scholarly journals Sampling strategy, characteristics and representativeness of the InGef research database

2021 ◽  
Author(s):  
Marion Ludwig ◽  
Dirk Enders ◽  
Frederike Basedow ◽  
Jochen Walker ◽  
Josephine Jacob
Keyword(s):  
Claims Data ◽  
Reference Data ◽  
Drug Prescription ◽  
Sampling Strategy ◽  
Mortality Rates ◽  
German Population ◽  
Research Database ◽  
Healthcare Database ◽  
Hospitalization Rates ◽  
Prescription Rates

Abstract Objectives The aim of this study was to describe the sampling strategy as well as characteristics and the external validity of a representative sample database drawn from the German InGef research database. Study Design This is a retrospective cohort study using anonymized claims data for the year 2019. Methods The InGef research database is an anonymized healthcare database with longitudinal claims data from approximately 8.8 Mio insurees. A sample of four million insurees was drawn intended to be representative for the German population with respect to age, sex and region. In addition to demographic information, data on hospitalization rates, mortality rates and drug prescription rates was analysed from the InGef sample database for the year 2019 to demonstrate validity and representativeness. Corresponding national reference data were obtained from official sources. Results The distributions of sex and age were similar in the InGef sample database and Germany (proportion of women: 50.8% vs. 50.7%; mean age: 44.1 vs 43.9 years). The proportion of insurees living in the eastern part of Germany was lower in the InGef sample database (16.5% vs. 19.5 %). There was good accordance with German reference data with respect to hospitalization rates and overall mortality rates. Prescription rates for the 20 most often reimbursed drug classes were slightly higher in the InGef sample database. Conclusions The InGef sample database shows good overall agreement with the German population on measures of morbidity, mortality, and drug usage.

scholarly journals The burden of illness in initiating intermittent catheterization: an analysis of German health care claims data

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Almuth Angermund ◽  
Gary Inglese ◽  
Jimena Goldstine ◽  
Laura Iserloh ◽  
Berit Libutzki
Keyword(s):  
Resource Use ◽  
Claims Data ◽  
Burden Of Illness ◽  
Intermittent Catheterization ◽  
German Population ◽  
Research Database ◽  
Physician Visits ◽  
Urologic Diseases ◽  
Cord Injury ◽  
Tract Infections

Abstract Background Intermittent catheterization (IC) is a common medical technique to drain urine from the bladder when this is no longer possible by natural means. The objective of this study was to evaluate the standard of care and the burden of illness in German individuals who perform intermittent catheterization and obtain recommendations for improvement of care. Methods A descriptive study with a retrospective, longitudinal cohort design was conducted using the InGef research database from the German statutory health insurance claims data system. The study consisted of individuals with initial IC use in 2013–2015. Results Within 3 years 1100 individuals with initial IC were identified in the database (~ 19,000 in the German population). The most common IC indications were urologic diseases, spinal cord injury, Multiple Sclerosis and Spina Bifida. Urinary tract infections (UTI) were the most frequent complication occurring 1 year before index (61%) and in follow-up (year 1 60%; year 2 50%). Resource use in pre-index including hospitalizations (65%), length of stay (12.8 ± 20.0 days), physician visits (general practitioner: 15.2 ± 29.1), prescriptions of antibiotics (71%) and healthcare costs (€17,950) were high. Comorbidities, complications, and healthcare resource use were highest 1 year before index, decreasing from first to second year after index. Conclusions The data demonstrated that prior to initial catheterization, IC users experienced UTIs and high healthcare utilization. While this demonstrates a potential high burden of illness prior to initial IC, UTIs also decreased over time, suggesting that IC use may have a positive influence. The findings also showed that after the first year of initial catheterization the cost decreased. Further studies are needed to better understand the extent of the burden for IC users compared to non-IC users.

scholarly journals Anticholinergic burden: First comprehensive analysis using claims data shows large variation by age and sex

