Identifying and characterizing COPD patients in US managed care. A retrospective, cross-sectional analysis of administrative claims data

Abstract Introduction Perianal fistulas (PF) are presumably a frequent extraintestinal manifestation of Crohn’s disease (CD), causing significant functional impairment. This study aims to gain representative data on the prevalence, characteristics, and treatment of CD patients suffering from PF in Germany. Materials and methods A retrospective cross-sectional analysis of claims data from several German company health insurance funds included adult patients with CD and PF in 2015. The dataset comprised in- and outpatient services with diagnoses, drug prescriptions, and other patient data. It is representative for age, gender, and region and allows extrapolation to the total German statutory health insurance (SHI) population. A systematic literature review was conducted to discuss these results in the international context. Results A CD prevalence of 299 per 100 000 and a PF prevalence in CD patients of 3.4 % was observed in this cross-sectional study. PF are most prevalent in young age groups (< 24 to 39). One-third of patients with PF received biologics and surgery. Surgical procedures were performed in 31.3 % of PF patients in the inpatient setting and in 4.4 % of PF patients in the outpatient setting. All complicated perianal fistula patients received at least 1 inpatient surgery and 44.8 % received biologic therapy. Discussion This claims data analysis in German patients estimates a CD prevalence in the SHI population that corresponds well to previously reported data. The prevalence rate for PF in CD patients is comparable with a previous cross-sectional German claims data analysis but is markedly lower than cumulative risks reported in longitudinal cohort studies. PF patients are young and treatment intensive with one-third requiring biologic treatment or inpatient surgery.

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Mental and somatic comorbidity of depression: a comprehensive cross-sectional analysis of 202 diagnosis groups using German nationwide ambulatory claims data

BMC Psychiatry ◽

10.1186/s12888-020-02546-8 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 3

Author(s):

Annika Steffen ◽

Julia Nübel ◽

Frank Jacobi ◽

Jörg Bätzing ◽

Jakob Holstiege

Keyword(s):

Claims Data ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Somatic Comorbidity ◽

Sectional Analysis

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Semen parameters among us men evaluated for infertility: cross sectional analysis of claims data

Fertility and Sterility ◽

10.1016/j.fertnstert.2018.07.816 ◽

2018 ◽

Vol 110 (4) ◽

pp. e289

Author(s):

C.H. Glazer ◽

S. Li ◽

C. Zhang ◽

A. Giwercman ◽

J.H. Bonde ◽

...

Keyword(s):

Claims Data ◽

Semen Parameters ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Analysis Of Claims Data ◽

Sectional Analysis

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Selective enrollment in Disease Management Programs for coronary heart disease in Germany – An analysis based on cross-sectional survey and administrative claims data

BMC Health Services Research ◽

10.1186/s12913-017-2162-y ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 3

Author(s):

Julia Röttger ◽

Miriam Blümel ◽

Reinhard Busse

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Disease Management ◽

Claims Data ◽

Administrative Claims ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Disease Management Programs ◽

Administrative Claims Data

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Effects of managed care on the proportion of inappropriate elective diagnostic coronary angiographies in non-emergency patients in Switzerland: a retrospective cross-sectional analysis

BMJ Open ◽

10.1136/bmjopen-2017-020388 ◽

2018 ◽

Vol 8 (11) ◽

pp. e020388

Author(s):

Corinne Chmiel ◽

Oliver Reich ◽

Andri Signorell ◽

Stefan Neuner-Jehle ◽

Thomas Rosemann ◽

...

Keyword(s):

Managed Care ◽

Artery Bypass ◽

Multiple Logistic Regression Analysis ◽

Emergency Setting ◽

Inclusion Criteria ◽

Health Insurance Data ◽

Cross Sectional ◽

Emergency Procedures ◽

Cross Sectional Analysis ◽

Sectional Analysis

ObjectiveGuidelines recommend non-invasive ischaemia testing (NIIT) for the majority of patients with suspected ischaemic heart disease in a non-emergency setting. A substantial number of these patients undergo diagnostic coronary angiography (CA) without therapeutic intervention inappropriately due to lacking preceding NIIT. The aim of this study was to evaluate the effect of voluntary healthcare models with limited access on the proportion of patients without NIIT prior to elective purely diagnostic CA.DesignRetrospective cross-sectional analysis of insurance claims data from 2012 to 2015. Data included claims of basic and voluntary healthcare models from approximately 1.2 million patients enrolled with the Helsana Insurance Group. Voluntary healthcare models with limited health access are divided into gate keeping (GK) and managed care (MC) capitation models. Inclusion criteria: patients undergoing CA. Exclusion criteria: Patients<18 years, incomplete health insurance data coverage, acute cardiac ischaemia and emergency procedures, therapeutic CA (coronary angioplasty/stenting or coronary artery bypass grafting). The effect of voluntary healthcare models on the proportion of NIIT undertaken within 2 months before diagnostic CA was assessed by means of multiple logistic regression analysis, controlled for influencing factors.Results9173 patients matched inclusion criteria. 33.2% (3044) did not receive NIIT before CA. Compared with basic healthcare models, MC was independently associated with a higher proportion of NIIT (p<0.001, OR 1.17, CI 1.045 to 1.312), when additionally controlled for demographics, insurance coverage, inpatient treatment, cardiovascular medication, chronic comorbidities, high-risk status (patients with therapeutic cardiac intervention 1 month after or 18 months prior to diagnostic CA). GK models showed no significant association with the rate of NIIT (p=0.07, OR 1.11, CI 0.991 to 1.253).ConclusionsIn a non-GK healthcare system, voluntary MC healthcare models with capitation were associated with a reduced inappropriate use of diagnostic CA compared with GK or basic models.

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