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

Copyright © Japan Medical Association..

Background: 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: 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: 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: 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.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:6

Enthalten in:

JMA journal - 6(2023), 3 vom: 14. Juli, Seite 233-245

Sprache:

Englisch

Beteiligte Personen:

Suto, Maiko [VerfasserIn]
Sugiyama, Takehiro [VerfasserIn]
Imai, Kenjiro [VerfasserIn]
Furuno, Takashi [VerfasserIn]
Hosozawa, Mariko [VerfasserIn]
Ichinose, Yuichi [VerfasserIn]
Ihana-Sugiyama, Noriko [VerfasserIn]
Kodama, Tomoko [VerfasserIn]
Koizumi, Ryuji [VerfasserIn]
Shimizu-Motohashi, Yuko [VerfasserIn]
Murata, Shunsuke [VerfasserIn]
Nakamura, Yayoi [VerfasserIn]
Niino, Mariko [VerfasserIn]
Sato, Misuzu [VerfasserIn]
Taguchi, Reina [VerfasserIn]
Takegami, Misa [VerfasserIn]
Tanaka, Motoko [VerfasserIn]
Tsutsumimoto, Kota [VerfasserIn]
Usuda, Kentaro [VerfasserIn]
Takehara, Kenji [VerfasserIn]
Iso, Hiroyasu [VerfasserIn]

Links:

Volltext

Themen:

Health insurance claims
Healthcare policy
Japan
Journal Article
Review
Scoping review
Validation studies

Anmerkungen:

Date Revised 11.08.2023

published: Print-Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.31662/jmaj.2022-0184

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM360599672