SWB made a significant contribution to HRQL in a sample of college students. Such a relationship should be considered by campus health program planners to improve the quality of life of young adults.

Objective The Greater Plains Collaborative (GPC) and other PCORnet Clinical Data Research Networks capture healthcare utilization within their health systems. Here, we describe a reusable environment (GPC Reusable Observable Unified Study Environment [GROUSE]) that integrates hospital and electronic health records (EHRs) data with state-wide Medicare and Medicaid claims and assess how claims and clinical data complement each other to identify obesity and related comorbidities in a patient sample. Materials and Methods EHR, billing, and tumor registry data from 7 healthcare systems were integrated with Center for Medicare (2011–2016) and Medicaid (2011–2012) services insurance claims to create deidentified databases in Informatics for Integrating Biology & the Bedside and PCORnet Common Data Model formats. We describe technical details of how this federally compliant, cloud-based data environment was built. As a use case, trends in obesity rates for different age groups are reported, along with the relative contribution of claims and EHR data-to-data completeness and detecting common comorbidities. Results GROUSE contained 73 billion observations from 24 million unique patients (12.9 million Medicare; 13.9 million Medicaid; 6.6 million GPC patients) with 1 674 134 patients crosswalked and 983 450 patients with body mass index (BMI) linked to claims. Diagnosis codes from EHR and claims sources underreport obesity by 2.56 times compared with body mass index measures. However, common comorbidities such as diabetes and sleep apnea diagnoses were more often available from claims diagnoses codes (1.6 and 1.4 times, respectively). Conclusion GROUSE provides a unified EHR-claims environment to address health system and federal privacy concerns, which enables investigators to generalize analyses across health systems integrated with multistate insurance claims.

The aim of this study was to determine the independent effect of existential well-being (EWB) and religious well-being (RWB), two dimensions of spiritual well-being, on various measures of health related quality of life (HQROL) in a sample of 804 young adults. Independent variables were measured using the EWB and RWB subscales of the Spiritual Well-Being Scale; dependent variables were measured using questions from the Centers for Disease Control and Prevention's HRQOL – 14 Measure. Linear and ordinal regression results found stronger associations of EWB, compared to RWB, with increased overall HQROL, more healthy days and fewer unhealthy days, and better general health status, respectively.