Use of Open Claims vs Closed Claims in Health Outcomes Research

**Background:** Closed claims are frequently used in outcomes research studies. Lately, the availability of open claims has increased the possibility of obtaining information faster and on a larger scale. However, because of the possibility of missing claims and duplications, these data sets have no...

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Main Authors: Onur Baser, Gabriela Samayoa, Nehir Yapar, Erdem Baser, Fatih Mete
Format: Article
Language:English
Published: Columbia Data Analytics, LLC 2023-09-01
Series:Journal of Health Economics and Outcomes Research
Online Access:https://doi.org/10.36469/001c.87538
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author Onur Baser
Gabriela Samayoa
Nehir Yapar
Erdem Baser
Fatih Mete
author_facet Onur Baser
Gabriela Samayoa
Nehir Yapar
Erdem Baser
Fatih Mete
author_sort Onur Baser
collection DOAJ
description **Background:** Closed claims are frequently used in outcomes research studies. Lately, the availability of open claims has increased the possibility of obtaining information faster and on a larger scale. However, because of the possibility of missing claims and duplications, these data sets have not been highly utilized in medical research. **Objective:** To compare frequently used healthcare utilization measures between closed claims and open claims to analyze if the possibility of missing claims in open claims data creates a downward bias in the estimates. **Methods:** We identified 18 different diseases using 2022 data from 2 closed claims data sets (MarketScan® and PharMetrics® Plus) and 1 open claims database (Kythera). After applying an algorithm that removes possible duplications from open claims data, we compared healthcare utilizations such as inpatient, emergency department, and outpatient use and length of stay among these 3 data sets. We applied standardized differences to compare the medians for each outcome. **Results:** The sample size of the open claims data sets was 10 to 65 times larger than closed claims data sets depending on disease type. For each disease, the estimates of healthcare utilization were similar between the open claims and closed claims data. The difference was statistically insignificant. **Conclusions:** Open claims data with a bigger sample size and more current available information provide essential advantages for healthcare outcomes research studies. Therefore, especially for new medications and rare diseases, open claims data can provide information much earlier than closed claims, which usually have a time lag of 6 to 8 months.
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spelling doaj-art-008bc94adcf642f68f3a715e43a2d56e2025-02-10T16:13:19ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362023-09-01102Use of Open Claims vs Closed Claims in Health Outcomes ResearchOnur BaserGabriela SamayoaNehir YaparErdem BaserFatih Mete**Background:** Closed claims are frequently used in outcomes research studies. Lately, the availability of open claims has increased the possibility of obtaining information faster and on a larger scale. However, because of the possibility of missing claims and duplications, these data sets have not been highly utilized in medical research. **Objective:** To compare frequently used healthcare utilization measures between closed claims and open claims to analyze if the possibility of missing claims in open claims data creates a downward bias in the estimates. **Methods:** We identified 18 different diseases using 2022 data from 2 closed claims data sets (MarketScan® and PharMetrics® Plus) and 1 open claims database (Kythera). After applying an algorithm that removes possible duplications from open claims data, we compared healthcare utilizations such as inpatient, emergency department, and outpatient use and length of stay among these 3 data sets. We applied standardized differences to compare the medians for each outcome. **Results:** The sample size of the open claims data sets was 10 to 65 times larger than closed claims data sets depending on disease type. For each disease, the estimates of healthcare utilization were similar between the open claims and closed claims data. The difference was statistically insignificant. **Conclusions:** Open claims data with a bigger sample size and more current available information provide essential advantages for healthcare outcomes research studies. Therefore, especially for new medications and rare diseases, open claims data can provide information much earlier than closed claims, which usually have a time lag of 6 to 8 months.https://doi.org/10.36469/001c.87538
spellingShingle Onur Baser
Gabriela Samayoa
Nehir Yapar
Erdem Baser
Fatih Mete
Use of Open Claims vs Closed Claims in Health Outcomes Research
Journal of Health Economics and Outcomes Research
title Use of Open Claims vs Closed Claims in Health Outcomes Research
title_full Use of Open Claims vs Closed Claims in Health Outcomes Research
title_fullStr Use of Open Claims vs Closed Claims in Health Outcomes Research
title_full_unstemmed Use of Open Claims vs Closed Claims in Health Outcomes Research
title_short Use of Open Claims vs Closed Claims in Health Outcomes Research
title_sort use of open claims vs closed claims in health outcomes research
url https://doi.org/10.36469/001c.87538
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AT fatihmete useofopenclaimsvsclosedclaimsinhealthoutcomesresearch