at ResDAC for linked claims.
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