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253336
Author(s):  
Jonas Reinold ◽  
Malte Braitmaier ◽  
Oliver Riedel ◽  
Ulrike Haug
Keyword(s):  
Older Persons ◽  
Claims Data ◽  
Population Sample ◽  
Age Groups ◽  
Cumulative Effect ◽  
Continuous Variable ◽  
German Population ◽  
Research Database ◽  
Targeted Interventions ◽  
Anticholinergic Burden

Purpose The cumulative effect of medication inhibiting acetylcholine activity—also known as anticholinergic burden (AB)—can lead to functional and cognitive decline, falls, and death. Given that studies on the population prevalence of AB are rare, we aimed to describe it in a large and unselected population sample. Methods Using the German Pharmacoepidemiological Research Database (GePaRD) with claims data from ~20% of the German population we analyzed outpatient drug dispensations in 2016. Based on the Anticholinergic Cognitive Burden (ACB) scale, we classified persons into four categories and determined the cumulative AB as continuous variable. Results Among 16,470,946 persons (54% female), the prevalence of clinically relevant AB (ACB≥3) was 10% (women) and 7% (men). Below age 40 it was highest in persons ≤18 years (6% both sexes). At older ages (50–59 vs. 90–99 years), prevalence of ACB≥3 increased from 7% to 26% (men) and from 10% to 32% (women). Medication classes contributing to the cumulative AB differed by age: antihistamines, antibiotics, glucocorticoids (≤19 years), antidepressants (20–49 years), antidepressants, cardiovascular medication, antidiabetics (50–64 years), and additionally medication for urinary incontinence/overactive bladder (≥65 years). Medication dispensed by general physicians contributed most to the cumulative AB. Conclusion Although a clinically relevant AB is particularly common in older persons, prevalence in younger age groups was up to 7%. Given the risks associated with AB in older persons, targeted interventions at the prescriber level are needed. Furthermore, risks associated with AB in younger persons should be explored.

Potential of German claims data to characterize utilization of new cancer drugs: the example of crizotinib

2021 ◽  
Author(s):  
Sarina Schwarz ◽  
Katja A Oppelt ◽  
Miriam Heinig ◽  
Ulrike Haug
Keyword(s):  
Real World ◽  
Claims Data ◽  
Patient Characteristics ◽  
German Population ◽  
Research Database ◽  
Cancer Drugs ◽  
Alk Inhibitor ◽  
Lung Cancer Therapy ◽  
World Information ◽  
German Pharmacoepidemiological Research Database

Aims: Premarketing clinical trials are typically conducted under controlled conditions and in selected study populations, so real-world information on the utilization of new cancer drugs is limited. We aimed to explore the potential of German claims data in this regard, exemplified by the ALK inhibitor crizotinib, used in non-small-cell lung cancer therapy. Materials & methods: We identified patients treated with crizotinib in the German Pharmacoepidemiological Research Database (2004–2017; 20% of the German population) and assessed patient characteristics, treatment and survival. Results: We identified 348 crizotinib-treated patients (56% female; 25% first-line users). After 2 years, overall survival was 48%, with higher survival in men than in women (58 vs 40%). Overall, 76% of patients discontinued crizotinib treatment. Of those, 41% received another ALK inhibitor afterward. Conclusion: The results underline the potential of German claims data for real-world monitoring of oncological drug utilization.

scholarly journals Comparison of claims data on hospitalization rates and repeat procedures in patients receiving a bowel preparation prior to colonoscopy

2017 ◽  
Vol 5 ◽  
pp. 205031211772799 ◽  
Author(s):  
Lisa E Young ◽  
Naomi C Sacks ◽  
Philip L Cyr ◽  
Abhishek Sharma ◽  
David N Dahdal
Keyword(s):  
Bowel Preparation ◽  
Claims Data ◽  
Hospitalization Rates ◽  
Repeat Procedures

scholarly journals Mortality and hospitalization for liver disease in the Western Amazon from 2008 to 2017

