Abstract

The MarketScan Medicare Supplemental Database provides detailed cost, use and outcomes data for healthcare services performed in both inpatient and outpatient settings.

It Include Medicare Supplemental records for all years, and Medicare Advantage records starting in 2020. This page also contains the MarketScan Medicare Lab Database starting in 2018.

Starting in 2026, there will be a data access fee for using the full dataset. Please refer to the 'Usage Notes' section of this page for more information.

Methodology

MarketScan Research Databases are a family of data sets that fully integrate many types of data for healthcare research, including:

• De-identified records of more than 250 million patients (medical, drug and dental)

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• Laboratory results

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• Hospital discharges

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The MarketScan Databases track millions of patients throughout the healthcare system. The data are contributed by large employers, managed care organizations, hospitals, EMR providers and Medicare.

Usage

This page contains the MarketScan Medicare Database.

We also have the following on other pages:

• The MarketScan Commercial Database
• The MarketScan Dental Database
• The MarketScan Benefit Plan Design data
• MarketScan Redbook (The MarketScan Code Reference Book)

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**Starting in 2026, there will be a data access fee for using the full dataset **

(though the 1% sample will remain free to use). The pricing structure and other

**relevant information can be found in this **FAQ Sheet.

Before Manuscript Submission

All manuscripts (and other items you'd like to publish) must be submitted to

support@stanfordphs.freshdesk.com for approval prior to journal submission.

We will check your cell sizes and citations.

For more information about how to cite PHS and PHS datasets, please visit:

https:/phsdocs.developerhub.io/need-help/citing-phs-data-core

Data Documentation

Data access is required to view this section.

Section 2

Metadata access is required to view this section.

Section 3

Metadata access is required to view this section.

The Agency for Healthcare Research and Quality (AHRQ) created SyH-DR from eligibility and claims files for Medicare, Medicaid, and commercial insurance plans in calendar year 2016. SyH-DR contains data from a nationally representative sample of insured individuals for the 2016 calendar year. SyH-DR uses synthetic data elements at the claim level to resemble the marginal distribution of the original data elements. SyH-DR person-level data elements are not synthetic, but identifying information is aggregated or masked.

Abstract

The MarketScan Commercial Database (previously called the 'MarketScan Database') contains real-world data for healthcare research and analytics to examine health economics and treatment outcomes.

This page also contains the MarketScan Commercial Lab Database starting in 2018.

Starting in 2026, there will be a data access fee for using the full dataset. Please refer to the 'Usage Notes' section of this page for more information.

Methodology

MarketScan Research Databases are a family of data sets that fully integrate many types of data for healthcare research, including:

• De-identified records of more than 188 million patients (medical, drug and dental)

%3C!-- --%3E

• Laboratory results

%3C!-- --%3E

• Hospital discharges

%3C!-- --%3E

The MarketScan Databases track millions of patients throughout the healthcare system. The data are contributed by large employers, managed care organizations, hospitals, EMR providers, and Medicare.

Usage

This page contains the MarketScan Commercial Database.

We also have the following on other pages:

• The MarketScan Medicare Supplemental Database
• The MarketScan Dental Database
• The MarketScan Benefit Plan Design data
• MarketScan Redbook (The MarketScan Code Reference Book)

%3C!-- --%3E

**Starting in 2026, there will be a data access fee for using the full dataset **(though the 1% sample will remain free to use). The pricing structure and other **relevant information can be found in this **FAQ Sheet.

Before Manuscript Submission

All manuscripts (and other items you'd like to publish) must be submitted to support@stanfordphs.freshdesk.com for approval prior to journal submission.

We will check your cell sizes and citations.

For more information about how to cite PHS and PHS datasets, please visit:

https:/phsdocs.developerhub.io/need-help/citing-phs-data-core

Data Documentation

Data access is required to view this section.

Section 2

Metadata access is required to view this section.

Section 3

Metadata access is required to view this section.

Usage FAQs (Answers provided in User Guide starting on page 56)

Metadata access is required to view this section.

Abstract

We had to delete V3 of MarketScan Medicare Supplemental because of some unusual circumstances with the formats of some of the files we were sent (to prevent the duplication of records). V3.1 contains all of the info that was in V3, however V3.1 has 2022 data & a slightly different version of the 2021 data. The data on this page is the version of the 2021 data that was in V3. Our purpose in posting this is to enable researchers who completed analyses on V3 to replicate their work by combining the data here with the data on the main page.

