A methodology for identifying married couples in Medicare data: Mortality,morbidity, and health care use among the married elderly

We describe a method for the development of cohorts of up to three quarters of the 14 million married couples aged 65 and over in the United States. T he health care experiences, illness histories, and mortality of these ident ified couples can be assessed longitudinally using Medicare data. We summar ize strengths and limitations of using data from Medicare administrative re cords for the study of marriage, health, and aging. We illustrate the metho d by demonstrating substantial differences in survival in a cohort of hospi ce patients as a function of not only the patient's own diagnosis and illne ss burden but also the patient's spouse's illness burden.