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Oba S, Murakami H, Saitoh T, Hayashi K, Okada Y, Imano Y, Takaki O, Kiryu I, Ishikawa M, Sato Y. Factors Related to Diagnosis of Diabetes After Detecting High Blood Glucose Levels Through Screening: One-Year Follow-up Among Publicly Insured Adults in Gunma, Japan. Asia Pac J Public Health 2024; 36:595-602. [PMID: 39054586 DOI: 10.1177/10105395241262852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
This study aimed to assess the diagnosis of diabetes after detecting high blood glucose levels through screening among insured individuals in Gunma, Japan. Data for men and women 35 to 74 years of age were provided by Japan Health Insurance Association, and 4133 individuals with high blood glucose levels while not currently being treated for diabetes were included in the study. About 13% received a diagnosis of diabetes at a subsequent physician visit, and individuals who were under treatment for hypertension were less likely to receive the added diagnosis of diabetes compared with those not being treated for hypertension (odds ratio = 0.42 from a logistic regression model). Fasting blood glucose levels were significantly improved in the next year only among individuals with a confirmed diagnosis of diabetes.
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Affiliation(s)
- Shino Oba
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
- Center for Food Science and Wellness, Gunma University, Maebashi, Japan
- Interfaculty Initiative in Public Health, Gunma University, Maebashi, Japan
| | - Hirokazu Murakami
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
- Gunma University of Health and Welfare, Maebashi, Japan
| | - Takayuki Saitoh
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Kunihiko Hayashi
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Yoshihisa Okada
- Japan Health Insurance Association, Gunma Branch, Maebashi, Japan
| | - Yasuko Imano
- Japan Health Insurance Association, Gunma Branch, Maebashi, Japan
| | - Osamu Takaki
- Faculty of Informatics, Gunma University, Maebashi, Japan
| | - Ikue Kiryu
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
- School of Nursing, Dokkyo Medical University, Shimotsuga, Japan
| | - Mai Ishikawa
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Yumi Sato
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
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Ito S, Muraki Y, Inose R, Mizuno K, Goto R, Kiyosuke M, Iinuma Y, Yagi T, Ohge H. Characteristics of pediatric patients claimed with acute upper respiratory infection during otorhinolaryngology consultations: A descriptive study of a large Japanese medical claims database. J Infect Chemother 2024; 30:815-819. [PMID: 38272261 DOI: 10.1016/j.jiac.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
This study aimed to clarify other diseases claimed simultaneously with acute upper respiratory infection (URI), antibiotic prescriptions, and examinations associated with infectious diseases in pediatric patients with acute URI insurance claims at otorhinolaryngology outpatient visits. Pediatric patients who visited an otolaryngology department between 2019 and 2021 and were definitively diagnosed with URI were selected using a large Japanese medical claims database. Patient backgrounds, antibiotic use, and examinations were descriptively evaluated. In total, 8010 patients were included in the analysis. The median number (interquartile range) of diseases claimed in the same month as acute URI was 4 (3-6). Only 519 (6.5 %) patients were claimed as acute URI alone. Regardless of the prescription of antibiotics, the most commonly redundantly claimed disease in these patients was allergic rhinitis, followed by acute bronchitis, acute sinusitis, and earwax impaction. The frequently prescribed antibiotics were third-generation cephalosporins, macrolides, and penicillins with extended-spectrum, including amoxicillin which was recommended by the Japanese manual; the proportion of patients with examinations was low (2.9-21.7 %). Among patients with acute URI, diagnoses requiring antibiotics were also claimed; therefore, when evaluating acute URI using the Japanese medical claims database, care must be taken in patient selection. Moreover, the implementation rate of examinations necessary for diagnosis was low, so there is an urgent need to develop an environment where examinations can be conducted in outpatient settings.
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Affiliation(s)
- Saki Ito
- Laboratory of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical University, Kyoto, 607-8414, Japan
| | - Yuichi Muraki
- Laboratory of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical University, Kyoto, 607-8414, Japan.
