Use of Medicare Data to Identify Incident Breast Cancer Cases

By Warren, Joan L.; Riley, Gerald F. et al. | Health Care Financing Review, Fall 1996 | Go to article overview

Use of Medicare Data to Identify Incident Breast Cancer Cases


Warren, Joan L., Riley, Gerald F., McBean, A. Marshall, Hakim, Rosemarie, Health Care Financing Review


Surveillance, Epidemiology and End Results (SEER) data from the National Cancer Institute (NCI) provide reliable information about cancer incidence. However, because SEER data are geographically limited and have a 2-year time lag, we evaluated whether Medicare data could provide timely information on cancer incidence. Comparing Medicare women hospitalized for breast cancer with women reported to SEER, Medicare data had high specificity (96.6 percent), yet low sensitivity (59.4 percent). We conclude that Medicare hospitalization data can identify incident cases for cancers that usually require inpatient hospitalization. For cancers that often only receive outpatient treatment, such as breast cancer, additional Medicare data, such as physician bills, are needed to understand the entirety of treatment practices.

INTRODUCTION

Data collected from the SEER program maintained by the NCI are usually considered the "gold standard" used to estimate the incidence and treatment of cancers throughout the United States. Prior to 1992, there were five States (Connecticut, Hawaii, Iowa, New Mexico, and Utah) and four metropolitan areas (Seattle, San Francisco-Oakland, Detroit, and Atlanta) participating in the SEER program. The geographic areas represent about 10 percent of the Nation's population (Miller et al., 1993), are concentrated in the western United States, and do not include large numbers of some demographic groups, such as African Americans, raising concerns about the representativeness of the data. Moreover, because the SEER areas are geographically limited, they may not capture regional variation in treatment practices for specific cancers, costs of care, and medical outcomes following treatment. In addition, there is a 2-year lag needed for NCI to obtain case reports from the State registries.

Given concern about the representativeness and timeliness of the SEER data, other data sources may be able to provide accurate and more current information regarding cancer incidence and treatment. A potential alternative source of information about the incidence of cancer in the population is the administrative data collected for insurance billing purposes, such as Medicare data. These data offer the opportunity for timely studies that include the entirety of the United States. The cancer diagnoses from administrative data for inpatient stays have been found to have high levels of sensitivity and specificity when compared with the medical record for the hospitalization (Fisher et al., 1992; Romano and Luft, 1992). Previous studies have used Medicare hospitalization bills to analyze whether incidence rates from Medicare data were comparable to incidence rates from SEER data for five cancers--breast, colon, esophagus, lung, prostate, and uterus (Whittle et al., 1991; McBean, Warren, and Babish, 1994; McBean, Babish, and Warren, 1993). The comparability of the rates varied by type of cancer. McBean, Warren, and Babish (1994) and McBean, Babish, and Warren (1993) found that for those cancers that are usually treated in the hospital setting, such as esophagus, lung, and uterine, Medicare rates were comparable to rates from the SEER data. For colon and prostate cancer, which are often treated in the outpatient setting only, the rates calculated from Medicare hospitalization and SEER data were significantly different. These studies only utilized aggregate data from SEER and Medicare for comparisons and did not attempt to link files at the individual level to determine if the same persons were being identified from the two independent sources of data.

The purpose of this study was to determine if persons identified as having incident breast cancer from the Medicare data were also found in the SEER data for that year. If a method could be developed to identify specific women with incident breast cancer from administrative data, it would help researchers to identify cohorts to examine treatment practices for the Nation or for subgroups.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Use of Medicare Data to Identify Incident Breast Cancer Cases
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.