2021 ◽  
Vol 31 (1) ◽  
pp. 116-124
Author(s):  
Alex Nunes Callado ◽  
Italla Maria Pinheiro Bezerra ◽  
Fernando Adami ◽  
Luiz Vinícius de Alcantara Sousa ◽  
Luiz Carlos de Abreu
Keyword(s):  
Liver Diseases ◽  
Alcohol Intake ◽  
Ecological Study ◽  
Hospital Admissions ◽  
Secondary Data ◽  
Mortality Rates ◽  
Hospitalization Rates ◽  
Series Design ◽  
Study Results ◽  
Male Patients

Introduction: As liver diseases (LDs) occur as liver damage takes place, their causes are variable and mostly caused by viruses and alcohol intake. The cases of LDs have increased significantly; they are also charged with mortality rates and hospitalizations. Objective: to analyze mortality and hospitalizations due to LDs in the Western Amazon. Methods: Ecological study with time series design using secondary data related to deaths and hospital admissions for LDs in the Western Amazon. Results: The number of cases of mortality due to male diseases is higher in men, considering the period from 2008 to 2017. The study results also show that the affected patients are mostly over 50 and under 20 years old, who are the least likely to die. Regarding hospitalization rates, male patients have the highest number of hospitalizations and are not different from mortality; patients over the age of 50 also represent the largest hospitalization cases. Conclusion: There is a tendency towards stability in cases of mortality and hospitalization due to liver diseases in the Western Amazonia.

scholarly journals Epidemiology and health care utilization of patients suffering from Huntington’s disease in Germany: real world evidence based on German claims data

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Christoph Ohlmeier ◽  
Kai-Uwe Saum ◽  
Wolfgang Galetzka ◽  
Dominik Beier ◽  
Holger Gothe
Keyword(s):  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Claims Data ◽  
Routine Care ◽  
Care Utilization ◽  
Research Database ◽  
Cross Sectional ◽  
Case Identification ◽  
Starting Point ◽  
Icd 10

Abstract Background Huntington’s disease (HD) is a rare, genetic, neurodegenerative and ultimately fatal disease with no cure or progression-delaying treatment currently available. HD is characterized by a triad of cognitive, behavioural and motor symptoms. Evidence on epidemiology and management of HD is limited, especially for Germany. This study aims to estimate the incidence and prevalence of HD and analyze the current routine care based on German claims data. Methods The source of data was a sample of the Institute for Applied Health Research Berlin (InGef) Research Database, comprising data of approximately four million insured persons from approximately 70 German statutory health insurances. The study was conducted in a retrospective cross-sectional design using 2015 and 2016 as a two-year observation period. At least two outpatient or inpatient ICD-10 codes for HD (ICD-10: G10) during the study period were required for case identification. Patients were considered incident if no HD diagnoses in the 4 years prior to the year of case identification were documented. Information on outpatient drug dispensations, medical aids and remedies were considered to describe the current treatment situation of HD patients. Results A 2-year incidence of 1.8 per 100,000 persons (95%-Confidence interval (CI): 1.4–2.4) and a 2-year period prevalence of 9.3 per 100,000 persons (95%-CI: 8.3–10.4) was observed. The prevalence of HD increased with advancing age, peaking at 60–69 years (16.8 per 100,000 persons; 95%-CI: 13.4–21.0) and decreasing afterwards. The most frequently observed comorbidities and disease-associated symptoms in HD patients were depression (42.9%), dementia (37.7%), urinary incontinence (32.5%), extrapyramidal and movement disorders (30.5%), dysphagia (28.6%) and disorders of the lipoprotein metabolism (28.2%). The most common medications in HD patients were antipsychotics (66.9%), followed by antidepressants (45.1%). Anticonvulsants (16.6%), opioids (14.6%) and hypnotics (9.7%) were observed less frequently. Physical therapy was the most often used medical aid in HD patients (46.4%). Nursing services and speech therapy were used by 27.9 and 22.7% of HD patients, respectively, whereas use of psychotherapy was rare (3.2%). Conclusions Based on a representative sample, this study provides new insights into the epidemiology and routine care of HD patients in Germany, and thus, may serve as a starting point for further research.

