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Developing an evaluation method of quality of care using claim data of health insurance

Research Project

Project/Area Number 18590593
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Public health/Health science
Research InstitutionThe University of Tokyo

Principal Investigator

KOBAYASHI Yasuki  The University of Tokyo, Graduate School of Medicine, Professor (70178341)

Project Period (FY) 2006 – 2007
Project Status Completed (Fiscal Year 2007)
Budget Amount *help
¥3,950,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥450,000)
Fiscal Year 2007: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Fiscal Year 2006: ¥2,000,000 (Direct Cost: ¥2,000,000)
Keywordsclaim data / quality of care / practice guideline / medical information / electronic database / diabetes mellitus / duplicative medication / 糠尿病 / 国民健康保険
Research Abstract

Using claim data of health insurance, which are automatically accumulated, the purpose of this study is to examine and develop a method of evaluating quality of care. Because currently most of claim data were paper-based, this study started with making an electronic database of claim data. After the Contract was exchanged with the National Health Insurance Union of a certain prefectures on the analysis of claim data, the claim data of two insurance societies belonging to the Union (the number of subscribers were about fourteen thousand) between May 2006 and October 2006 were put into a database(the total number of claims for this period were about 65,000). In the database, each claim datum was merged by individual, and all the data were electronized in the anonymous manner in which linkage were impossible. Finally, the claim database was completed, in which the claim information of averagely 7,500 patients per month was given. The database showed that the average number of diseases per patient was 6.8. From the same database, using selection criterion such as continual treatment of the same disease, a subset of database was made for those patients who were treated for diabetes mellitus for six months. Using this database (n=838), the quality of care for diabetes mellitus treatment was examined by comparing with an existing practice guideline. As a result, HbA1c measurement which was an index to glycemic control was carried out at the high rate, however, the frequency of check-up of nephropathy and retinopathy was low in comparison with that reported in European and American countries. In addition, the frequency of the HbA1c measurement was relatively low in older people, and there was the regional difference. This study indicated procedures and methods for evaluation quality of care using claim data.

Report

(3 results)
  • 2007 Annual Research Report   Final Research Report Summary
  • 2006 Annual Research Report
  • Research Products

    (14 results)

All 2008 2007

All Journal Article (11 results) (of which Peer Reviewed: 2 results) Presentation (3 results)

  • [Journal Article] Duplicative medications in patients who visit multiple medical institutions among the insured of a corporate health insurancesociety in Japan.2008

    • Author(s)
      Kinoshita H, Kobayashi Y, Fukuda T
    • Journal Title

      Health Policy 85

      Pages: 114-123

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Final Research Report Summary
    • Peer Reviewed
  • [Journal Article] レセプト情報のデータベース化に向けて2008

    • Author(s)
      小林 廉毅
    • Journal Title

      公衆衛生 72巻2号

      Pages: 143-146

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Annual Research Report 2007 Final Research Report Summary
  • [Journal Article] Duplicative medications in patients who visit multiple medical institutions among the insured of a corporate health insurance society in Japan2008

    • Author(s)
      Kinoshita H, Kobayashi Y, Fukuda T
    • Journal Title

      Health Policy 85

      Pages: 114-123

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Journal Article] Toward establishing a claim database(in Japanese)2008

    • Author(s)
      Kobayashi Y
    • Journal Title

      Koshu Eisei 72(2)

      Pages: 143-146

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Journal Article] Duplicative medications in patiellts who visit multiple medical institutions among the insured of a corporate health insurance society in Japan.2008

    • Author(s)
      Kinoshita H, Kobayashi Y, Fukuda T
    • Journal Title

      Health Policy 85

      Pages: 114-123

    • Related Report
      2007 Annual Research Report
    • Peer Reviewed
  • [Journal Article] レセプト情報を活かす(1)レセプト情報とは2007

    • Author(s)
      小林 廉毅
    • Journal Title

      公衆衛生 71巻4号

      Pages: 340-344

    • NAID

      40015425115

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Annual Research Report 2007 Final Research Report Summary
  • [Journal Article] レセプト情報を活かす(2)レセプト情報で何ができるか2007

    • Author(s)
      小林 廉毅
    • Journal Title

      公衆衛生 71巻5号

      Pages: 428-431

    • NAID

      40015457331

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Annual Research Report 2007 Final Research Report Summary
  • [Journal Article] 公衆衛生領域の医療経済データと個人情報保護2007

    • Author(s)
      小林 廉毅
    • Journal Title

      学術の動向 12巻12号

      Pages: 54-58

    • NAID

      130001752498

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Annual Research Report 2007 Final Research Report Summary
  • [Journal Article] Using claim data : What are claim data?(in Japanese)2007

    • Author(s)
      Kobayashi Y
    • Journal Title

      Koshu Eisei 71(4)

      Pages: 340-344

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Journal Article] Using claim data : For what and how can claim data be used?(in Japanese)2007

    • Author(s)
      Kobayashi Y
    • Journal Title

      Koshu Eisei 71(5)

      Pages: 428-431

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Journal Article] Health economic data and privacy protection in public health(in Japanese)2007

    • Author(s)
      Kobayashi Y
    • Journal Title

      Gakujutsu no Doko 12(12)

      Pages: 54-58

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Presentation] Duplicative medications in patients who visit multiple medical institutions and their implications for drug expenditures in Japan2007

    • Author(s)
      Kinoshita H, Kobayashi Y, Fukuda T
    • Organizer
      The 6th World Congress of International Health Economic Association (iHEA)
    • Place of Presentation
      Copenhagen, Denmark
    • Year and Date
      2007-07-09
    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Presentation] Duplicative medications in patients who visit multiple medical institutions and their implications for drug expenditures in Japan2007

    • Author(s)
      Kinoshita H, Kobayashi Y, Fukuda T
    • Organizer
      The 6th World Congress of International Health Economic Association(iHEA)
    • Place of Presentation
      Copenhagen, Denmark
    • Year and Date
      2007-07-09
    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Presentation] Duplicative medications in patients who visit multiple medica1 institutions and their implications for drug expenditures in Japan2007

    • Author(s)
      Kinoshita H, Kobayashi Y, Fukuda T
    • Organizer
      The 6th World Congress of International Health Economic Association (iHEA)
    • Place of Presentation
      Copenhagen, Denmark
    • Year and Date
      2007-07-09
    • Related Report
      2007 Annual Research Report

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Published: 2006-04-01   Modified: 2016-04-21  

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