Cohort definition and data sources
The study population represented the Medicare health plan (elderly population > 65 years and individuals with disability including those below 65 years) financed by the US government and managed by an independent healthcare organization. The Medicare health plan consists of Medicare Advantage and Medicare/Medicaid Plan participants, and were drawn from different geographical areas across the US continent. The study cohort was gathered from medical claims databases during the April 1 2018 – Nov 30 2020 time window based on primary and secondary ICD10 codes. Each participant had to contribute at least 32 months of medical and pharmacy coverage during the study and records in the medical database. IRB approval was not required for the extraction of data from the claim databases; however compliance with US privacy laws and Company governance is required for use of data.