The Application of Medicare Data for Musculoskeletal Research in the United States: A Systematic Review.

Abstract

Musculoskeletal conditions disproportionately affect the lives of aging adults. We aimed to examine the literature using Medicare claims data in the United States for musculoskeletal surgical procedures. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, we searched the PubMed and Medline databases for peer-reviewed articles published between 1990 and 2015. We included the studies that (1) reported primary Medicare claims data use, (2) involved musculoskeletal surgery, and (3) were original peer-reviewed studies. We abstracted the types of surgical procedure and aims, and evaluated outcomes, and strengths and weaknesses of each included article. We assessed the quality of included articles with Newcastle Ottawa Assessment Scale. The literature search returned 3,233 articles, of which 119 met our inclusion criteria. These studies focused on different outcomes: epidemiology and treatment variation (26), cost of care (15), hospital-level analyses (30), health outcomes (31), the validity and accuracy of Medicare claims data (4), disparities in health care (10), and policy evaluation (3). Medicare claims data provide a unique way for researchers to study a nationally representative patient population longitudinally. A significant limitation of using claims data has been a lack of granularity on defining severity of a condition. Therapeutic level III.