Medicare Reimbursements (1992-2019)

<h2>Overview</h2>
<p>The Dartmouth Institute for Health Policy and Clinical Practice (TDI) has created a publicly available source of data that provides researchers, payers, regulators, and innovators with metrics that quantify temporal and regional patterns of health care spending and utilization in the United States. Using CMS Medicare claims data (mostly for age >64 enrollees), Atlas researchers built cohorts (“denominators”) and numerous measures or events (“numerators”) which were then used to calculate rates either by geography or for patients assigned to specific hospitals. These rates, which are calculated consistently across time and place, provide researchers with opportunities to evaluate spatial and temporal variation/trends. </p>

<p>This entry contains annual per capita Medicare reimbursements (i.e., Medicare spending) for fee-for-service (FFS) patients, age 65 to 99, who are Medicare Part A and B entitled. In addition to overall reimbursement rates, separate rates are provided for hospitals and skilled nursing facilities, physician services, outpatient facilities, home health agencies, hospice care, and durable medical equipment. Rates are provided at the state, hospital referral region (HRR), hospital service area (HSA), and county levels, and all rates have been adjusted for age, sex, and race. Beginning in 2003, two types of rates are provided for each expenditure category, one which adjusts for location-specific differences in prices and Medicare reimbursement policies, and one which does not. </p>

<p> Users downloading data should review the methods sections of the related publications for context as well as for information about any temporal changes in methods. All reports in the Dartmouth Atlas of Health Care series are available from the National Library of Medicine <a href="https://www.ncbi.nlm.nih.gov/books/NBK584737/">https://www.ncbi.nlm.nih.gov/books/NBK584737/</a>. Depending on the year, Medicare reimbursement rate datasets are based on 5%, 20%, or 100% samples of beneficiaries (see README file and reports for details). <p>

<p> Note that for the general Dartmouth Atlas rate datasets, which span multiple decades, the author list includes all Dartmouth staff (programmers, analysts, supervisors, etc.) involved in generating all types of Atlas rates across all years. We do not attempt to assign individuals to specific datasets or years. <p>

<h2>概述</h2>
<p>达特茅斯卫生政策与临床实践研究所（TDI）构建了公开可用的数据源，为研究人员、支付方、监管机构及创新者提供量化美国医疗支出与利用的时间及区域模式的指标。利用联邦医疗保险和医疗补助服务中心（CMS）的联邦医疗保险（Medicare）索赔数据（主要针对64岁以上参保者），Atlas研究人员构建了队列（cohort）（“分母”，denominators）及大量测量指标或事件（“分子”，numerators），随后用于计算按地理区域划分或特定医院收治患者的比率。这些比率在时间与地域上的计算方法保持一致，为研究人员评估空间与时间变异/趋势提供了契机。</p>

<p>本条目包含65至99岁、享有联邦医疗保险A部分和B部分权益的按服务收费（FFS，Fee-for-Service）患者的年度人均联邦医疗保险报销金额（即联邦医疗保险支出）。除总体报销率外，还提供针对医院与专业护理机构、医师服务、门诊机构、家庭健康机构、临终关怀护理及耐用医疗设备的分项报销率。报销率按州、医院转诊区域（HRR，Hospital Referral Region）、医院服务区域（HSA，Hospital Service Area）及县级别提供，且所有比率均已根据年龄、性别和种族进行调整。自2003年起，每个支出类别均提供两种比率：一种针对地区特定的价格差异及联邦医疗保险报销政策进行调整，另一种则未调整。</p>

<p>下载数据的用户应查阅相关出版物的方法部分，以了解背景信息及方法的任何时间变化。《达特茅斯医疗保健图谱》系列的所有报告均可从美国国家医学图书馆获取：<a href="https://www.ncbi.nlm.nih.gov/books/NBK584737/">https://www.ncbi.nlm.nih.gov/books/NBK584737/</a>。根据年份不同，联邦医疗保险报销率数据集基于5%、20%或100%的受益人样本（详见README文件及报告）。</p>

<p>请注意，对于跨越数十年的通用达特茅斯图谱比率数据集，作者列表包含所有参与生成历年各类图谱比率的达特茅斯工作人员（程序员、分析师、主管等）。我们未尝试将个人与特定数据集或年份关联。</p>