Enhancing Lyme Disease Surveillance by Using Administrative Claims Data, Tennessee, USA - Volume 21, Number 9—September 2015 - Emerging Infectious Disease journal - CDC
Volume 21, Number 9—September 2015
Emerging Infections Program
Emerging Infections Program
Enhancing Lyme Disease Surveillance by Using Administrative Claims Data, Tennessee, USA
Lyme disease is the most common tickborne disease in the United States, with >36,000 cases reported to the Centers for Disease Control and Prevention (CDC) during 2013 (1). Tennessee, a low-incidence state, reported only 25 Lyme disease cases during 2013 (2). In addition, Borrelia burgdorferi–infected ticks have been identified in only 1 Tennessee county (G.J. Hickling, unpub. data).
CDC estimates that Lyme disease may be underreported by a factor of 10 (3). A study using administrative claims data from a Tennessee health insurance provider similarly estimated that Lyme disease incidence is 7-fold higher than is reported to the Tennessee Department of Health (TDH) (4). To determine the usefulness of claims data, which can vary in accuracy (5,6), we evaluated medical records of persons given a Lyme disease diagnosis in claims data or surveillance in Tennessee.
This study was a special collaboration between TDH and BCBST medical informatics staff and required substantial resources of personnel and time, a level of surveillance not sustainable long-term. Although claims data offer an opportunity for identifying additional Lyme disease cases for public health surveillance, a more efficient means for differentiating cases from noncases is needed before such a system will be practical.
Dr. Clayton is an Epidemic Intelligence Service officer at CDC, assigned to the Tennessee Department of Health. His primary research interests include vector-borne diseases.
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Suggested citation for this article: Clayton JL, Jones SG, Dunn JR, Schaffner W, Jones TF. Enhancing Lyme disease surveillance by using administrative claims data, Tennessee, USA. Emerg Infect Dis. 2015 Sep [date cited]. http://dx.doi.org/10.3201/eid2109.150344
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