| | - Ryo Inose
- Laboratory of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical University, Kyoto, 607-8414, Japan
| | - Kanako Mizuno
- Laboratory of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical University, Kyoto, 607-8414, Japan
| | - Ryota Goto
- Laboratory of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical University, Kyoto, 607-8414, Japan
| | - Makiko Kiyosuke
- Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, Fukuoka, 812-8582, Japan
| | - Yoshitsugu Iinuma
- Department of Infectious Disease, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Tetsuya Yagi
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, 466-0065, Japan
| | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
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Jeon B, Tamiya N, Yoshie S, Iijima K, Ishizaki T. Potentially avoidable hospitalizations, non-potentially avoidable hospitalizations and in-hospital deaths among residents of long-term care facilities. Geriatr Gerontol Int 2019; 18:1272-1279. [PMID: 30136395 DOI: 10.1111/ggi.13458] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 04/20/2018] [Accepted: 05/27/2018] [Indexed: 11/29/2022]
Abstract
AIM The present study aimed to examine the percentage of and risk factors for potentially avoidable hospitalizations (PAH), non-PAH and in-hospital deaths among residents of special nursing homes for the elderly (SNH) and geriatric health service facilities (GHSF). METHODS Long-term care and national health insurance claims data (April 2012 to September 2013) were obtained from a suburban city in Chiba prefecture, Japan. Study participants were aged ≥75 years and resided in either SNH (n = 1138) or GHSF (n = 885). The PAH were defined using 17 medical condition groups, and the percentage of PAH, non-PAH and in-hospital deaths was identified, and associated factors were compared using multilevel logistic regression models for SNH and GHSF, respectively. RESULTS A total of 34.5% SNH residents experienced any hospitalization, and this was composed of PAH (16.3%), non-PAH (12.2%) or in-hospital deaths (6.1%). Of the GHSF residents, 23.8% experienced any hospitalization, and this was comprised of PAH (9.5%), non-PAH (10.6%) and in-hospital death (3.7%). More than 70% of the PAH were related to respiratory infections, urinary tract infections or congestive heart failure. In both SNH and GHSF, artificial nutrition was positively associated with PAH and non-PAHs, and male sex was positively associated with non-PAHs and in-hospital deaths. However, there were also discrepancies between SNH and GHSF in terms of risk factors for PAH. CONCLUSIONS The percentage of PAH was higher in SNH than in GHSF, which might be related to their different personnel and managerial regulations. The linkage of health and long-term care claims data might facilitate data-based evidence on policy-making. Geriatr Gerontol Int 2018; 18: 1272-1279.
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Affiliation(s)
- Boyoung Jeon
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Division of Health Service for the Disabled, National Rehabilitation Center, Seoul, Republic of Korea
| | - Nanako Tamiya
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Health Services Research & Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Satoru Yoshie
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Institute of Gerontology, The University of Tokyo, Tokyo, Japan.,Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Tatsuro Ishizaki
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Ohisa M, Kimura Y, Matsuo J, Akita T, Sato T, Matsuoka T, Sakamune K, Katayama K, Huy Do S, Miyakawa Y, Tanaka J. Estimated numbers of patients with liver disease related to hepatitis B or C virus infection based on the database reconstructed from medical claims from 2008 to 2010 in Japan. Hepatol Res 2015; 45:1228-40. [PMID: 25627814 DOI: 10.1111/hepr.12497] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 01/01/2015] [Accepted: 01/20/2015] [Indexed: 12/20/2022]
Abstract
AIM To estimate the number of patients with liver-related diseases classified by hepatitis viruses (HBV, HCV) based on the information from re-coded medical claims including several diagnosed diseases. METHODS We analyzed reimbursement data provided by health insurance societies for 2.1 million individuals during 2008-2010. Database information of employees and their families aged under 65 years employees with hepatitis-related disease was extracted, the 1-year period prevalence was calculated, and then number of patients with liver disease related to HBV and HCV by sex and age groups, respectively, was estimated. RESULTS The estimated number of patients were almost equivalent during 2008-2010. As for HBV and HCV, the estimated numbers of patients with chronic hepatitis (CH) in a year ranged 192 641-226 601 and 282 438-306 877, respectively. CONCLUSION In the 2008 Patient Survey in Japan, the number of patients was estimated by the main disease in one patient, even though the patient was diagnosed with several diseases. Based on the database with hepatitis-related diseases after evaluating several diagnosed diseases from medical claims, the estimation method and protocol may minimize the disadvantage of medical claim analysis, and is useful for patients, especially asymptomatic carriers and those with CH which had been underestimated in the 2008 Patient Survey.
