How does sex affect the care dependency risk one year after stroke? A study based on claims data from a German health insurance fund

AbstractRecently, health insurance claims have regained the attention of the scientific community as a source of real-world evidence in health care research and quality improvement. To date, very few studies are available which investigate the validity of health insurance claims; these may be affected by bias from several sources, such as possible upcoding of co-morbidities and complications for reimbursement advantages. The IDOMENEO study investigates the inpatient treatment of peripheral arterial disease (PAD) comprehensively using various data sources with a consortium involving experts from health care research and data privacy, a large health insurance fund, biostatisticians, jurists, and computer scientists. Prospective registry data were collected from 30–40 vascular centres in Germany using the GermanVasc registry. In addition, health insurance claims data were prospectively collected from BARMER, the second largest health insurance fund in Germany. The consortium is currently developing a data privacy compliant method of health insurance claims data validation, the methodological foundations of which are described here.

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The effects of different lookback periods on the sociodemographic structure of the study population and on the estimation of incidence rates: analyses with German claims data

BMC Medical Research Methodology ◽

10.1186/s12874-020-01108-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Jelena Epping ◽

Siegfried Geyer ◽

Juliane Tetzlaff

Keyword(s):

Myocardial Infarction ◽

Health Care ◽

Health Insurance ◽

Claims Data ◽

Incidence Rates ◽

Insurance Fund ◽

Health Insurance Fund ◽

Study Population ◽

Incident Cases ◽

Occupational Qualification

Abstract Background Defining incident cases has always been a challenging issue for researchers working with routine data. Lookback periods should enable researchers to identify and exclude recurrent cases and increase the accuracy of the incidence estimation. There are different recommendations for lookback periods depending on a disease entity of up to 10 years. Well-known drawbacks of the application of lookback periods are shorter remaining observation period in the dataset or smaller number of cases. The problem of selectivity of the remaining population after introducing lookback periods has not been considered in the literature until now. Methods The analyses were performed with pseudonymized claims data of a German statutory health insurance fund with annual case numbers of about 2,1 million insured persons. Proportions of study population excluded due to the application of lookback periods are shown according to age, occupational qualification and income. Myocardial infarction and stroke were used to demonstrate changes in incidence rates after applying lookback periods of up to 5 years. Results Younger individuals show substantial dropouts after the application of lookback periods. Furthermore, there are selectivities regarding occupational qualification and income, which cannot be handled by age standardization. Due to selective dropouts of younger individuals, crude incidence rates of myocardial infarction and stroke increase after applying lookback periods. Depending on the income group, age-standardized incidence rates changed differentially, leading to a decrease and possible underestimation of the social gradient after applying lookback periods. Conclusions Selectivity analyses regarding age and sociodemographic structure should be performed for the study population after applying lookback periods since the selectivity can affect the outcome especially in health care research. The selectivity effects might occur not only in claims data of one health insurance fund, but also in other longitudinal data with left- or right-censoring not covering the whole population. The effects may also apply to health care systems with a mix of public and private health insurance. A trade-off has to be considered between selectivity effects and eliminating recurrent events for more accuracy in the definition of incidence.

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Assessing Statin-Associated Myopathy using Administrative Data from a German Health Insurance Fund: Results of a Pilot Study

Value in Health ◽

10.1016/j.jval.2016.09.1811 ◽

2016 ◽

Vol 19 (7) ◽

pp. A661

Author(s):

P Ihle ◽

F Dippel ◽

I Schubert

Keyword(s):

Health Insurance ◽

Pilot Study ◽

Administrative Data ◽

Insurance Fund ◽

Health Insurance Fund ◽

German Health

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Lipid-lowering therapy and patient adherence in the MULTI GAP 2013 trial

Orvosi Hetilap ◽

10.1556/oh.2014.29905 ◽

2014 ◽

Vol 155 (17) ◽

pp. 669-675

Author(s):

Gábor Simonyi

Keyword(s):

