Adverse Drug Events Using Medicare Claims Data to Identify High-Risk Populations


What is an ADE?

Any harms occurring during medical care resulting from medication exposure

Impact on U.S. Healthcare System

Impact on Elderly Prescriptions

Impact on Hospital Utilization

What we ALREADY know

Prevention is a Priority

3 Rx = 60% of ED Visits Made by Seniors

Medicare Claims are Accessible Source of Data on Use Patterns & Outcomes


Use Medicare Claims Data To:

Identify Populations at High-Risk for ADEs
Calculate Rates of Hospitalization Among the High-Risk
Share Data for Targeted Quality Improvement Interventions


Identify High-Risk Population:

8,178,753 (20.7%) Total High-Risk Beneficiaries

Annual Rate of Outpatient ADEs*

Annual Rate = 46.28/1000 (4.6%) *Resulting in Hospital Visit

Rates of Hospital Utilization

Discussion Topics

Risks Associated With Multiple Rx Use

Link Between Rx Use Patterns & Outcomes

The Risks of Anticoagulants


Use of Medicare Claims to Identify Populations at High-Risk for ADEs


Journal of Managed Care & Speciality Pharmacy (3/2019)


Rachel Digmann, Sherry Peppercorn, LiJing Zhang, Kim Irby, Jane Brock, Anita Thomas, & Amanda Ryan

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