FOR THE MAJORITY OF RESEARCHERS, however, we strongly recommend using V3.1, and ignoring this page, as it will be irrelevant for most research going forward. (Rule of thumb: If you are unsure whether you need the data on this page, then you probably don't need it.)

Usage

To recreate V3 of the data, use the data for 2020 and earlier that is on the main MarketScan Medicare Supplemental page, and combine it with the data on this page. That will give you the exact same data that was in V3.

The data documentation on the main MarketScan Medicare Supplemental page also applies to the data on this page.

How is the data on this page different from the 2021 data on the main MarketScan Medicare Supplemental page?

Metadata access is required to view this section.

All credit for variables in AHRQ_included_variables.csv is attributed to

• AHRF: Area Health Resources Files (AHRF) 2009-2018. US Department of Health and
  Human Services, Health Resources and Services Administration, Bureau of Health Workforce,
  Rockville, MD.
• AHRQ SDOH Database (v1), from American Hospital Association Annual Survey Data,
  https://www.ahadata.com/,
• AHRQ SDOH Database (v1), from Health Resources and Services Administration. (2021, Nov 1).
  Area Health Resources Files [Database]. U.S. Department of Health and Human Services, Health
  Resources and Services Administration, Bureau of Health Workforce.
  https://data.hrsa.gov/data/download.
• AHRQ SDOH Database (v1), from the Foundation for AIDS Research. Opioid & Health Indicators
  Database. https://opioid.amfar.org/about/download
• AHRQ SDOH Database (v1), from United States Census Bureau. (n.d.). County Adjacency File
  [Data file]. https://www.census.gov/geographies/reference-files/2010/geo/countyadjacency.html.
• AHRQ SDOH Database (v1), from United States Census Bureau. County Business Patterns [Data
  series]. U.S. Department of Commerce, Bureau of the Census, Data User Services Division.
  https://www.census.gov/programs-surveys/cbp/data/tables.html.
• AHRQ SDOH Database (v1), from Local Education Agency (School District) Finance Survey (F-33)
  Data, v.1a—Provisional Common Core of Data (CCD) - CCD Data Files (ed.gov). Retrieved March
  2021 from https://nces.ed.gov/ccd/files.asp#Fiscal:1,LevelId:5,Page:1.
• AHRQ SDOH Database (v1), from Centers for Disease Control and Prevention, Division for Heart
  Disease and Stroke Prevention, Interactive Atlas of Heart Disease and Stroke,
  http://nccd.cdc.gov/DHDSPAtlas.
• AHRQ SDOH Database (v1), from Centers for Disease Control and Prevention. NCHHSTP
  AtlasPlus. Updated 2017. https://www.cdc.gov/nchhstp/atlas/index.htm.
• AHRQ SDOH Database (v1), from PLACES: Local Data for Better Health. Center for Disease
  Control and Prevention (2020 and 2021 Release). Retrieved January 2022 from:
  https://chronicdata.cdc.gov/browse?category=500+Cities+%26+Places&sortBy=newest&utf8.
• AHRQ SDOH Database (v1), from Centers for Disease Control and Prevention, National Center for
  Health Statistics. Multiple Cause of Death, 1999–2019, in CDC WONDER Online Database. (2021).
  Data are from the Multiple Cause of Death Files, 1999–2019, as compiled from data provided by
  the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program.
  http://wonder.cdc.gov/mcd-icd10.html.
• United States Census Bureau. Cartographic Boundary Files – Shapefile.
  https://www.census.gov/geographies/mapping-files/time-series/geo/carto-boundary-file.html.
• AHRQ SDOH Database (v1), from Robert Wood Johnson Foundation, & University of Wisconsin
  Population Health Institute. (2020). County Health Rankings & Roadmaps.
  https://www.countyhealthrankings.org.
• AHRQ SDOH Database (v1), from U.S. Department of Education. (n.d.). Civil Rights Data
  Collection. Retrieved September 2021, from https://ocrdata.ed.gov.
• AHRQ SDOH Database (v1), from Community Resilience Estimates Social, Economic, and
  Housing Statistics Division U.S. Census Bureau. Retrieved September 2021 from
  https://www.census.gov/programs-surveys/community-resilience-estimates.html.
• AHRQ SDOH Database (v1), from United States Environmental Protection Agency. Outdoor Air
  Quality Data. Air Quality Statistics Report. Retrieved March 2022 from:
  https://www.epa.gov/outdoor-air-quality-data/air-quality-statistics-report
• AHRQ SDOH Database (v1), from United States Environmental Protection Agency (EPA) National
  Walkability Index (2021). Retrieved June 2021 from: https://catalog.data.gov/dataset/walkabilityindex.
• AHRQ SDOH Database (v1), from U.S. Department of Agriculture, Economic Research Service.
  2010 Rural-Urban Commuting Area codes, from https://www.ers.usda.gov/data-products/ruralurban-commuting-area-codes.
• AHRQ SDOH Database (v1), from Economic Research Service (ERS), U.S. Department of
  Agriculture (USDA). Food Access Research Atlas, Retrieved November 2021 from
  https://www.ers.usda.gov/data-products/food-access-research-atlas/
• AHRQ SDOH Database (v1), from U.S. Department of Agriculture (USDA), Economic Research
  Service (ERS) 2020. Food Environment Atlas. Retrieved September 2021 from:
  https://www.ers.usda.gov/data-products/food-environment-atlas/data-access-anddocumentation-downloads/.
• AHRQ SDOH Database (v1), from LTCFocus Public Use Data sponsored by the National Institute
  on Aging (P01 AG027296) through a cooperative agreement with the Brown University School of
  Public Health. Available at www.ltcfocus.org. https://doi.org/10.26300/h9a2-2c26.
• AHRQ SDOH Database (v1), from Centers for Medicare & Medicaid Services. (n.d.). Home Health
  Compare. https://www.medicare.gov/nursinghomecompare/search.html.
• AHRQ SDOH Database (v1), from the Department of Homeland Security. Homeland Infrastructure
  Foundation-Level Data (HIFLD)—Urgent Care Facilities. 2018. Available: https://hifldgeoplatform.opendata.arcgis.com/datasets/urgent-care-facilities.
• AHRQ SDOH Database (v1), from the Indian Health Service. IHS facilities. 2021. Available:
  https://www.ihs.gov/locations/.
• AHRQ SDOH Database (v1), from the Centers for Medicare & Medicaid Services. (2020, June). MA
  State/County Penetration, from https://www.cms.gov/Research-Statistics-DataandSystems/Statistics-Trends-and-Reports/MCRAdvPartDEnrolData/MA-State-CountyPenetration.
• AHRQ SDOH Database (v1), from the Centers for Medicare & Medicaid Services. (2020, June).
  Medicare Geographic Variation Public Use File, from https://www.cms.gov/Research-StatisticsData-and-Systems/Statistics-Trends-and-Reports/Medicare-Geographic-Variation/GV_PUF.
• AHRQ SDOH Database (v1), from the Centers for Disease Control and Prevention; U.S.
  Department of Health and Human Services; Agency for Toxic Substances and Disease Registry.
  Minority Health Social Vulnerability Index 2018. Retrieved July 2021 from
  https://www.minorityhealth.hhs.gov/minority-health-svi/.
• AHRQ SDOH Database (v1), from the Centers for Medicare & Medicaid Services, Office of Minority
  Health. (2020). Medicare Mapping Disparities Tool, from https://data.cms.gov/tools/mappingmedicare-disparities-by-population.
• AHRQ SDOH Database (v1), from the Health Resources and Services Administration. (2021).
  Medically Underserved Areas, from https://data.hrsa.gov/data/download.
• AHRQ SDOH Database (v1), from Ingram, D. D., & Franco, S. J. (2014, April). 2013 NCHS urban–
  rural classification scheme for counties. Vital and Health Statistics. Series 2, Data Evaluation and
  Methods Research. Number 166, 1–73. https://pubmed.ncbi.nlm.nih.gov/24776070.
• AHRQ SDOH Database (v1), from the Centers for Disease Control and Prevention. (2020).
  National Environmental Public Health Tracking Network from https://www.cdc.gov/ephtracking.
• AHRQ SDOH Database (v1), from the Centers for Medicare & Medicaid Services. (n.d.). Nursing
  Home Compare. https://www.medicare.gov/nursinghomecompare/search.html.
• Vose, R. S., Applequist, S., Squires, M., Durre, I., Menne, M. J., Williams, C. N., Jr., Fenimore, C.,
  Gleason, K., & Arndt, D. (2014). Improved Historical Temperature and Precipitation Time Series for
  U.S. Climate Divisions, Journal of Applied Meteorology and Climatology, 53(5), 1232-1251.
  Retrieved Oct 29, 2021, from https://journals.ametsoc.org/view/journals/apme/53/5/jamc-d-13-
  0248.1.xml.
  AHRQ SDOH Database (v1), from Vose, Russell S.; Applequist, Scott; Squires, Mike; Durre, Imke;
  Menne, Matthew J.; Williams, Claude N., Jr.; Fenimore, Chris; Gleason, Karin; Arndt, Derek (2014):
  NOAA Monthly U.S. Climate Divisional Database (NClimDiv). NOAA National Climatic Data Center.
  doi:10.7289/V5M32STR. Retrieved from: https://www.ncei.noaa.gov/data/climdiv/access/.
• AHRQ SDOH Database (v1), from National Center for Environmental Information (NCEI), National
  Environmental Satellite, Data and Information Service (NESDIS) and National Oceanic and
  Atmospheric Administration (NOAA), Storm Events Database 2009-2020 Retrieved August 2021
  from https://www.ncei.noaa.gov/pub/data/swdi/stormevents/csvfiles/.
• AHRQ SDOH Database (v1), from U.S. Census Bureau, Opportunity Insights. Opportunity Atlas [All
  Outcomes by Census Tract Race, Gender, and Parental Income Percentile, All Outcomes by
  County Race, Gender, and Parental Income Percentile] Retrieved October 2021 from:
  https://www.c
• AHRQ SDOH Database (v1), from National Center for Education Statistics. U.S. Skills Map: State
  and County Indicators of Adult Literacy and Numeracy. Retrieved March 2021 from:
  https://nces.ed.gov/surveys/piaac/skillsmap/.
• AHRQ SDOH Database (v1), from Centers for Medicare & Medicaid Services. (n.d.). Physician
  Compare. https://data.cms.gov/provider-data/topics/doctors-clinicians.
• AHRQ SDOH Database (v1), from Centers for Medicare & Medicaid Services. (n.d.). Provider of
  Services File. https://www.cms.gov/Research-Statistics-Data-and-Systems/Downloadable-PublicUse-Files/Provider-of-Services.
• AHRQ SDOH Database (v1), from Small Area Health Insurance Estimates. (n.d.). U.S. Census
  Bureau. https://www.census.gov/data/datasets/time-series/demo/sahie/estimates-acs.html
• AHRQ SDOH Database (v1), from Reardon, S. F., Ho, A. D., Shear, B. R., Fahle, E. M., Kalogrides, D.,
  Jang, H., &

