2007 Fiscal Year Final Research Report Summary
Developing an evaluation method of quality of care using claim data of health insurance
| Project/Area Number |
18590593
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Public health/Health science
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| Research Institution | The University of Tokyo |
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Principal Investigator |
KOBAYASHI Yasuki The University of Tokyo, Graduate School of Medicine, Professor (70178341)
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| Project Period (FY) |
2006 – 2007
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| Keywords | claim data / quality of care / practice guideline / medical information / electronic database / diabetes mellitus / duplicative medication |
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| 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.
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