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Validation of claims data to identify death among aged persons utilizing enrollment data from health insurance unions.
Environ Health Prev Med. 2019 Nov 23; 24(1):63.EH

Abstract

The identification of death is critical for epidemiological research. Despite recent developments in health insurance claims databases, the quality of death information in claims is not guaranteed because health insurance claims are collected primarily for reimbursement. We aimed to examine the usefulness and limitations of death information in claims data and to examine methods for improving the quality of death information for aged persons.We used health insurance claims data and enrollment data (as the gold standard) from September 2012 through August 2015 for nondependent persons aged 65-74 years enrolled in Japanese workplace health insurance. Overall, 3,710,538 insured persons were registered in the database during the study period. We analyzed 45,441 eligible persons. Inpatient and outpatient deaths were identified from the discharge/disease status in the claims, with sensitivities of 94.3% and 47.4%, specificities of 98.5% and 99.9%, and PPVs of 96.3% and 95.7%, respectively, using enrollment data as the gold standard. For outpatients, death defined as a combination of disease status and charge data for terminal care still indicated low sensitivity (54.7%).The validity of death information in inpatient claims was high, suggesting its potential usefulness for identifying death. However, given the low sensitivity for outpatient deaths, the use of death information obtained solely from records in outpatient claims is not recommended.

Authors+Show Affiliations

Department of Health Informatics, Kyoto University School of Public Health, Yoshidakonoe-cho, Sakyo-ku Kyoto, 606-8501, Japan. sakai.michi.7v@kyoto-u.ac.jp. Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku Kyoto, 606-8507, Japan. sakai.michi.7v@kyoto-u.ac.jp. Department of Research, Institute for Health Economics and Policy, Tokyo, Japan. sakai.michi.7v@kyoto-u.ac.jp.Department of Health Informatics, Kyoto University School of Public Health, Yoshidakonoe-cho, Sakyo-ku Kyoto, 606-8501, Japan. Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku Kyoto, 606-8507, Japan.Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku Kyoto, 606-8507, Japan.Department of Health Informatics, Kyoto University School of Public Health, Yoshidakonoe-cho, Sakyo-ku Kyoto, 606-8501, Japan. Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku Kyoto, 606-8507, Japan.Solutions Center for Health Insurance Claims, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku Kyoto, 606-8507, Japan.Department of Health Informatics, Kyoto University School of Public Health, Yoshidakonoe-cho, Sakyo-ku Kyoto, 606-8501, Japan.Department of Health Informatics, Kyoto University School of Public Health, Yoshidakonoe-cho, Sakyo-ku Kyoto, 606-8501, Japan.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31759388

Citation

Sakai, M, et al. "Validation of Claims Data to Identify Death Among Aged Persons Utilizing Enrollment Data From Health Insurance Unions." Environmental Health and Preventive Medicine, vol. 24, no. 1, 2019, p. 63.
Sakai M, Ohtera S, Iwao T, et al. Validation of claims data to identify death among aged persons utilizing enrollment data from health insurance unions. Environ Health Prev Med. 2019;24(1):63.
Sakai, M., Ohtera, S., Iwao, T., Neff, Y., Kato, G., Takahashi, Y., & Nakayama, T. (2019). Validation of claims data to identify death among aged persons utilizing enrollment data from health insurance unions. Environmental Health and Preventive Medicine, 24(1), 63. https://doi.org/10.1186/s12199-019-0819-3
Sakai M, et al. Validation of Claims Data to Identify Death Among Aged Persons Utilizing Enrollment Data From Health Insurance Unions. Environ Health Prev Med. 2019 Nov 23;24(1):63. PubMed PMID: 31759388.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Validation of claims data to identify death among aged persons utilizing enrollment data from health insurance unions. AU - Sakai,M, AU - Ohtera,S, AU - Iwao,T, AU - Neff,Y, AU - Kato,G, AU - Takahashi,Y, AU - Nakayama,T, AU - ,, Y1 - 2019/11/23/ PY - 2019/05/08/received PY - 2019/09/23/accepted PY - 2019/11/25/entrez PY - 2019/11/25/pubmed PY - 2019/12/21/medline KW - Aged KW - Health insurance claims KW - Sensitivity KW - Specificity KW - Validation SP - 63 EP - 63 JF - Environmental health and preventive medicine JO - Environ Health Prev Med VL - 24 IS - 1 N2 - The identification of death is critical for epidemiological research. Despite recent developments in health insurance claims databases, the quality of death information in claims is not guaranteed because health insurance claims are collected primarily for reimbursement. We aimed to examine the usefulness and limitations of death information in claims data and to examine methods for improving the quality of death information for aged persons.We used health insurance claims data and enrollment data (as the gold standard) from September 2012 through August 2015 for nondependent persons aged 65-74 years enrolled in Japanese workplace health insurance. Overall, 3,710,538 insured persons were registered in the database during the study period. We analyzed 45,441 eligible persons. Inpatient and outpatient deaths were identified from the discharge/disease status in the claims, with sensitivities of 94.3% and 47.4%, specificities of 98.5% and 99.9%, and PPVs of 96.3% and 95.7%, respectively, using enrollment data as the gold standard. For outpatients, death defined as a combination of disease status and charge data for terminal care still indicated low sensitivity (54.7%).The validity of death information in inpatient claims was high, suggesting its potential usefulness for identifying death. However, given the low sensitivity for outpatient deaths, the use of death information obtained solely from records in outpatient claims is not recommended. SN - 1347-4715 UR - https://www.unboundmedicine.com/medline/citation/31759388/Validation_of_claims_data_to_identify_death_among_aged_persons_utilizing_enrollment_data_from_health_insurance_unions L2 - https://environhealthprevmed.biomedcentral.com/articles/10.1186/s12199-019-0819-3 DB - PRIME DP - Unbound Medicine ER -