The primary data sources for the Medicare population are the Medicare Provider Analysis and Review (MedPAR
) Inpatient Research Identifiable Files (RIFs) for 2007-2008 and the 100 percent Inpatient Limited Data Set (LDS) Standard Analytic Files for 2009-2013.
Using the hospital Medicare provider ID, we merged HSOPS data from the 264 hospitals providing safety culture information with MedPAR
patient-level data for AMI discharges from the same institutions.
First, the MEDPAR
files were used to identify 17 major procedures performed on Medicare beneficiaries 65 years of age or over.
file has an encrypted health insurance claim (HIC) number for every hospital admission, which permits linking records from different episodes.
This approach to defining transfers is used because previous studies of Medicare transfers found that the admission and discharge destination information in the MEDPAR
file were often inconsistent (Jencks and Bobula, 1988; Freiman and Sederer, 1990).
In brief, we used the MedPAR
, Outpatient, and Carrier RIFs to identify all of the PCPs and medical and surgical specialists who billed for services rendered during a claims window beginning 30 days prior to a beneficiary's surgery and extending 60 days after hospital discharge.
Furthermore, because the 1981 MEDPAR
file has only one procedure code, it is a less reliable source of data for surgical procedures than later HCFA files.
(16,17) The American Hospital Association (AHA) and MedPAR
and Provider of Services data downloaded from CMS provided hospital characteristics.
All research was based on the following public data sets: Medicare cost reports, Medicare Provider Analysis and Review (MEDPAR
) data, and core measures and patient satisfaction data from the Centers for Medicare & Medicaid Services (CMS) Hospital Compare website.
We acquired inpatient hospital admissions data using the Medicare Provider Analysis and Review (MEDPAR
) files from the Center for Medicare and Medicaid Services (CMS).
* Statistics are based on Healthgrades analysis of MedPAR
data for years 2015 through 2017 and represent three-year estimates for Medicare patients only.
Statistics are based on Healthgrades analysis of MedPAR
data for years 2014 through 2016 and represent 3-year estimates for Medicare patients only.