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Ldl Cholesterol ◽

Patient Adherence ◽

Lipid Lowering ◽

Insurance Fund ◽

Lipid Lowering Therapy ◽

Health Insurance Fund ◽

National Health Insurance Fund

Introduction: Dyslipidemia is a well-known cardiovascular risk factor. To achieve lipid targets patient adherence is a particularly important issue. Aim: To assess adherence and persistence to statin therapy in patients with atherosclerotic disease who participated in the MULTI Goal Attainment Problem 2013 (MULTI GAP 2013) study. Patient adherence was assessed using estimation by the physicians in charge and analysis of pick up rate of prescribed statins in 319 patients based on data of National Health Insurance Fund Administration of Hungary. Method: In the MULTI GAP 2013 study, data from standard and structured questionnaires of 1519 patients were processed. Serum lipid values of patients treated by different healthcare professionals (general practitioners, cardiologists, diabetologists, neurologists, and internists), treatment adherence of patients assessed by doctors and treatment adherence based on data of National Health Insurance Fund Administration of Hungary were analysed. Satisfaction of doctors with results of statin therapy and the relationship between the level of adherence and serum lipid values were also evaluated. Results: Considering the last seven years of survey data, the use of more effective statins became more prevalent with an about 70% increase of prescriptions of atorvastatin and rosuvastatin from 49% to 83%. Patients with LDL-cholesterol level below 2.5 mmol/l had 8 prescriptions per year. In contrast, patients who had LDL-cholesterol levels above 2.5 mmol/l had only 5.3–6.3 prescriptions per year. Patients who picked up their statins 10–12 or 7–9 times per year had significantly lower LDL-cholesterol level than those who had no or 1–3 pick up. The 100% persistence assessed by doctors was significantly lower (74%) based on data from the National Health Insurance Fund Administration of Hungary. About half of the patients were considered to display 100% adherence to lipid-lowering therapy by their doctors, while data from the National Health Insurance Fund Administration of Hungary showed only 36%. In patients with better adherence (90–100%) LDL-cholesterol levels below 2.5 mmol/l were more frequent (59.5%) compared to those with worse adherence. Satisfaction of doctors with lipid targets achieved was 69–80% in patients with total cholesterol between 4.5 and 6 mmol/l, and satisfaction with higher cholesterol values was also high (53–54%). Conclusions: The results show that doctors may overestimate patient adherence to lipid-lowering treatment. Based on data from the National Health Insurance Fund Administration of Hungary, satisfaction of doctors with high lipid level appears to be high. There is a need to optimize not only patient adherence, but adherence of doctors to lipid guidelines too.

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Prävention – Lohnt sich Prävention für die gesetzlichen - Krankenkassen in Deutschland?

Gesundheitsökonomie & Qualitätsmanagement ◽

10.1055/a-1199-1006 ◽

2020 ◽

Vol 25 (03) ◽

pp. 128-129

Keyword(s):

Health Insurance ◽

Disease Prevention ◽

Economic Impact ◽

Statutory Health Insurance ◽

Insurance Fund ◽

Chronische Erkrankungen ◽

Health Insurance Fund ◽

Health Econ ◽

Financing System ◽

Statutory Health Insurance Fund

Weinhold et al. Economic impact of disease prevention in a morbidity-based financing system: does prevention pay off for a statutory health insurance fund in Germany? Eur J Health Econ 2019; 20 (8): 1181–1193 Das deutsche Gesundheitssystem wird durch vermeidbare chronische Erkrankungen in besonderem Maße belastet. Die Finanzierung geeigneter Präventionsmaßnahmen obliegt den Krankenkassen. Weinhold et al. untersuchten in einer retrospektiven Studie die ökonomischen Auswirkungen von Prävention für die GKV.

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Charter of the Kazan Society of Physicians for the provision of medical care to participants in the sickness funds established by law on June 3, 1912

Kazan medical journal ◽

10.17816/kazmj48887 ◽

1913 ◽

Vol 13 (2) ◽

pp. 91-110

Keyword(s):

Health Insurance ◽

Medical Care ◽

Insurance Fund ◽

Health Insurance Fund ◽

Medical Assistance ◽

Medical Aid ◽

Insurance Funds ◽

The Law ◽

Health Insurance Funds ◽

The City

The Kazan Society of Physicians for the Provision of Medical Aid to the Participants of the Health Insurance Funds Established on the Basis of the Law of June 23, 1912 "has the goal of providing medical assistance to the participants of the Health Insurance Fund established on the basis of the Law of June 23, 1912 in the city of Kazan and its environs.

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Health related costs of smoking from the viewpoint of the Health Insurance Fund in Hungary

Orvosi Hetilap ◽

10.1556/oh.2012.29280 ◽

2012 ◽

Vol 153 (9) ◽

pp. 344-350 ◽

Cited By ~ 2

Author(s):

Miklós Gresz ◽

Júlia Nagy ◽

Petra Freyler

Keyword(s):

Lung Cancer ◽

Health Insurance ◽

Product Distribution ◽

Tobacco Product ◽

Insurance Fund ◽

Health Insurance Fund ◽

Life Years ◽

Health Related ◽

Hungarian Population ◽

The Individual

In recent times, the topic of smoking has been extensively debated in Hungary. A new Act has been issued for the protection of non-smokers and for the regulation of tobacco product distribution. Aims: The aim of the authors was to examine the economic burden of smoking on the society. Methods: According to wildly accepted estimates, 30% of the Hungarian population smokes. Smoking leads to the development of several diseases, for example, it is responsible for 90% of lung cancer cases. Results: 17.2% of the curative–preventive costs and 15% of the pharmaceutic costs are estimated to be spent on the health damages caused by smoking. In 2009, the Health Insurance Fund had to spend approximately 174.6 billion HUF for health damages including sick leave costs caused by smoking. Working days lost (patients on sick list) as a consequence of smoking decreased the GDP of Hungary by around 95 billion HUF in the same year. Literature suggests that smoking leads to a loss of approximately seven life years. Shortened life span might cause 594.9 billion HUF loss to the Hungarian economy not to mention the economical and emotional loss of the individual families. Conclusions: The authors estimated a total of 864.4 billion HUF loss to the Hungarian economy due to smoking. Orv. Hetil., 2012, 153, 344–350.

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