Understanding the High Prevalence of Low-Prevalence Chronic Disease Combinations: Databases and Methods for Research. State of Colorado Dataset

09/20/2013

Colorado All Payer Claims Database
Database Description
White Paper(s): Data Systems and the Prevalence of Chronic Disease Combinations & Multiple Chronic Conditions and Disparities.
Sponsorship: State of Colorado, Colorado Health Foundation, The Colorado Trust, Caring for Colorado Foundation, Rose Community Foundation and Kaiser Permanente Community Benefit Program; Center for Improving Value in Health Care (CIVHC).
Description: The APCD is a secure database that includes claims data from commercial health plans, Medicare and Medicaid. Created by legislation in 2010 and administered by the Center for Improving Value in Health Care (CIVHC), the APCD is the only comprehensive source of health care claims data from public and private payers in Colorado.
Database: (Scope, Size, Setting, Population, Age Range) State All Payer Database (Commercial carriers, Medicaid, Medicare, Self-funded plans and small group). By 2014, the APCD will have collected claims data for 90% of Colorado’s 4.2 million insured.
Database Type: (Survey, Registry, Research Study, Program Database, Claims, Administrative Data, and Clinical Databases) All Payer Claims Database
Database Source/Origin: All claims: commercial carriers, Medicaid, Medicare, self-funded plans and small group plans.
Date or Frequency of Data Collection: 2008–2011; update regularly
Longitudinal vs. Cross-sectional Database: Longitudinal
Data Collection Methodology: Health insurance carriers are required to submit health insurance files.
Sampling Strategy: Information is collected on all Colorado healthcare expenditures.
Unit of Analysis: Patient
Diagnosis Information
Diagnosis Variable Type: (Chronic Condition Status, Principal Diagnosis, Primary Diagnosis, Secondary Diagnosis, Admit/Discharge Diagnosis and Self-Reported Diagnosis)

Admitting Diagnosis

Principal Diagnosis

12 “Other Diagnosis” Categories

Diagnosis Codes: (ICD-9, ICD-10, SNOMED) ICD-9
Number of Diagnoses Captured: n/a
Cost, Utilization & Clinical Information
Measures of Cost: (Claims, Out-of-pocket expenses, Self- reported expenditures, and Prescription Drug Costs)

Total Cost

Inpatient Facility Cost

Outpatient Facility Cost (including ER cost)

Profession Cost

Drug Cost

Measures of Healthcare Utilization: (Number of Visits, Any Procedures/Number of Procedures/Type of Procedure, Number of Admission/Type of Admission, Length of Stay, Hospitalizations, Emergency Department Utilization, etc.)

Hospital Admissions

Type of Service (ortho vs. pediatric)

Readmissions

Measures of Healthcare Access: Provider Density Variable
Demographic Information: (Sex, Age, Race, Ethnicity, Marital Status, Disability Status, Language, Insurance Type, Educational Attainment).

Sex

Gender

Age

Insurance Status

Clinical Information: (BMI, Medical Conditions [high blood pressure], Smoker Status, History of Various Conditions, Preventative Health Measures , Activities of Daily Living, Instrumental Activities of Daily Living) Yes, extensive clinical data from EHRs.
Measures of Socioeconomic Status: (Occupation, Employment Status, Income, Wealth, Place of Residence, Household Size & Composition, geographic location) n/a
Site of Service Information: Zip Code, County, Type of Service (inpatient vs. outpatient).
Measures of Healthcare Outcomes: (Mortality, Morbidity, Mobility, Functional Status, Quality of Life, Quality Measures, Quality of Care, Readmissions)

Discharge Status

Readmissions

Strengths, Limitations & Feasibility
Data Strengths: Large patient sample size; represents all types of payment sources.
Data Limitations: Only representative of the State of Colorado; still in development and missing claims data for some periods of time.
Data Access Restrictions: Data is publically available.
Data Linking Feasibility: (Unique identifiers or sufficient demographics to allow for data linkages) Social Security Number, Plan Number, Employee Number, Provider Number. Information is grouped by zip code or region to protect personal health information.
Related Grouping Systems: All ICD-related grouping systems.

References:

Colorado All-Payer Claims Database. 2013. http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1249996141729

 

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