scholarly journals Assessment of excess medical costs for persons with type 2 diabetes according to age groups: an analysis of German health insurance claims data

2019 ◽  
Author(s):  
K. Kähm ◽  
R. Stark ◽  
M. Laxy ◽  
U. Schneider ◽  
R. Leidl
Keyword(s):  
Type 2 Diabetes ◽  
Health Insurance ◽  
Claims Data ◽  
Age Groups ◽  
Medical Costs ◽  
German Health ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Health Insurance Claims

scholarly journals Recent transition of medical cost and relapse rate of multiple sclerosis in Japan based on analysis of a health insurance claims database

2019 ◽  
Author(s):  
Izumi Kawachi ◽  
Shuichi Okamoto ◽  
Mariko Sakamoto ◽  
Hiroyuki Ohta ◽  
Yusuke Nakamura ◽  
...  
Keyword(s):  
Health Insurance ◽  
Medical Cost ◽  
Claims Data ◽  
Medical Costs ◽  
Insurance Claims ◽  
Total Medical Cost ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Health Insurance Claims ◽  
Relapse Rates

Abstract Background In this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data. Methods We analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis. Results 4,374 MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from \87,640 (US$787.7 or €723.0 as of May 2017) to \102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from \23,039 (US$207.1 or €190.1) to \51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (\424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (\119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost. Conclusion Concomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. There is currently a lack of evidence for direct causality between DMT and reduction of relapse rates. However, even if DMT cannot be directly shown to be the cause of lower relapse rates and fewer hospitalizations among MS patients, a better quality of life for MS patients and a reduction in hospital costs have been achieved concomitantly with the increasing prevalence of DMT.

scholarly journals Recent transition of medical cost and relapse rate of multiple sclerosis in Japan based on analysis of a health insurance claims database

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Izumi Kawachi ◽  
Shuichi Okamoto ◽  
Mariko Sakamoto ◽  
Hiroyuki Ohta ◽  
Yusuke Nakamura ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Health Insurance ◽  
Medical Cost ◽  
Claims Data ◽  
Medical Costs ◽  
Insurance Claims ◽  
Total Medical Cost ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Health Insurance Claims

Abstract Background In this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data. Methods We analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis. Results Four thousand three hundred seventy-four MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from ¥87,640 (US$787.7 or €723.0 as of May 2017) to ¥102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from ¥23,039 (US$207.1 or €190.1) to ¥51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (¥424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (¥119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost. Conclusion Concomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. Although this study does not show the direct causality between DMT and reduction of relapse rates/fewer hospitalizations among MS patients, a reduction in hospital costs has been revealed concomitantly with the increasing prevalence of DMT.

scholarly journals Recent transition of medical cost and relapse rate of multiple sclerosis in Japan based on analysis of a health insurance claims database

2019 ◽  
Author(s):  
Izumi Kawachi ◽  
Shuichi Okamoto ◽  
Mariko Sakamoto ◽  
Hiroyuki Ohta ◽  
Yusuke Nakamura ◽  
...  
Keyword(s):  
Health Insurance ◽  
Medical Cost ◽  
Claims Data ◽  
Medical Costs ◽  
Insurance Claims ◽  
Total Medical Cost ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Health Insurance Claims ◽  
Relapse Rates

Abstract Background In this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data. Methods We analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis. Results 4,374 MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from \87,640 (US$787.7 or €723.0 as of May 2017) to \102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from \23,039 (US$207.1 or €190.1) to \51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (\424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (\119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost. Conclusion Concomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. There is currently a lack of evidence for direct causality between DMT and reduction of relapse rates. However, even if DMT cannot be directly shown to be the cause of lower relapse rates and fewer hospitalizations among MS patients, a better quality of life for MS patients and a reduction in hospital costs have been achieved concomitantly with the increasing prevalence of DMT.

scholarly journals Recent transition of medical cost and relapse rate of multiple sclerosis in Japan based on analysis of a health insurance claims database

2019 ◽  
Author(s):  
Izumi Kawachi ◽  
Shuichi Okamoto ◽  
Mariko Sakamoto ◽  
Hiroyuki Ohta ◽  
Yusuke Nakamura ◽  
...  
Keyword(s):  
Health Insurance ◽  
Medical Cost ◽  
Claims Data ◽  
Medical Costs ◽  
Insurance Claims ◽  
Total Medical Cost ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Health Insurance Claims ◽  
Relapse Rates

Abstract Background In this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data. Methods We analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis. Results 4,374 MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from \87,640 (US$787.7 or €723.0 as of May 2017) to \102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from \23,039 (US$207.1 or €190.1) to \51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (\424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (\119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost. Conclusion Concomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. There is currently a lack of evidence for direct causality between DMT and reduction of relapse rates. However, even if DMT cannot be directly shown to be the cause of lower relapse rates and fewer hospitalizations among MS patients, a better quality of life for MS patients and a reduction in hospital costs have been achieved concomitantly with the increasing prevalence of DMT.

scholarly journals Implementation of an algorithm for the identification of breast cancer deaths in German health insurance claims data: a validation study based on a record linkage with administrative mortality data

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026834 ◽  
Author(s):  
Ingo Langner ◽  
Christoph Ohlmeier ◽  
Ulrike Haug ◽  
Hans Werner Hense ◽  
Jonas Czwikla ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Insurance ◽  
Validation Study ◽  
Record Linkage ◽  
Claims Data ◽  
Mortality Rates ◽  
German Health ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Health Insurance Claims

ObjectiveTo adapt a Canadian algorithm for the identification of female cases of breast cancer (BC) deaths to German health insurance claims data and to test and validate the algorithm by comparing results with official cause of death (CoD) data on the individual and the population level.DesignValidation study, secondary data, medical claims.SettingClaims data of two statutory health insurance providers (SHIs) for inpatient and outpatient care, CoD added via record linkage with epidemiological cancer registry (ECR).ParticipantsAll women insured with the two SHIs and who deceased in the period 2006–2013, were residents of North Rhine Westphalia (NRW) and were linked with ECR data: n=22 413.Main outcome measuresBased on inpatient and outpatient diagnoses in the year before death, six algorithms were derived and the accordance of the algorithm-based CoD with the official CoD was evaluated calculating specificity, sensitivity, negative and positive predictive values (NPV, PPV). Furthermore, algorithm-based age-specific BC mortality rates covering several calendar years were calculated for the entire insured female population and compared with official national rates.ResultsOur final algorithm, derived from the NRW subsample, comprised codes indicating the presence of BC, metastases, a terminal illness phase and the absence of codes for other tumours. Overall, specificity, sensitivity, NPV and PPV of this algorithm were 97.4%, 91.3%, 98.9% and 81.7%, respectively. In the age range 40–80 years, sensitivity and PPV slightly decreased with increasing age. Algorithm-based age-specific BC mortality rates agreed well with official rates except for the age group 85 years and older.ConclusionsThe algorithm-based identification of BC deaths in German claims data is feasible and valid, except for higher ages. The algorithm to ascertain BC mortality rates in an epidemiological study seems applicable when information on the official CoD is not available in the original database.

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