Studies of health insurance claims data in Japan : a scoping review

• Material Type: 記事
• Title: Studies of health insurance claims data in Japan : a scoping review
• Author/Editor: Maiko Suto; Takehiro Sugiyama; Kenjiro Imai; Takashi Furuno; Mariko Hosozawa; Yuichi Ichinose; Noriko Ihana-Sugiyama; Tomoko Kodama; Ryuji Koizumi; Yuko Shimizu-Motohashi; Shunsuke Murata; Yayoi Nakamura1; Mariko Niino; Misuzu Sato; Reina Taguchi; Misa Takegami; Motoko Tanaka; Kota Tsutsumimoto; Kentaro Usuda; Kenji Takehara; Hiroyasu Iso
• Publication, Distribution, etc.: 日本 : Japan Medical Association
• Publication Date: 2023-07-14
• Publication Date (W3CDTF): 2023-07-14
• Periodical title: JMA Journal
• No. or year of volume/issue: 6(3)
• Volume: 6(3)
• ISSN (Periodical Title): 2433-3298
• ISSN-L (Periodical Title): 2433-328X
• Text Language Code: eng
• DOI: 10.31662/jmaj.2022-0184; https://doi.org/10.31662/jmaj.2022-0184
• Persistent ID (NDL): info:ndljp/pid/14495015; https://dl.ndl.go.jp/pid/14495015
• Collection: 障害者向け資料
• Collection (Materials For Handicapped People:1): テキストデータ
• Collection (particular): 国立国会図書館デジタルコレクション > 電子書籍・電子雑誌 > その他; https://dl.ndl.go.jp/collections/B00035
• Acquisition Basis: インターネット資料収集保存事業（WARP）
• Date Accepted (W3CDTF): 2025-10-21T09:04:40+09:00
• Date Captured (W3CDTF): 2024-09-26
• Format (IMT): application/pdf
• Access Restrictions: インターネット公開
• Availability of remote photoduplication service: 不可
• Periodical Title (URI): https://warp.da.ndl.go.jp/info:ndljp/pid/13747952/www.jmaj.jp/detail.php?id=10.31662%2Fjmaj.2022-0184
• Periodical Title (Persistent ID (NDL)): info:ndljp/pid/14495014; https://dl.ndl.go.jp/pid/14495014
• Data Provider (Database): 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp

• Summary, etc.: <p><b>Background:</b> Health insurance claims data are used in various research fields; however, an overview on how they are used in healthcare research is scarce in Japan. Therefore, we conducted a scoping review to systematically map the relevant studies using Japanese claims data.</p><p><b>Methods:</b> MEDLINE, EMBASE, and Ichushi-Web were searched up to April 2021 for studies using Japanese healthcare claims data. We abstracted the data on study characteristics and summarized target diseases and research themes by the types of claims database. Moreover, we described the results of studies that aimed to compare health insurance claims data with other data sources narratively.</p><p><b>Results:</b> A total of 1,493 studies were included. Overall, the most common disease classifications were "Diseases of the circulatory system" (18.8%, n = 281), "Endocrine, nutritional, and metabolic diseases" (11.5%, n = 171; mostly diabetes), and "Neoplasms" (10.9%, n = 162), and the most common research themes were "medical treatment status" (30.0%, n = 448), "intervention effect" (29.9%, n = 447), and "clinical epidemiology, course of diseases" (27.9%, n = 417). Frequent diseases and themes varied by type of claims databases. A total of 19 studies aimed to assess the validity of the claims-based definition, and 21 aimed to compare the results of claims data with other data sources. Most studies that assessed the validity of claims data compared to medical records were hospital-based, with a small number of institutions.</p><p><b>Conclusions:</b> Claims data are used in various research areas and will increasingly provide important evidence for healthcare policy in Japan. It is important to use previous claims database studies and share information on methodology among researchers, including validation studies, while informing policymakers about the applicability of claims data for healthcare planning and management.</p>
• DOI: 10.31662/jmaj.2022-0184
• Access Restrictions: インターネット公開
• Data Provider (Database): 科学技術振興機構 : J-STAGE; http://www.jstage.jst.go.jp

• Summary, etc.: <p><b>Background:</b> Health insurance claims data are used in various research fields; however, an overview on how they are used in healthcare research is scarce in Japan. Therefore, we conducted a scoping review to systematically map the relevant studies using Japanese claims data.</p><p><b>Methods:</b> MEDLINE, EMBASE, and Ichushi-Web were searched up to April 2021 for studies using Japanese healthcare claims data. We abstracted the data on study characteristics and summarized target diseases and research themes by the types of claims database. Moreover, we described the results of studies that aimed to compare health insurance claims data with other data sources narratively.</p><p><b>Results:</b> A total of 1,493 studies were included. Overall, the most common disease classifications were "Diseases of the circulatory system" (18.8%, n = 281), "Endocrine, nutritional, and metabolic diseases" (11.5%, n = 171; mostly diabetes), and "Neoplasms" (10.9%, n = 162), and the most common research themes were "medical treatment status" (30.0%, n = 448), "intervention effect" (29.9%, n = 447), and "clinical epidemiology, course of diseases" (27.9%, n = 417). Frequent diseases and themes varied by type of claims databases. A total of 19 studies aimed to assess the validity of the claims-based definition, and 21 aimed to compare the results of claims data with other data sources. Most studies that assessed the validity of claims data compared to medical records were hospital-based, with a small number of institutions.</p><p><b>Conclusions:</b> Claims data are used in various research areas and will increasingly provide important evidence for healthcare policy in Japan. It is important to use previous claims database studies and share information on methodology among researchers, including validation studies, while informing policymakers about the applicability of claims data for healthcare planning and management.</p>
• DOI: 10.31662/jmaj.2022-0184; https://doi.org/10.31662/jmaj.2022-0184
• Access Restrictions: インターネット公開
• Related Material (URI): http://id.ndl.go.jp/digimeta/14495015; https://dl.ndl.go.jp/pid/14495015; https://www.jmaj.jp/download.php?id=10.31662/jmaj.2022-0184; https://search.jamas.or.jp/link/ui/2024269064
• Is Referenced By: Maternal age and the rising incidence of hypertensive disorders of pregnancy: A comprehensive analysis of national claims data from Japan; https://cir.nii.ac.jp/crid/1360025431099819776; Prevalence of systemic lupus erythematosus and age-stratified treatment trends in the Japanese population: A cross-sectional study based on the National Database of Health Insurance Claims; https://cir.nii.ac.jp/crid/1360306904404484736; Changes in the Utilization of Outpatient and Visiting Dental Care and Per-attendance Care Cost by Age Groups During COVID-19 Pandemic Waves in Japan: A Time-series Analysis From the LIFE Study; https://cir.nii.ac.jp/crid/1390302071848380032; Sex Differences in Post-Noncardiac Surgery Risks Assessed Using the Revised Cardiac Risk Index ― A Nationwide Retrospective Cohort Study ―; https://cir.nii.ac.jp/crid/1390868295121593600
• Data Provider (Database): 国立情報学研究所 : CiNii Research; https://cir.nii.ac.jp/
• Original Data Provider (Database): Japan Link Center; https://japanlinkcenter.org/top; 雑誌記事索引データベース; https://ndlsearch.ndl.go.jp; Crossref; https://www.crossref.org
• Bibliographic ID (NDL): 14495015; http://id.ndl.go.jp/bib/14495015