Finding Married Couples in Medicare Claims Data

Medicare claims data have proven extraordinarily useful for the cost-effective examination of many epidemiologic and health services research problems. However, their richness in utilization and health status details is offset by a lack of social information. In this paper, we review a method to uniquely link husbands and wives using only data already present in the Medicare claims, allowing the construction of couple-level health care utilization histories. We compare the ability of this method to detect couples to married elderly couples identified in the 1990 Census, and find that it detects at least 59% of couples overall, with only modest variation as a function of the age or age-difference. There appears to be modestly lower detection of Black couples and those in coastal states. We discuss how comparison groups of the widowed can be developed to study the effects of marriage and bereavement on health care use and outcomes. (December 2002)