The Use of Claims Data in Healthcare Research

Claims-based studies have become common during the past 15 years. The electronic records of millions of transactions include information entered on bills (claims) submitted by healthcare providers to third-party payers. They are an attractive data source to researchers; however, they contain many weaknesses that threaten the integrity of many studies that utilize them.

We wanted to learn: (1) how widespread are studies that utilize claims data; (2) in what healthcare areas are claims data being used; (3) is the use of claims data increasing; and (4) do researchers inform readers of the weaknesses of the data?

1,956 original research studies, published during 2000-2005 in five healthcare journals, were reviewed to: (1) determine their data sources, (2) establish their healthcare areas, and (3) if claims-based, to ascertain any discussion of the data’s weaknesses.

Use of claims databases in research may have leveled. They are often used to study healthcare areas for which they may be appropriate, but they are also used in areas where they might not be suitable. Less than half the authors of claims-based research mentioned any weaknesses of the data.