Validating the use of Medicare Australia billing data to examine trends in skin cancer

Abstract

Background: Epidemiological data surrounding non-melanomatous skin cancer (NMSC) is highly variable, in part due to the lack of government cancer registries. Several studies employ the use of Medical Australia (MA) rebate data in assessing such trends, the validity of which has not been studied in the past. Conversely, melanoma skin cancer is a notifiable disease, and thus, MA and cancer registry data is readily available. The aim of the current study is to assess the use of MA for epidemiological measures for skin cancers, by using melanoma as a disease sample. Methods: Following ethics approval, data from MA and Victorian Cancer Registry (VCR) from 2004-2008 were extracted. Incidence of MA and VCR unique melanoma cases were compared and stratified by age and local government area (LGA). Regression and a paired-samples t-test were performed. Results: During the study period; 15,150 and 13,886 unique melanoma patients were identified through VCR and MA data sources respectively. An outlier in the >80­ year age group was noted between MA and VCR data. When stratified by age, significant correlation between MA and VCR was observed for all patients (gradient 0.91, R²= 0.936) and following exclusion of >80 patients (gradient 0.96, R²= 0.995). When stratified by LGA, a high degree of observation was observed for all patients (gradient 0.94, R²= 0.977) and following exclusion of >80 patients (gradient 0.996, R²= 0.975). Conclusion: Despite the inclusion of outlier data groups, acceptable correlation between MA and VCR melanoma data was observed, suggesting that MA may be suitable for assessing epidemiological trends. Such principals may be used to validate the use of MA data for similar calculations assessing NMSC trends.

Association of Age-Related Cataract With Skin Cancer in an Australian Population

“…32 To address this limitation, individuals who received health care services under the Department of Veteran's Affairs program were excluded from the study. 40 Additionally, the aged care eligibility assessment used to ascertain the history of skin cancer and cataract only records up to 10 health conditions; the aged care eligibility assessors only report those conditions that have been diagnosed by a suitably qualified individual and impact on the person's need for assistance. 41 It is possible that neither cataract nor skin cancer were listed.…”

Keratinocyte cancers in South Australia: incidence, geographical variability and service trends

“…A validation study of MBS data with linked Queensland KC cases demonstrated the overall reliability of using Medicare claims for identifying KC, as approximately 88% were identified when using the primary excision, cryotherapy or serial curettage items for KC treatment 10 . MBS data are also suitable for assessing epidemiological trends in skin cancer 11 …”

Changing trends in surgical management of renal tumours from 2000 to 2016: a nationwide study of Medicare claims data

“…Such data requires the accurate billing by surgeons and administrators associated with each respective case. Despite these concerns, MBS‐based data has been validated for use in the setting of various procedures, including melanoma excision, by comparing frequencies to the respective cancer registries . Further, data on billings from public sector was not available for analysis.…”

“…Despite these concerns, MBSbased data has been validated for use in the setting of various procedures, including melanoma excision, by comparing frequencies to the respective cancer registries. 33 Further, data on billings from public sector was not available for analysis. Due to limitations in MBS data, information pertaining to oncological (final pathology, pathological stage), patient (comorbidities, renal function), peri-operative (operative approach, Da Vinci generation, conversion rate and reason, RAPN age and gender specific details) and social (socioeconomic status, private health insurance coverage, geographical location) were not available for analysis, making definitive conclusions for the trends observed or comparisons to other cohorts difficult.…”