Use of insurance claims data in measuring quality of care

Int J Technol Assess Health Care. 1990;6(2):263-71. doi: 10.1017/s0266462300000787.


This article discusses data that might be used for measuring quality of care, for health care administrative purposes, and for tracking the use of technologies. The advantages and limitations of administrative data banks for research purposes and some process-of-care and outcome analysis are noted. Three important obstacles to their use--reliability of diagnosis and service information, unique patient identifiers, and provider identifiers--are discussed briefly.

Publication types

  • Review

MeSH terms

  • Health Services Research*
  • Humans
  • Information Systems
  • Insurance Claim Review / statistics & numerical data*
  • Insurance, Health / statistics & numerical data*
  • Methods
  • Outcome and Process Assessment, Health Care
  • Quality of Health Care*
  • United States