The Healthcare Cost and Utilization Project (HCUP) Nationwide Emergency Department Sample (NEDS) is the largest all-payer emergency department (ED) database in the United States. yielding national estimates of hospital-owned ED visits. Unweighted, it contains data from over 30 million ED visits each year. Weighted, it estimates roughly 145 million ED visits nationally. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality, HCUP data inform decision making at the national, State, and community levels. Sampled from the HCUP State Inpatient Databases (SID) and State Emergency Department Databases (SEDD), the HCUP NEDS can be used to create national and regional estimates of ED care. The SID contain information on patients initially seen in the ED and subsequently admitted to the same hospital. The SEDD capture information on ED visits that do not result in an admission (i.e., treat-and-release visits and transfers to another hospital). Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality, HCUP data inform decision making at the national, State, and community levels. The NEDS contain information about geographic characteristics, hospital characteristics, patient characteristics, and the nature of visits (e.g., common reasons for ED visits, including injuries). The NEDS contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). It includes ED charge information for over 85% of patients, regardless of expected payer, including but not limited to Medicare, Medicaid, private insurance, self-pay, or those billed as ‘no charge’. The NEDS excludes data elements that could directly or indirectly identify individuals, hospitals, or states.Restricted access data files are available with a data use agreement and brief online security training.

