EE446 The Missing Link: Evaluating Economic Outcomes of an Uncoded Novel Diagnostic from Claims Data
نویسندگان
چکیده
Healthcare claims are often used to assess medical resource utilization (MRU) and costs but less suited for evaluating novel diagnostics or therapeutics not issued a unique code, limiting payer decision-making on their real-world value. Complicated urinary tract infections (cUTIs) must be diagnosed treated early accurately reduce risk of poor outcomes. We aimed develop evaluate claims-based method identify an uncoded rapid diagnostic (ND) mono/polymicrobial pathogens sensitivities assessed MRU cost outcomes its use compared with standard culture (SC) cUTI. Using 5% 2017-2019 Medicare Limited Dataset, we algorithmically identified Parts A+B beneficiaries cUTI; the specific ND from billed codes, laboratory identifiers test date; UTI-related propensity-matched cUTI cohorts whose outpatient UTIs were entirely versus SC one year following baseline year. About 11% ∼1.5M in each had principal secondary diagnosis UTI. 3184 tests identified, representing 0.40% all UTI tests. Adjusting sample size, this represented 110% laboratories’ reported volume diagnostic. 69 678 individuals propensity-matched. 65.2% 72.0% ≥1 additional (p=0.24). Rates composite (urgent care, emergency, inpatient, skilled nursing) 115.9 199.1 events per 1000 patient-years (p=0.168) mean allowed total (excluding SC) $629.55 (95%CI: 430.27, 920.90) $1,131.39 (1002.16, 1,277.27) (p=0.004). Subgroup analyses suggested greatest benefit diabetics (p=.012). demonstrated found significant patients cUTIs.
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ژورنال
عنوان ژورنال: Value in Health
سال: 2022
ISSN: ['1098-3015', '1524-4733']
DOI: https://doi.org/10.1016/j.jval.2022.04.694