首页> 美国卫生研究院文献>Journal of the American Medical Informatics Association : JAMIA >Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data?
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Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data?

机译:支持健康保险扩展:电子健康记录是否具有有效的保险核实和登记数据?

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摘要

>Objective To validate electronic health record (EHR) insurance information for low-income pediatric patients at Oregon community health centers (CHCs), compared to reimbursement data and Medicaid coverage data.>Materials and Methods Subjects Children visiting any of 96 CHCs (N = 69 189) from 2011 to 2012. Analysis The authors measured correspondence (whether or not the visit was covered by Medicaid) between EHR coverage data and (i) reimbursement data and (ii) coverage data from Medicaid.>Results Compared to reimbursement data and Medicaid coverage data, EHR coverage data had high agreement (87% and 95%, respectively), sensitivity (0.97 and 0.96), positive predictive value (0.88 and 0.98), but lower kappa statistics (0.32 and 0.49), specificity (0.27 and 0.60), and negative predictive value (0.66 and 0.45). These varied among clinics.>Discussion/Conclusions EHR coverage data for children had a high overall correspondence with Medicaid data and reimbursement data, suggesting that in some systems EHR data could be utilized to promote insurance stability in their patients. Future work should attempt to replicate these analyses in other settings.
机译:>目的,以将俄勒冈州社区卫生中心(CHC)的低收入儿科患者的电子健康记录(EHR)保险信息与报销数据和医疗补助覆盖率数据进行比较。>材料和方法主题从2011年到2012年访问96个CHC(N = 69189)中的任何一个的儿童。分析作者测量了EHR覆盖率数据与(i)报销数据和(ii) >结果与报销数据和Medicaid覆盖数据相比,EHR覆盖数据具有较高的一致性(分别为87%和95%),敏感性(0.97和0.96),阳性预测值(0.88)和0.98),但较低的Kappa统计量(0.32和0.49),特异性(0.27和0.60)和阴性预测值(0.66和0.45)。这些不同的诊所之间存在差异。>讨论/结论儿童的EHR覆盖数据与Medicaid数据和报销数据具有较高的总体对应性,这表明在某些系统中EHR数据可用于促进其患者的保险稳定性。未来的工作应尝试在其他环境中复制这些分析。

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