Abstract
BackgroundJapan’s National Database (NDB) includes data on health checks and health insurance claims, is linkable using hash functions, and is available for research use. However, the linkage rate between health check and health insurance claims data has not been investigated.MethodsLinkage rate was evaluated by comparing observed medical and pharmaceutical charges among health check recipients in fiscal year (FY) 2009 (N = 21 588 883) with expected charges from the same population when record linkage was complete. Using the NDB, observed charges were estimated from the first published result of linking health check recipients in FY2009 and their health insurance claims in FY2010. Expected charges were estimated by combining 3 publicly available datasets, including data from the Medical Care Benefit Survey and an ad-hoc report by the Japan Health Insurance Association.ResultsOnly 14.9% of expected charges were linked by the NDB. The linkage rate was higher for women than for men (18.2% vs 12.4%) and for elderly adults as compared with younger adults (>25% vs <10%).ConclusionsThe linkage rate in the NDB was so low that any research linking health check and health insurance claims will not be reliable. Causes for the low linkage rate include differences between health check and health insurance claims data in name format (eg, insertion of a space between family and given names) and date of birth (Japanese vs Gregorian calendar). Investigation of the causes for the low linkage rate and measures for improvement are urgently needed.
Highlights
In 2008, the National Database (NDB) was created in Japan for the “development, implementation, and evaluation” of the Health Care Cost Containment Plan (HCCCP), as set forth by Section 16 of the Elderly Health Care Security Act
Data from regular health checks and guidance have been collected since fiscal year (FY) 2008, and health insurance claims data have been collected since April 2009
[4] Per capita medical and pharmaceutical charges for health check recipients in FY20097 A report submitted by the MHLW to the Seventh Meeting of the Committee on Health Checks and Guidance on February 24, 2012 used hash functions to link health check data in FY2009 and health insurance claims data in FY2010 on an individual basis and was the first published evidence of the accuracy of record linkage in the NDB
Summary
In 2008, the National Database (NDB) was created in Japan for the “development, implementation, and evaluation” of the Health Care Cost Containment Plan (HCCCP), as set forth by Section 16 of the Elderly Health Care Security Act. By combining 2 hash functions, the NDB maximizes record linkage of health insurance claims with health check data from the same person.. Japan’s National Database (NDB) includes data on health checks and health insurance claims, is linkable using hash functions, and is available for research use. Using the NDB, observed charges were estimated from the first published result of linking health check recipients in FY2009 and their health insurance claims in FY2010. Conclusions: The linkage rate in the NDB was so low that any research linking health check and health insurance claims will not be reliable. Causes for the low linkage rate include differences between health check and health insurance claims data in name format (eg, insertion of a space between family and given names) and date of birth (Japanese vs Gregorian calendar). Investigation of the causes for the low linkage rate and measures for improvement are urgently needed
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
