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Combining Multiple Decedent Data Sources for a Population-Based Picture of End-of-Life Healthcare Utilization.

Publication ,  Journal Article
Ma, J; Beliveau, J; Snider, W; Jordan, W; Casarett, D
Published in: J Pain Symptom Manage
September 2021

CONTEXT: Although health systems need to track utilization and mortality, it can be difficult to obtain reliable information on patients who die outside of the health system. This leads to missing data and introduces the potential for bias. OBJECTIVES: To evaluate the linkage of patient death data sources with a tertiary health system electronic health record (EHR) to increase the accuracy of health system end-of-life healthcare utilization data in the last month and six months of life. METHODS: The federal Death Master File (DMF) and North Carolina Department of Health and Human Services (NC DHHS) decedent files from 2017 and 2018 were linked to a health system EHR. Descriptive statistics and chi-square tests were utilized to define impact of additional data sources with demographic data and end-of-life utilization. RESULTS: A total of 65,935 patient deaths were identified through our multi-step data integration process. Approximately a quarter of patients (28.3%) had at least one inpatient or outpatient health system encounter in the last six months of life. Of these, patient deaths identified only in the NC DHHS file were less likely (OR 0.45 [95%CI 0.39-0.52]) to be hospitalized in the last month of life. CONCLUSION: We describe a method to supplement EHR data with decedent information across data sources. While additional decedent data improves the accuracy of death data in the health system, patient healthcare utilization is biased towards those who use the health system at the end of life.

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Published In

J Pain Symptom Manage

DOI

EISSN

1873-6513

Publication Date

September 2021

Volume

62

Issue

3

Start / End Page

e200 / e205

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Patient Acceptance of Health Care
  • Information Storage and Retrieval
  • Humans
  • Electronic Health Records
  • Death
  • Anesthesiology
  • 42 Health sciences
  • 32 Biomedical and clinical sciences
  • 11 Medical and Health Sciences
 

Citation

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Ma, J., Beliveau, J., Snider, W., Jordan, W., & Casarett, D. (2021). Combining Multiple Decedent Data Sources for a Population-Based Picture of End-of-Life Healthcare Utilization. J Pain Symptom Manage, 62(3), e200–e205. https://doi.org/10.1016/j.jpainsymman.2021.03.005
Ma, Jessica, Jessica Beliveau, Wendy Snider, Weston Jordan, and David Casarett. “Combining Multiple Decedent Data Sources for a Population-Based Picture of End-of-Life Healthcare Utilization.J Pain Symptom Manage 62, no. 3 (September 2021): e200–205. https://doi.org/10.1016/j.jpainsymman.2021.03.005.
Ma J, Beliveau J, Snider W, Jordan W, Casarett D. Combining Multiple Decedent Data Sources for a Population-Based Picture of End-of-Life Healthcare Utilization. J Pain Symptom Manage. 2021 Sep;62(3):e200–5.
Ma, Jessica, et al. “Combining Multiple Decedent Data Sources for a Population-Based Picture of End-of-Life Healthcare Utilization.J Pain Symptom Manage, vol. 62, no. 3, Sept. 2021, pp. e200–05. Pubmed, doi:10.1016/j.jpainsymman.2021.03.005.
Ma J, Beliveau J, Snider W, Jordan W, Casarett D. Combining Multiple Decedent Data Sources for a Population-Based Picture of End-of-Life Healthcare Utilization. J Pain Symptom Manage. 2021 Sep;62(3):e200–e205.
Journal cover image

Published In

J Pain Symptom Manage

DOI

EISSN

1873-6513

Publication Date

September 2021

Volume

62

Issue

3

Start / End Page

e200 / e205

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Patient Acceptance of Health Care
  • Information Storage and Retrieval
  • Humans
  • Electronic Health Records
  • Death
  • Anesthesiology
  • 42 Health sciences
  • 32 Biomedical and clinical sciences
  • 11 Medical and Health Sciences