Administrative Data Systems
Since administrative data are by definition created for some purpose other than research, their ‘input’ features must be understood for researchers to properly use them.
Level of the data. By their very nature, medical insurance based administrative data exist at the level of the “event”: hospitalization, physician visit, pharmacy prescription, etc. This is the level at which services are paid for following a utilization event. In some cases, the level of the data relate to an individual patient and might include repeated assessments of some aspect of the patient’s clinical condition; for instance the results of annual screening and/or physical exams.
An additional level is that of the provider organization: the hospital, the nursing home, etc. Such data are also repeated periodically in the form of annual cost reports, inspections, etc. Medicare/Medicaid certified health care maintains and periodically updates “Provider of Service” files for many different types of providers. Cost reports, required of Medicare providers, contain data relevant to staffing, organization, services, and business practices which can then be linked to individual Medicare beneficiaries served by the patient.
Finally, all the levels of data above can be aggregated up to the level of a geographic area, such as a zip code, county, Hospital Service Area, Hospital Referral Region or state (Cooper, Yuan et al., 2001; Wennberg, Fisher et al., 2004a).