Studies of Health Insurance Claims Data in Japan: A Scoping Review.

Japan health insurance claims healthcare policy scoping review validation studies

Journal

JMA journal
ISSN: 2433-3298
Titre abrégé: JMA J
Pays: Japan
ID NLM: 101769797

Informations de publication

Date de publication:
14 Jul 2023
Historique:
received: 25 11 2022
accepted: 12 04 2023
medline: 10 8 2023
pubmed: 10 8 2023
entrez: 10 8 2023
Statut: ppublish

Résumé

Health insurance claims data are used in various research fields; however, an overview on how they are used in healthcare research is scarce in Japan. Therefore, we conducted a scoping review to systematically map the relevant studies using Japanese claims data. MEDLINE, EMBASE, and Ichushi-Web were searched up to April 2021 for studies using Japanese healthcare claims data. We abstracted the data on study characteristics and summarized target diseases and research themes by the types of claims database. Moreover, we described the results of studies that aimed to compare health insurance claims data with other data sources narratively. A total of 1,493 studies were included. Overall, the most common disease classifications were "Diseases of the circulatory system" (18.8%, n = 281), "Endocrine, nutritional, and metabolic diseases" (11.5%, n = 171; mostly diabetes), and "Neoplasms" (10.9%, n = 162), and the most common research themes were "medical treatment status" (30.0%, n = 448), "intervention effect" (29.9%, n = 447), and "clinical epidemiology, course of diseases" (27.9%, n = 417). Frequent diseases and themes varied by type of claims databases. A total of 19 studies aimed to assess the validity of the claims-based definition, and 21 aimed to compare the results of claims data with other data sources. Most studies that assessed the validity of claims data compared to medical records were hospital-based, with a small number of institutions. Claims data are used in various research areas and will increasingly provide important evidence for healthcare policy in Japan. It is important to use previous claims database studies and share information on methodology among researchers, including validation studies, while informing policymakers about the applicability of claims data for healthcare planning and management.

Sections du résumé

Background UNASSIGNED
Health insurance claims data are used in various research fields; however, an overview on how they are used in healthcare research is scarce in Japan. Therefore, we conducted a scoping review to systematically map the relevant studies using Japanese claims data.
Methods UNASSIGNED
MEDLINE, EMBASE, and Ichushi-Web were searched up to April 2021 for studies using Japanese healthcare claims data. We abstracted the data on study characteristics and summarized target diseases and research themes by the types of claims database. Moreover, we described the results of studies that aimed to compare health insurance claims data with other data sources narratively.
Results UNASSIGNED
A total of 1,493 studies were included. Overall, the most common disease classifications were "Diseases of the circulatory system" (18.8%, n = 281), "Endocrine, nutritional, and metabolic diseases" (11.5%, n = 171; mostly diabetes), and "Neoplasms" (10.9%, n = 162), and the most common research themes were "medical treatment status" (30.0%, n = 448), "intervention effect" (29.9%, n = 447), and "clinical epidemiology, course of diseases" (27.9%, n = 417). Frequent diseases and themes varied by type of claims databases. A total of 19 studies aimed to assess the validity of the claims-based definition, and 21 aimed to compare the results of claims data with other data sources. Most studies that assessed the validity of claims data compared to medical records were hospital-based, with a small number of institutions.
Conclusions UNASSIGNED
Claims data are used in various research areas and will increasingly provide important evidence for healthcare policy in Japan. It is important to use previous claims database studies and share information on methodology among researchers, including validation studies, while informing policymakers about the applicability of claims data for healthcare planning and management.

Identifiants

DOI: 10.31662/jmaj.2022-0184 PMID: 37560376 PMC: PMC10407298
pubmed: 37560376
doi: 10.31662/jmaj.2022-0184
pmc: PMC10407298
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

233-245

Informations de copyright

Copyright © Japan Medical Association.

Déclaration de conflit d'intérêts

None

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Auteurs

Maiko Suto (M)

Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.

Takehiro Sugiyama (T)

Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
Department of Health Services Research, Institute of Medicine, University of Tsukuba, Ibaraki, Japan.
Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.

Kenjiro Imai (K)

Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.

Takashi Furuno (T)

Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.

Mariko Hosozawa (M)

Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.

Yuichi Ichinose (Y)

Division of Health Services Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan.

Noriko Ihana-Sugiyama (N)

Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.

Tomoko Kodama (T)

Department of Public Health Policy, National Institute of Public Health, Saitama, Japan.

Ryuji Koizumi (R)

AMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.

Yuko Shimizu-Motohashi (Y)

Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.

Shunsuke Murata (S)

Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan.

Yayoi Nakamura (Y)

AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.

Mariko Niino (M)

Division of Health Services Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan.

Misuzu Sato (M)

Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.

Reina Taguchi (R)

Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
Institute for Health Economics and Policy, Tokyo, Japan.

Misa Takegami (M)

Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan.

Motoko Tanaka (M)

Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
Department of Health Care Policy and Management, Doctoral Program in Public Health, Degree Programs in Comprehensive Human Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.

Kota Tsutsumimoto (K)

Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.

Kentaro Usuda (K)

Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.

Kenji Takehara (K)

Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.

Hiroyasu Iso (H)

Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.

Classifications MeSH