Claims data linked to hospital registry data enhance evaluation of the quality of care of breast cancer.
BACKGROUND
Complete treatment data is central to evaluation and improvement of cancer care quality. Cancer registries vary in completeness of radiation (RT), chemotherapy (CT), and hormone therapy (HT) data. Administrative claims from health payers may supplement these registries. This study assesses the ability to link private payer claims to the National Cancer Data Base (NCDB) and the extent of additional treatment data identified in claims.


METHODS
Claims for patients with breast cancer surgery from one payer in Western New York (WNY) were matched with NCDB for participating hospitals for 2001-2003 using available identifiers (reporting hospital, gender, birth date, ZIP code). Claims were analyzed for breast and axillary surgery, RT, CT, and HT, and compared with treatment recorded in the NCDB.


RESULTS
Four hundred seventy women had claims for breast cancer surgery and 439 (91%) matched to the NCDB. Seventeen had duplicate/incomplete records. Non-matches included cases with surgery for cancer recurrence. Among 422 evaluable cases, stage was 0: 9%; I: 49%; II: 33%; III: 7%; and IV: 2%. Claims and registry were highly concordant for surgery. Registry identified RT, CT, and HT in 38%, 47%, 18%, respectively, of treatment reported in claims. Claims also provided information on drugs used and treatment duration.


CONCLUSIONS
The NCDB can be matched with private payer claims using available identifiers. Registry data in this convenience sample of hospitals did not include a substantial fraction of outpatient data identified by claims. Private payer claims may help enhance the completeness of NCDB treatment information.
Meguerditchian
Ari-Nareg
AN
Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.
Stewart
Andrew
A
Roistacher
James
J
Watroba
Nancy
N
Cropp
Michael
M
Edge
Stephen B
SB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D003625:Data Collection / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data*; D008498:Medical Record Linkage; D008875:Middle Aged; D009518:New York; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data*