Dataset Information

Comparison of primary payer in cancer registry and discharge data.

ABSTRACT:

Objectives

To determine agreement between variables capturing the primary payer at cancer diagnosis across the Pennsylvania Cancer Registry (PCR) and statewide facility discharge records (Pennsylvania Health Care Cost Containment Council [PHC4]) for adults younger than 65 years, and to specifically examine factors associated with misclassification of Medicaid status in the registry given the role of managed care.

Study design

Cross-sectional analysis of the primary cancer cases among adults aged 21 to 64 years in the PCR from 2010 to 2016 linked to the PHC4 facility visit records.

Methods

We assessed agreement of payer at diagnosis (Medicare, Medicaid, private, other, uninsured, unknown) across data sources, including positive predictive value (PPV) and sensitivity, using the PHC4 records as the gold standard. The probability of misclassifying Medicaid in registry was estimated using multivariate logit models.

Results

Agreement of payers was high for private insurance (PPV, 89.7%; sensitivity, 83.6%), but there was misclassification and/or underreporting of Medicaid in the registry (PPV, 80%; sensitivity, 58%). Among cases with "other" and "unknown" insurance, 73.8% and 62.1%, respectively, had private insurance according to the PHC4 records. Medicaid managed care was associated with a statistically significant increase of 12.6 percentage points (95% CI, 9.4-15.8) in the probability of misclassifying Medicaid enrollment as private insurance in the registry.

Conclusions

Findings suggest caution in conducting and interpreting research using insurance variables in cancer registries.

SUBMITTER: Kwon Y

PROVIDER: S-EPMC11363816 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Comparison of primary payer in cancer registry and discharge data.

Kwon Youngmin Y Perraillon Marcelo C MC Drake Coleman C Jacobs Bruce L BL Bradley Cathy J CJ Sabik Lindsay M LM

The American journal of managed care 20230901 9

<h4>Objectives</h4>To determine agreement between variables capturing the primary payer at cancer diagnosis across the Pennsylvania Cancer Registry (PCR) and statewide facility discharge records (Pennsylvania Health Care Cost Containment Council [PHC4]) for adults younger than 65 years, and to specifically examine factors associated with misclassification of Medicaid status in the registry given the role of managed care.<h4>Study design</h4>Cross-sectional analysis of the primary cancer cases am ...[more]

PMID: 37729528

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Dataset Information

Comparison of primary payer in cancer registry and discharge data.

Objectives

Study design

Methods

Results

Conclusions

Publications

Comparison of primary payer in cancer registry and discharge data.

Similar Datasets

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