Journal
EMERGING INFECTIOUS DISEASES
Volume 27, Issue 2, Pages 499-507Publisher
CENTERS DISEASE CONTROL & PREVENTION
DOI: 10.3201/eid2702.202728
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MarketScan, a commercial insurance claims database, is a reliable source for monitoring trends in Lyme disease diagnoses in the United States. Despite differences in diagnostic patterns, the age and sex distributions of cases are similar to those reported through surveillance. Further investigation is needed to understand epidemiologic differences, such as misdiagnoses in low-incidence states.
We evaluated MarketScan, a large commercial insurance claims database, for its potential use as a stable and consistent source of information on Lyme disease diagnoses in the United States. The age, sex, and geographic composition of the enrolled population during 2010-2018 remained proportionally stable, despite fluctuations in the number of enrollees. Annual incidence of Lyme disease diagnoses per 100,000 enrollees ranged from 49 to 88, approximate to 6-8 times higher than that observed for cases reported through notifiable disease surveillance. Age and sex distributions among Lyme disease diagnoses in MarketScan were similar to those of cases reported through surveillance, but proportionally more diagnoses occurred outside of peak summer months, among female enrollees, and outside high-incidence states. Misdiagnoses, particularly in low-incidence states, may account for some of the observed epidemiologic differences. Commercial claims provide a stable data source to monitor trends in Lyme disease diagnoses, but certain important characteristics warrant further investigation.
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