The Nuclear Medicine National HQ System database is a series of MS Excel spreadsheets and Access Database Tables by fiscal year. They consist of information from all Veterans Affairs Medical Centers (VAMCs) performing or contracting nuclear medicine services in Veterans Affairs medical facilities. The medical centers are required to complete questionnaires annually (RCS 10-0010-Nuclear Medicine Service Annual Report). The information is then manually entered into the Access Tables, which includes: * Distribution and cost of in-house VA - Contract Physician Services, whether contracted services are made via sharing agreement (with another VA medical facility or other government medical providers) or with private providers. * Workload data for the performance and/or purchase of PET/CT studies. * Organizational structure of services. * Updated changes in key imaging service personnel (chiefs, chief technicians, radiation safety officers). * Workload data on the number and type of studies (scans) performed, including Medicare Relative Value Units (RVUs), also referred to as Weighted Work Units (WWUs). WWUs are a workload measure calculated as the product of a study's Current Procedural Terminology (CPT) code, which consists of total work costs (the cost of physician medical expertise and time), and total practice costs (the costs of running a practice, such as equipment, supplies, salaries, utilities etc). Medicare combines WWUs together with one other parameter to derive RVUs, a workload measure widely used in the health care industry. WWUs allow Nuclear Medicine to account for the complexity of each study in assessing workload, that some studies are more time consuming and require higher levels of expertise. This gives a more accurate picture of workload; productivity etc than using just 'total studies' would yield. * A detailed Full-Time Equivalent Employee (FTEE) grid, and staffing distributions of FTEEs across nuclear medicine services. * Information on Radiation Safety Committees and Radiation Safety Officers (RSOs). Beginning in 2011 this will include data collection on part-time and non VA (contract) RSOs; other affiliations they may have and if so to whom they report (supervision) at their VA medical center.Collection of data on nuclear medicine services' progress in meeting the special needs of our female veterans. Revolving documentation of all major VA-owned gamma cameras (by type) and computer systems, their specifications and ages. * Revolving data collection for PET/CT cameras owned or leased by VA; and the numbers and types of PET/CT studies performed on VA patients whether produced on-site, via mobile PET/CT contract or from non-VA providers in the community.* Types of educational training/certification programs available at VA sites * Ongoing funded research projects by Nuclear Medicine (NM) staff, identified by source of funding and research purpose. * Data on physician-specific quality indicators at each nuclear medicine service.* Academic achievements by NM staff, including published books/chapters, journals and abstracts. * Information from polling field sites re: relevant issues and programs Headquarters needs to address. * Results of a Congressionally mandated contracted quality assessment exercise, also known as a Proficiency study. Study results are analyzed for comparison within VA facilities (for example by mission or size), and against participating private sector health care groups. * Information collected on current issues in nuclear medicine as they arise. Radiation Safety Committee structures and membership, Radiation Safety Officer information and information on how nuclear medicine services provided for female Veterans are examples of current issues.The database is now stored completely within MS Access Database Tables with output still presented in the form of Excel graphs and tables.

Abstract

The MarketScan Commercial Database (previously called the 'MarketScan Database') contains real-world data for healthcare research and analytics to examine health economics and treatment outcomes.

This page also contains the MarketScan Commercial Lab Database starting in 2018.

Starting in 2026, there will be a data access fee for using the full dataset. Please refer to the 'Usage Notes' section of this page for more information.

Methodology

MarketScan Research Databases are a family of data sets that fully integrate many types of data for healthcare research, including:

• De-identified records of more than 188 million patients (medical, drug and dental)

%3C!-- --%3E

• Laboratory results

%3C!-- --%3E

• Hospital discharges

%3C!-- --%3E

The MarketScan Databases track millions of patients throughout the healthcare system. The data are contributed by large employers, managed care organizations, hospitals, EMR providers, and Medicare.

Usage

This page contains the MarketScan Commercial Database.

We also have the following on other pages:

• The MarketScan Medicare Supplemental Database
• The MarketScan Dental Database
• The MarketScan Benefit Plan Design data
• MarketScan Redbook (The MarketScan Code Reference Book)

%3C!-- --%3E

**Starting in 2026, there will be a data access fee for using the full dataset **(though the 1% sample will remain free to use). The pricing structure and other **relevant information can be found in this **FAQ Sheet.

Before Manuscript Submission

All manuscripts (and other items you'd like to publish) must be submitted to support@stanfordphs.freshdesk.com for approval prior to journal submission.

We will check your cell sizes and citations.

For more information about how to cite PHS and PHS datasets, please visit:

https:/phsdocs.developerhub.io/need-help/citing-phs-data-core

Data Documentation

Data access is required to view this section.

