scholarly journals 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

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.

Characteristics of patient pathways in Hungary

2011 ◽  
Vol 152 (9) ◽  
pp. 338-343
Author(s):  
Miklós Gresz
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
Outpatient Care ◽  
Insurance Fund ◽  
Health Insurance Fund ◽  
Outpatient Services ◽  
The Past ◽  
Patient Pathways ◽  
Insured Patients

Over the past four years, there were nearly 250 million registered visits of insured patients in outpatient services in Hungary according to the database of the National Health Insurance Fund. In the process of renewal of health care system it is extremely important to analyze the characteristics of patient pathways. With the analysis of registered visits between 2007 and 2010 the author shows that 65%-96% (average 86%) of the insured patients used the services of outpatient care in the county of their living. This figure was the lowest (65%) in Pest County, which is the service area of several providers located in Budapest. Author presents and analyses the characteristics of patient pathways in different counties of Hungary. Orv. Hetil., 2011, 152, 338–343.

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

2017 ◽  
Vol 24 (6) ◽  
pp. 415-421 ◽  
Author(s):  
Susanne Schnitzer ◽  
Johannes Deutschbein ◽  
Christian H. Nolte ◽  
Martin Kohler ◽  
Adelheid Kuhlmey ◽  
...  
Keyword(s):  
Health Insurance ◽  
Claims Data ◽  
Insurance Fund ◽  
Health Insurance Fund ◽  
Care Dependency ◽  
German Health ◽  
One Year

scholarly journals Data Privacy Compliant Validation of Health Insurance Claims Data: the IDOMENEO Approach

2019 ◽  
Vol 82 (S 02) ◽  
pp. S94-S100 ◽  
Author(s):  
Christian-Alexander Behrendt ◽  
Thea Schwaneberg ◽  
Sandra Hischke ◽  
Tobias Müller ◽  
Tom Petersen ◽  
...  
Keyword(s):  
Health Insurance ◽  
Data Privacy ◽  
Claims Data ◽  
Health Care Research ◽  
Insurance Fund ◽  
Health Insurance Fund ◽  
Insurance Claims ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Health Insurance Claims

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.

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

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Susanne Schnitzer ◽  
Olaf von dem Knesebeck ◽  
Martin Kohler ◽  
Dirk Peschke ◽  
Adelheid Kuhlmey ◽  
...  
Keyword(s):  
Health Insurance ◽  
Claims Data ◽  
Insurance Fund ◽  
Health Insurance Fund ◽  
Care Dependency ◽  
German Health ◽  
One Year

Evaluating the National Health Insurance database of Hungary from the aspect of a health insurance specialist

2012 ◽  
Vol 153 (31) ◽  
pp. 1234-1239 ◽  
Author(s):  
Miklós Gresz
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
National Health Insurance ◽  
National Health ◽  
National Database ◽  
Insurance Fund ◽  
Health Insurance Fund ◽  
Patient Transport ◽  
Insurance Database

There is currently only one national database in the Hungarian health care system: the financial database of the National Health Insurance Fund. It includes all patients’ data of state-funded services since 2000, those for pharmaceuticals, health spas and suppliers for patient transport. Any information for scientific research purposes can be obtained from this database. The database for inpatient records is complicated, and it is difficult to make queries. On the basis of his ten-year-experience, the author outlines the typical errors, which hinder a correct query. Orv. Hetil., 2012, 153, 1234–1239.

scholarly journals Medical crowdfunding in a healthcare system with universal coverage: an exploratory study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ágnes Lublóy
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Universal Coverage ◽  
Insurance Fund ◽  
Health Care Needs ◽  
Health Coverage ◽  
Health Insurance Fund ◽  
Care Needs ◽  
Unmet Health Care Needs ◽  
Universal Health

