Linking Physician Characteristics and Medicare Claims Data

BACKGROUND: Increasingly, investigators are using administrative databases to answer research questions requiring physician characteristics information. This article provides a roadmap for investigators who use Medicare data to answer such questions, focusing on use of the Surveillance, Epidemiology, and End Results (SEER)-Medicare files. METHODS: Three data sources that can be linked to identify physician characteristics-Medicare claims, the Unique Physician Identification Number (UPIN) Registry, and the American Medical Association (AMA) Masterfile-were examined for data availability, linkage rates, and quality. These databases also were used to explore measurement issues regarding physician specialty and practice volume. RESULTS: Over 98 percent of UPINs identified from the Medicare claims could be linked with both the AMA Masterfile and the UPIN Registry. The AMA Masterfile is the best source of sociodemographic and medical training information; the Medicare claims are the best source of practice ZIP code; and the UPIN Registry is the best source of practice organization data. The operationalization of variables such as physician specialty and practice volume is dependent on the specific research question that is being addressed. CONCLUSION: Administrative databases, such as SEER-Medicare data linked to AMA Masterfile or UPIN Registry data, are an important resource for investigators interested in assessing the relationship between physicians' personal and practice characteristics and the content or outcomes of clinical care

Family medicine · Identification (biology) · MEDLINE · Specialty · Healthcare Policy and Management · Medical Coding and Health Information · Medicine · Primary Care and Health Outcomes

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  Añadir item

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  Añadir item

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  Jane S Der, M Alan Brookhart•Medical Care•2020

  Añadir item

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  Open Access•Leighton Chan, L Gary Hart et al.•The Journal of Rural Health•2004

  Añadir item

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  M Alan Brookhart, J Avorn et al.•Medical Care•2007

  Añadir item

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  M Alan Brookhart, Jeremy A Rassen et al.•Medical Care•2007

  Añadir item

• Effects of Surgeon Volume and Hospital Volume on Quality of Care in Hospitals

  Robert G Hughes, Robert Hughes et al.•Medical Care•1987

  Añadir item

• Physician and Practice Characteristics Associated With Judgments About Breast Cancer Treatment

  Stephanie L Mcfall, Scott Moss et al.•Medical Care•1994

  Añadir item

• Self-Reported Physician Specialties and the Primary Care Content of Medical Practice

  Judy A Shea, Philip R Kletke et al.•Medical Care•1999

  Añadir item

• Physician Volume and Obstetric Outcome

  Michael Lefevre, Michael L Lefevre•Medical Care•1992

  Añadir item

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  Rebecca A Silliman, Serkalem Demissie et al.•Medical Care•1999

  Añadir item