Section 2

Metadata access is required to view this section.

Section 3

Metadata access is required to view this section.

Usage FAQs (Answers provided in User Guide starting on page 56)

Metadata access is required to view this section.

Negative exposure control: anomalously cool weather and MS-related visits, 2003–20171,2,3.

These are peer-reviewed supplementary materials for the article 'Impact of surgical complications on hospital costs and revenues: retrospective database study of Medicare claims' published in the Journal of Comparative Effectiveness Research.Figure A1: Comparison of study complication rates to the ACS NSQIP risk calculator average risk of any complication for the procedures of interest.Table A1: Summary of covariates, full dataset and matched dataset. Table A2: Matched dataset balance diagnostics. Standardized mean differences. No complications (control) versus complications.Table A3: Procedures and diagnoses (i.e., complications) groups, ICD10 codes and countsTable A4: Comparison of Study complication rates to ACS NSQIP average risk of any and serious complicationsAim: To compare the length of stay, hospital costs and hospital revenues for Medicare patients with and without a subset of potentially preventable postoperative complications after major noncardiac surgery. Materials & methods: Retrospective data analysis using the Medicare Standard Analytical Files, Limited Data Set, 5% inpatient claims files for years 2016–2020. Results: In 74,103 claims selected for analysis, 71,467 claims had no complications and 2636 had one or more complications of interest. Claims with complications had significantly longer length of hospital stay (12.41 vs 3.95 days, p < 0.01), increased payments to the provider ($34,664 vs $16,641, p < 0.01) and substantially higher estimates of provider cost ($39,357 vs $16,158, p < 0.01) compared with claims without complications. This results on average in a negative difference between payments and costs for patients with complications compared with a positive difference for claims without complications (-$4693 vs $483, p < 0.01). Results were consistent across three different cost estimation methods used in the study. Conclusion: Compared with patients without postoperative complications, patients developing complications stay longer in the hospital and incur increased costs that outpace the increase in received payments. Complications are therefore costly to providers and payers, may negatively impact hospital profitability, and decrease the quality of life of patients. Quality initiatives aimed at reducing complications can be immensely valuable for both improving patient outcomes and hospital finances.

Descriptive characteristics of 3957 patients of study population within the Surveillance, Epidemiology, and End Results (SEER) Medicare-linked database and 272 propensity score-matched patients.

This directory contains analytic code used to build cohorts, dependent variables, and covariates, and run all statistical analyses for the study, "Changes in care associated with integrating Medicare and Medicaid for dual eligible individuals: Examination of a Fully Integrated Special Needs Plan."The code files enclosed in this directory are:SAS_Cohorts_Outcomes 23-9-30.sas. This SAS code file builds study cohorts, dependent variables, and covariates. This code produced a person-by-month level database of outcomes and covariates for individuals in the integration and comparison cohorts.STATA_Models_23-6-5_weight_jama.do. This Stata program reads in the person-by-month level database (output from SAS) and conducts all statistical analyses used to produce the main and supplementary analyses reported in the manuscript.We have provided this code and documentation to disclose our study methods. Our Data Use Agreements prohibit publishing of row-level data for this study. Therefore, researchers would need to obtain Data Use Agreements with data providers to implement these analyses. We also note that some measures reference macros with proprietary code (e.g., Medispan® files) which require a separate user license to run. Interested readers should contact the study PI, Eric T. Roberts (eric.roberts@pennmedicine.upenn.edu) for further information.

Statistical Analysis Plan (SAP) for detailing methods on comparing rates of cancer between patients with Membranous Nephropathy (MN) and others of the same sex and age without MN.

We will analyze data from Truven Health MarketScan Research Databases (MarketScan) and the MarketScan Medicare Supplemental Database (MS-Medicare). These databases capture commercial claims from inpatient and outpatient encounters from employees and their dependents from a selection of large employers, health plans, and governmental, and public organizations.

United States NHE: Research data was reported at 47.670 USD bn in 2016. This records an increase from the previous number of 46.451 USD bn for 2015. United States NHE: Research data is updated yearly, averaging 10.836 USD bn from Dec 1960 (Median) to 2016, with 57 observations. The data reached an all-time high of 49.658 USD bn in 2011 and a record low of 694.000 USD mn in 1960. United States NHE: Research data remains active status in CEIC and is reported by Centers for Medicare & Medicaid Services . The data is categorized under Global Database’s USA – Table US.G083: National Health Expenditures.

