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Showing content from https://pubmed.ncbi.nlm.nih.gov/21747107/ below:

Electronic health records vs Medicaid claims: completeness of diabetes preventive care data in community health centers

Comparative Study

. 2011 Jul-Aug;9(4):351-8. doi: 10.1370/afm.1279. Electronic health records vs Medicaid claims: completeness of diabetes preventive care data in community health centers

Affiliations

Affiliation

¹ Department of Family Medicine, Oregon Health and Science University, Portland, Oregon, USA. devoej@ohsu.edu

PMID: 21747107
PMCID: PMC3133583
DOI: 10.1370/afm.1279

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Comparative Study

Electronic health records vs Medicaid claims: completeness of diabetes preventive care data in community health centers

Jennifer E Devoe et al. Ann Fam Med. 2011 Jul-Aug.

. 2011 Jul-Aug;9(4):351-8. doi: 10.1370/afm.1279. Affiliation

¹ Department of Family Medicine, Oregon Health and Science University, Portland, Oregon, USA. devoej@ohsu.edu

PMID: 21747107
PMCID: PMC3133583
DOI: 10.1370/afm.1279

Item in Clipboard

Abstract

Purpose: Electronic Health Record (EHR) databases in community health centers (CHCs) present new opportunities for quality improvement, comparative effectiveness, and health policy research. We aimed (1) to create individual-level linkages between EHR data from a network of CHCs and Medicaid claims from 2005 through 2007; (2) to examine congruence between these data sources; and (3) to identify sociodemographic characteristics associated with documentation of services in one data set vs the other.

Methods: We studied receipt of preventive services among established diabetic patients in 50 Oregon CHCs who had ever been enrolled in Medicaid (N = 2,103). We determined which services were documented in EHR data vs in Medicaid claims data, and we described the sociodemographic characteristics associated with these documentation patterns.

Results: In 2007, the following services were documented in Medicaid claims but not the EHR: 11.6% of total cholesterol screenings received, 7.0% of total influenza vaccinations, 10.5% of nephropathy screenings, and 8.8% of tests for glycated hemoglobin (HbA(1c)). In contrast, the following services were documented in the EHR but not in Medicaid claims: 49.3% of cholesterol screenings, 50.4% of influenza vaccinations, 50.1% of nephropathy screenings, and 48.4% of HbA(1c) tests. Patients who were older, male, Spanish-speaking, above the federal poverty level, or who had discontinuous insurance were more likely to have services documented in the EHR but not in the Medicaid claims data.

Conclusions: Networked EHRs provide new opportunities for obtaining more comprehensive data regarding health services received, especially among populations who are discontinuously insured. Relying solely on Medicaid claims data is likely to substantially underestimate the quality of care.

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Figures
Figure 1.

Relationship between the 2 study…

Figure 1.

Relationship between the 2 study data sources.

Figure 1.

Relationship between the 2 study data sources.