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Affiliation(s)
- Masayuki Ohisa
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuki Kimura
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Junko Matsuo
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomoyuki Akita
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomoki Sato
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toshihiko Matsuoka
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuaki Sakamune
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keiko Katayama
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Son Huy Do
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Tanihara S. Assessment of text documentation accompanying uncoded diagnoses in computerized health insurance claims in Japan. J Epidemiol 2015; 25:181-8. [PMID: 25716369 PMCID: PMC4340994 DOI: 10.2188/jea.je20140105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Uncoded diagnoses in health insurance claims (HICs) may introduce bias into Japanese health statistics dependent on computerized HICs. This study’s aim was to identify the causes and characteristics of uncoded diagnoses. Methods Uncoded diagnoses from computerized HICs (outpatient, inpatient, and the diagnosis procedure-combination per-diem payment system [DPC/PDPS]) submitted to the National Health Insurance Organization of Kumamoto Prefecture in May 2010 were analyzed. The text documentation accompanying the uncoded diagnoses was used to classify diagnoses in accordance with the International Classification of Diseases-10 (ICD-10). The text documentation was also classified into four categories using the standard descriptions of diagnoses defined in the master files of the computerized HIC system: 1) standard descriptions of diagnoses, 2) standard descriptions with a modifier, 3) non-standard descriptions of diagnoses, and 4) unclassifiable text documentation. Using these classifications, the proportions of uncoded diagnoses by ICD-10 disease category were calculated. Results Of the uncoded diagnoses analyzed (n = 363 753), non-standard descriptions of diagnoses for outpatient, inpatient, and DPC/PDPS HICs comprised 12.1%, 14.6%, and 1.0% of uncoded diagnoses, respectively. The proportion of uncoded diagnoses with standard descriptions with a modifier for Diseases of the eye and adnexa was significantly higher than the overall proportion of uncoded diagnoses among every HIC type. Conclusions The pattern of uncoded diagnoses differed by HIC type and disease category. Evaluating the proportion of uncoded diagnoses in all medical facilities and developing effective coding methods for diagnoses with modifiers, prefixes, and suffixes should reduce number of uncoded diagnoses in computerized HICs and improve the quality of HIC databases.
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Affiliation(s)
- Shinichi Tanihara
- Department of Public Health and Preventive Medicine, School of Medicine, Fukuoka University
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Tanihara S. The proportion of uncoded diagnoses in computerized health insurance claims in Japan in May 2010 according to ICD-10 disease categories. J Epidemiol 2014; 24:392-6. [PMID: 24975015 PMCID: PMC4150010 DOI: 10.2188/jea.je20130194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Uncoded diagnoses in computerized health insurance claims are excluded from statistical summaries of health-related risks and other factors. The effects of these uncoded diagnoses, coded according to ICD-10 disease categories, have not been investigated to date in Japan. Methods I obtained all computerized health insurance claims (outpatient medical care, inpatient medical care, and diagnosis procedure-combination per-diem payment system [DPC/PDPS] claims) submitted to the National Health Insurance Organization of Kumamoto Prefecture in May 2010. These were classified according to the disease categories of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). I used accompanying text documentation related to the uncoded diagnoses to classify these diagnoses. Using these classifications, I calculated the proportion of uncoded diagnoses by ICD-10 category. Results The number of analyzed diagnoses was 3 804 246, with uncoded diagnoses accounting for 9.6% of the total. The proportion of uncoded diagnoses in claims for outpatient medical care, inpatient medical care, and DPC/PDPS were 9.3%, 10.9%, and 14.2%, respectively. Among the diagnoses, Congenital malformations, deformations, and chromosomal abnormalities had the highest proportion of uncoded diagnoses (19.3%), and Diseases of the respiratory system had the lowest proportion of uncoded diagnoses (4.7%). Conclusions The proportion of uncoded diagnoses differed by the type of health insurance claim and disease category. These findings indicate that Japanese health statistics computed using computerized health insurance claims might be biased by the exclusion of uncoded diagnoses.
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Affiliation(s)
- Shinichi Tanihara
- Department of Public Health and Preventive Medicine, School of Medicine
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Okamoto E. Effects of health guidance on outpatient and pharmacy expenditures: a disease- and drug-specific 3-year observational study using propensity-score matching. J Epidemiol 2013; 23:262-9. [PMID: 23728485 PMCID: PMC3709548 DOI: 10.2188/jea.je20120136] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Evidence is lacking on whether health guidance for metabolic syndrome reduces health care expenditures. The author used propensity-score matching to evaluate the effects of health guidance on health care expenditure. METHODS Men who did and did not receive health guidance from a health insurance society (approximately 60 000 covered lives) were matched (n = 397 respectively) using propensity scores. Health insurance claims were compared using cumulative health care expenditures for metabolic syndrome-related outpatient medical care and drug costs for the period from the initial consultation to 3 years later. RESULTS No difference was observed between intervention and control groups in cumulative outpatient charges or drug costs related to metabolic syndrome. However, regression analysis using the Tobit model showed that health guidance resulted in a small, nonsignificant reduction in health care expenditure. CONCLUSIONS Health guidance for metabolic syndrome did not reduce outpatient charges or drug costs related to metabolic syndrome during the 3-year period after the intervention. Findings from Tobit regression suggest that health guidance might eventually result in savings, but this hypothesis remains untested.
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Affiliation(s)
- Etsuji Okamoto
- National Institute of Public Health, Department of Health and Welfare Service Research, Wako, Saitama, Japan.
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