scholarly journals Association of Preceding Antithrombotic Therapy in Atrial Fibrillation Patients With Ischemic Stroke, Intracranial Hemorrhage, or Gastrointestinal Bleed and Mortality

2019 ◽  
Author(s):  
Joris J Komen ◽  
Tomas Forslund ◽  
Aukje K Mantel-Teeuwisse ◽  
Olaf H Klungel ◽  
Mia von Euler ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Propensity Score ◽  
Intracranial Hemorrhage ◽  
Cox Regression ◽  
Mortality Rates ◽  
Antithrombotic Treatment ◽  
Healthcare Database ◽  
Gastrointestinal Bleed ◽  
History Of

Abstract Aims To analyze 90-day mortality in AF patients after a stroke or a severe bleed and assess associations with the type of antithrombotic treatment at the event. Methods and Results From the Stockholm Healthcare database, we selected 6 017 patients with a known history of AF who were diagnosed with ischemic stroke, 3 006 with intracranial hemorrhage, and 4 291 with a severe gastrointestinal bleed (GIB). The 90-day mortality rates were 25.1% after ischemic stroke, 31.6% after intracranial hemorrhage, and 16.2% after severe GIB. We used Cox regression and propensity score matched analyses to test the association between antithrombotic treatment at the event and 90-day mortality. After intracranial hemorrhage, there was a significantly higher mortality rate in warfarin compared to NOAC treated patients (adjusted hazard ratio (aHR): 1.36 CI: 1.04 – 1.78). After an ischemic stroke and a severe GIB, patients receiving antiplatelets or no antithrombotic treatment had significantly higher mortality rates compared to patients on NOACs, but there was no difference comparing warfarin to NOACs (aHR 0.84 CI: 0.63 – 1.12 after ischemic stroke, aHR 0.91 CI: 0.66 – 1.25 after severe GIB). Propensity score matched analysis yielded similar results. Conclusion Mortality rates were high in AF patients suffering from an ischemic stroke, an intracranial hemorrhage, or a severe GIB. NOAC treatment was associated with a lower 90 day mortality after intracranial hemorrhage than warfarin.

scholarly journals Effects of a Dementia Screening Program on Healthcare Utilization in South Korea: A Difference-In-Difference Analysis

2019 ◽  
Vol 16 (20) ◽  
pp. 3837 ◽  
Author(s):  
Su Jung Lee ◽  
Hyun-Ju Seo ◽  
Dong Young Lee ◽  
So-Hyun Moon
Keyword(s):  
Screening Program ◽  
Drug Prescription ◽  
Healthcare Services ◽  
Control Group ◽  
Difference In Difference ◽  
Difference Analysis ◽  
Screening Programs ◽  
Dementia Screening ◽  
People With Dementia ◽  
Prescription Rates

To determine whether Seoul’s dementia screening program increased the rate of diagnosis and the appropriate use of healthcare services for people with dementia, a retrospective data analysis was conducted based on administrative data from the Health Insurance Review and Assessment Service. Two cohorts were constructed to represent the year before Seoul’s dementia screening program began (2007) (control group) and the year after the implementation of the program (2009) (treatment group). A difference-in-difference analysis was used to compare the diagnosis rates, number of clinic visits, and dementia-related drug prescription rates for 4 districts that implemented dementia screening programs between 2007 and 2009 and 14 areas that did not. After the introduction of the program, there was a 55.4% increase in physician-diagnosed dementia. The “average drug cost per patient” increased by 52.2% (Exp(β) = 1.522, p = 0.0264), the “average outpatient visits per patient” tended to increase by 13.5% (Exp(β) = 1.135, p = 0.1852), and the “average outpatient treatment fees per visit per patient” tended to increase by 24.4% (Exp(β) = 1.244, p = 0.0821). The implementation of dementia screening programs led to an increase in healthcare service utilization. Therefore, this program was found to be an effective strategy for reducing undiagnosed dementia cases and encouraging patients to use adequate healthcare services.

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