Abstract Background In recent years, crowdfunding for medical expenses has gained popularity, especially in countries without universal health coverage. Nevertheless, universal coverage does not imply covering all medical costs for everyone. In countries with universal coverage unmet health care needs typically emerge due to financial reasons: the inability to pay the patient co-payments, and additional and experimental therapies not financed by the health insurance fund. This study aims at mapping unmet health care needs manifested in medical crowdfunding campaigns in a country with universal health coverage. Methods In this exploratory study we assess unmet health care needs in Germany by investigating 380 medical crowdfunding campaigns launched on Leetchi.com. We combine manual data extraction with text mining tools to identify the most common conditions, diseases and disorders which prompted individuals to launch medical crowdfunding campaigns in Germany. We also assess the type and size of health-related expenses that individuals aim to finance from donations. Results We find that several conditions frequently listed in crowdfunding campaigns overlap with the most disabling conditions: cancer, mental disorders, musculoskeletal disorders, and neurological disorders. Nevertheless, there is no strong association between the disease burden and the condition which prompted individuals to ask for donations. Although oral health, lipoedema, and genetic disorders and rare diseases are not listed among leading causes of disability worldwide, these conditions frequently prompted individuals to turn to crowdfunding. Unmet needs are the highest for various therapies not financed by the health insurance fund; additional, complementary, and animal-assisted therapies are high on the wish list. Numerous people sought funds to cover the cost of scientifically poorly supported or unsupported therapies. In line with the social drift hypothesis, disability and bad health status being associated with poor socioeconomic status, affected individuals frequently collected donations for their living expenses. Conclusions In universal healthcare systems, medical crowdfunding is a viable option to finance alternative, complementary, experimental and scientifically poorly supported therapies not financed by the health insurance fund. Further analysis of the most common diseases and disorders listed in crowdfunding campaigns might provide guidance for national health insurance funds in extending their list of funded medical interventions. The fact of numerous individuals launching crowdfunding campaigns with the same diseases and disorders signals high unmet needs for available but not yet financed treatment. One prominent example of such treatment is liposuction for patients suffering from lipoedema; these treatments were frequently listed in crowdfunding campaigns and might soon be available for patients at the expense of statutory health insurance in Germany.

scholarly journals Health Insurance in Kenya

2020 ◽  
Vol 5 (9) ◽  
pp. 963-966
Author(s):  
Evans Kiptoo Korir
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Secondary Data ◽  
Insurance Companies ◽  
Insurance Fund ◽  
Health Care Insurance ◽  
Health Insurance Fund ◽  
Microsoft Excel ◽  
The Government ◽  
Provide Health Care

Health insurance in Kenya was launched by the government in 1967 when they introduced National Health Insurance Fund (NHIF) to provide health care to Kenyans. Since then, the sector has grown widely due to liberalization of the industry and increase in the medical costs. In Kenya, the health care insurance is provided by both government and private insurers. This article aims to study the concept, benefits, and the growth of the health insurance in Kenya. It also highlights the health insurance plans available in the country. The study is based on secondary data collected from journals, articles, and Insurance Regulatory Authority (IRA) website. To study the growth of the health insurance in the country, premium, claims, and expense of 22 insurance companies offering health insurance from 2010 to 2018 were taken into consideration. Microsoft Excel was utilized for the analysis. The paper outlined the concept, health insurance plans, and their importance to the insured. The paper also revealed that the premium, claims, and expenses of the insurance companies increased constantly during the study period.

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

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.

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

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.

Drug Prescription Patterns in Schizophrenia Outpatients: Analysis of Data from a German Health Insurance Fund

2009 ◽  
Vol 42 (02) ◽  
pp. 66-71 ◽  
Author(s):  
S. Weinbrenner ◽  
H.-J. Assion ◽  
T. Stargardt ◽  
R. Busse ◽  
G. Juckel ◽  
...  
Keyword(s):  
Health Insurance ◽  
Drug Prescription ◽  
Insurance Fund ◽  
Health Insurance Fund ◽  
Prescription Patterns ◽  
German Health
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