One of the challenges of studying import issues in health economics is that the patients often come in and out of your data file. For instance, beneficiaries often switch their private health insurance plan, or can become eligible for public insurance (e.g., Medicare or Medicaid) or the individual may lose their insurace coverage. In each of these cases, it is difficult to track these patients over time.
One effort to solve this problem is AHRQ’s All-Payer Claims Databases (APCD). AHRQ does not create the APCDs themselves but facilitates States efforts to create them. According to a 2010 fact sheet:
Payers include insurance carriers, third party administrators (TPAs), pharmacy benefit managers (PBMs), dental benefit administrators,state Medicaid agencies, CMS (Medicare), Federal EmployeesHealth Benefit (FEHB) and TRICARE administrators.APCD systems collect data from existing claims transaction systemsused by health care providers (facility and practitioners) andpayers.
The information typically collected in an APCD includes patient demographics, provider demographics, clinical, financial,and utilization data. Because of the difficulties involved with thecollection of certain information, most states implementing APCD systems have typically excluded a number of data sources, such asdenied claims, workers compensation claims, and, because claimsdo not exist, services provided to the uninsured.
One concern with these data is that the APCD must maintain beneficiary confidentiality. On the one hand, one of the key benefits of APCD is that it allows researchers to examine patterns in the cost and quality of care for beneficiaries who change insurers. The institution administering the APCD, however, must institute a strong institutional review board (IRB) or data use agreement (DUA) policy.
Also, the APCD must determine whether or not the claims files are updated. Oftentimes, claims payment amounts can change or the claims can be later denied. The APCD must determine a policy for updating the data files over time.
Although there are a number of challenges, some states are making progress. ”Oregon and Tennessee willhave live systems in 2010. Hawaii and Colorado havecurrently submitted legislation for their 2010 session toauthorize development.”
Hopefully, the APCD will be a high-quality, useful data resource that can be used to answer a variety of research questions.
What is an ISBN?
April 13, 2012 in Books, Data | 2 comments
You may have seen on Amazon or near the UPC of your book an ISBN. What is an ISBN? Can it be any number? Why does the Healthcare Economist care?
Answers are provided below.
What is an ISBN?
According to Wikipedia:
“The International Standard Book Number (ISBN) is a unique numeric commercial book identifier based upon the 9-digit Standard Book Numbering (SBN) code created by Gordon Foster, Emeritus Professor of Statistics at Trinity College, Dublin, for the booksellers and stationers W. H. Smith and others in 1966.
The 10-digit ISBN format was developed by the International Organization for Standardization (ISO) and was published in 1970 as international standard ISO 2108.[4] (However, the 9-digit SBN code was used in the United Kingdom until 1974.) Currently, the ISO’s TC 46/SC 9 is responsible for the ISBN. The ISO on-line facility only refers back to 1978.”
Since 1 January 2007, ISBNs have contained 13 digits
Can it be any number?
The answer is no. Here is why the ISBN is interesting, you can identify certain invalid ISBN yourself! How can you do this? The answer is that the ISBN system uses an check digit error detection function. A check digit is a form of redundancy check used for error detection, the decimal equivalent of a binary checksum. It consists of a single digit computed from the other digits in the message.
“The final character of a ten digit International Standard Book Number is a check digit computed so that multiplying each digit by its position in the number (counting from the right) and taking the sum of these products modulo 11 is 0. The digit the farthest to the right (which is multiplied by 1) is the check digit, chosen to make the sum correct. It may need to have the value 10, which is represented as the letter X.”
Take the book the Social Transformation of American Medicine by Paul Starr for instance. Its ISBN is 0465079350. The sum of products is 0×10 + 4×9 + 6×8 + 5×7 + 0×6 + 7×5 + 9×4 + 3×3 + 5×2 + 0×1 = 209 ≡ 0 mod 11 (because 209/11 is exactly 19 with a remainder of 0). Thus, this ISBN is valid.
I have created a spreadsheet that you can use to check if the ISBN is valid and also see in more detail how the math works. All you need to do is enter the ISBN in the yellow box. There are additional tabs that gives examples of sample valid and invalid ISBN-10 numbers.
Why does the Healthcare Economist care?
Two reasons: i) I like books and ii) validity checks any time you use data, whether its data on books or healthcare records.
Tags: Books, Check Sum, Validity Check