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      Registry and health insurance claims data in vascular research and quality improvement

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          Abstract

          Abstract. The expansion of procedures in multidisciplinary vascular medicine has sparked a controversy regarding measures of quality improvement. In addition to primary registries, the use of health insurance claims data is becoming of increasing importance. However, due to the fact that health insurance claims data are not collected for scientific evaluation but rather for reimbursement purposes, meticulous validation is necessary before and during usage in research and quality improvement matters. This review highlights the advantages and disadvantages of such data sources. A recent comprehensive expert opinion panel examined the use of health insurance claims data and other administrative data sources in medicine. Results from several studies concerning the validity of administrative data varied significantly. Validity of these data sources depends on the clinical relevance of the diagnoses considered. The rate of implausible information was 0.04 %, while the validity of the considered diagnoses varied between 80 and 97 % across multiple validation studies. A matching study between health insurance claims data of the third-largest German health insurance provider, DAK-Gesundheit, and a prospective primary registry of the German Society for Vascular Surgery demonstrated a good level of validity regarding the mortality of endovascular and open surgical treatment of abdominal aortic aneurysm in German hospitals. In addition, a large-scale international comparison of administrative data for the same disorder presented important results in treatment reality, which differed from those from earlier randomized controlled trials. The importance of administrative data for research and quality improvement will continue to increase in the future. When discussing the internal and external validity of this data source, one has to distinguish not only between its intended usage (research vs. quality improvement), but also between the included diseases and/or treatment procedures. Linkage between primary registry data and administrative data could be a reasonable solution to some current major issues of validity.


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          Author and article information

          Contributors
          Journal
          vas
          VASA
          European Journal of Vascular Medicine
          Hogrefe AG, Bern
          0301-1526
          1664-2872
          November 21, 2016
          January 05, 2017
          : 46
          : 1
          : 11-15
          Affiliations
          [ 1 ]University Heart Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany
          [ 2 ]Department of Vascular Medicine GermanVasc
          Author notes
          Dr. Christian-Alexander Behrendt, Department of Vascular Medicine, University Heart Center Hamburg, Martinistraße 52, 20246 Hamburg, Germany, E-mail ch.behrendt@ 123456uke.de
          Article
          vas_46_1_11
          10.1024/0301-1526/a000589
          27871211
          e71134e9-6a01-4ecb-a5b1-6d70fd3506e8
          Copyright @ 2016
          History
          : July 21, 2016
          : August 25, 2016
          Categories
          Review

          Medicine
          administrative data,routine data,quality improvement,data validity,health insurance claims data,Registry

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