United States NHE: Research: Federal Government data was reported at 35.557 USD bn in 2016. This records an increase from the previous number of 34.761 USD bn for 2015. United States NHE: Research: Federal Government data is updated yearly, averaging 8.618 USD bn from Dec 1960 (Median) to 2016, with 57 observations. The data reached an all-time high of 39.022 USD bn in 2011 and a record low of 504.000 USD mn in 1960. United States NHE: Research: Federal Government data remains active status in CEIC and is reported by Centers for Medicare & Medicaid Services . The data is categorized under Global Database’s USA – Table US.G084: National Health Expenditures.

The Healthcare Cost and Utilization Project (HCUP) State Emergency Department Databases (SEDD) contain the universe of emergency department visits in participating States. The data are translated into a uniform format to facilitate multi-State comparisons and analyses. The SEDD consist of data from hospital-based emergency department visits that do not result in an admission. The SEDD include all patients, regardless of the expected payer including but not limited to Medicare, Medicaid, private insurance, self-pay, or those billed as ‘no charge’. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ), HCUP data inform decision making at the national, State, and community levels. The SEDD contain clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and facilities (as required by data sources). Data elements include but are not limited to: diagnoses, procedures, admission and discharge status, patient demographics (e.g., sex, age, race), total charges, length of stay, and expected payment source, including but not limited to Medicare, Medicaid, private insurance, self-pay, or those billed as ‘no charge’. In addition to the core set of uniform data elements common to all SEDD, some include State-specific data elements. The SEDD exclude data elements that could directly or indirectly identify individuals. For some States, hospital and county identifiers are included that permit linkage to the American Hospital Association Annual Survey File and the Bureau of Health Professions' Area Resource File except in States that do not allow the release of hospital identifiers. Restricted access data files are available with a data use agreement and brief online security training.

Negative exposure control: random permutation of temperature anomalies, 2003–20171,2,3.

BackgroundThe number of patients with diabetes is increasing particularly in Asia-Pacific region. Many of them are treated with antidiabetics. As the basis of the studies on the benefit and harm of antidiabetic drugs in the region, the information on patterns of market penetration of new classes of antidiabetic medications is important in providing context for subsequent research and analyzing and interpreting results.MethodsWe compared penetration patterns of dipeptidyl peptidase-4 (DPP-4) inhibitors in Taiwan, Hong Kong, Japan, and the United States. We used the Taiwan National Health Insurance Research Database, a random sample of the Hong Kong Clinical Data Analysis and Reporting System, the Japan Medical Data Center database, and a 5% random sample of the US Medicare database converted to the Observational Medical Outcomes Partnership’s Common Data Model to identify new users of oral antidiabetic medications. We standardized prevalence and incidence rates of medication use by age and sex to those in the 2010 Taiwanese population. We compared age, sex, comorbid conditions, and concurrent medications between new users of DPP-4 inhibitors and biguanides.ResultsUse of DPP-4 inhibitors 1 year after market entry was highest in Japan and lowest in Hong Kong. New users had more heart failure, hyperlipidemia, and renal failure than biguanide users in Taiwan, Hong Kong, and the United States while the proportions were similar in Japan. In a country with low penetration of DPP-4 inhibitors (eg, Hong Kong), users had diabetes with multiple comorbid conditions compared with biguanidine users. In a country with high penetration (eg, Japan), the proportion of users with comorbid conditions was similar to that of biguanide users.ConclusionsWe observed a marked difference of the penetration patterns of newly marketed antidiabetics in different countries in Asia. Those results will provide the basic information useful in the future studies.

United States NHE: Research: Private data was reported at 5.466 USD bn in 2016. This records an increase from the previous number of 5.301 USD bn for 2015. United States NHE: Research: Private data is updated yearly, averaging 839.000 USD mn from Dec 1960 (Median) to 2016, with 57 observations. The data reached an all-time high of 5.466 USD bn in 2016 and a record low of 139.000 USD mn in 1960. United States NHE: Research: Private data remains active status in CEIC and is reported by Centers for Medicare & Medicaid Services . The data is categorized under Global Database’s USA – Table US.G083: National Health Expenditures.

Demographic and clinical characteristics of patients with HCC