Description of North Carolina Medicaid databases and potential uses for health professionals

/ -^STUDIES A SPECIAL REPORT SERIES BY THE N.C. DEPARTMENT OF ENVIRONMENT. HEALTH. AND NATURAL RESOURCES. DIVISION OF STATISTICS AND INFORMATION SERVICES, CENTER FOR HEALTH AND ENVIRONMENTAL STATISTICS. P.O. BOX 27687. RALEIGH. N.C. 27611-7687. No. 59 July 1991 A DESCRIPTION OF NORTH CAROLINA MEDICAID DATABASES AND POTENTIAL USES FOR HEALTH PROFESSIONALS by Kenneth P. Kaufman ABSTRACT Currently over seven percent of North Carolina residents are Medicaid eligible, and about one-third of resident births are funded by Medicaid. Medicaid data can be used for describing the health status and needs of this population, as well as for evaluating health programs and services. This report describes the major Medicaid databases that are available in North Carolina and the annual processing of these data carried out by the Center for Health and Environmental Statistics. Paid claims are the largest data source and include patient demographics, diagnoses and procedures, and fiscal and provider information. These claims data are reorganized to produce episode-of-care files, which are more amenable to statistical analysis. Data are presented on birthweight and prenatal care characteristics of Medicaid births, hospitalization of Medicaid eligibles, outpatient visits, and physician office visits. Other recent uses of Medicaid data are also described. Increased use of Medicaid data should improve health services planning and resource allocation, resulting in better services for people in poverty in North Carolina.