Data Source
We used de-identified administrative claims data from the OptumLabs® Data Warehouse (OLDW), which includes medical and pharmacy claims and enrollment records for commercial and Medicare Advantage enrollees. The database contains longitudinal health information for over 200 million enrollees and patients, representing a mixture of ages, ethnicities, and geographical regions across the U.S. Our study period was from 7/1/2000 to 6/30/2019. Diagnoses were obtained using International Statistical Classification of Diseases and Related Health Problems (ICD9/ICD10) diagnostic and procedure codes, Current Procedural Terminology (CPT) codes, Diagnosis Related Group (DRG) codes, and Healthcare Common Procedure Coding System (HCPCS) codes. Since this study involved analysis of pre-existing data that was de-identified in compliance with the Health Insurance Portability and Accountability Act (HIPAA) of 1996, it was exempt from Institutional Review Board oversight.19