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. 2018 Jul 27:10:863-874.
doi: 10.2147/CLEP.S151890. eCollection 2018.

Cross-national health care database utilization between Spain and France: results from the EPICHRONIC study assessing the prevalence of type 2 diabetes mellitus

Guillaume Moulis #  1   2   3 , Berta Ibañez #  4   5   6 , Aurore Palmaro  2   3 , Felipe Aizpuru  6   7   8 , Eduardo Millan  6   8 , Maryse Lapeyre-Mestre  2   3   9 , Laurent Sailler  1   2   3 , Koldo Cambra  5   6   10
Affiliations

Cross-national health care database utilization between Spain and France: results from the EPICHRONIC study assessing the prevalence of type 2 diabetes mellitus

Guillaume Moulis et al. Clin Epidemiol. .

Abstract

Aim: The EPICHRONIC (EPIdemiology of CHRONIC diseases) project investigated the possibility of developing common procedures for French and Spanish electronic health care databases to enable large-scale pharmacoepidemiological studies on chronic diseases. A feasibility study assessed the prevalence of type 2 diabetes mellitus (T2DM) in Navarre and the Basque Country (Spain) and the Midi-Pyrénées region (France).

Patients and methods: We described and compared database structures and the availability of hospital, outpatient, and drug-dispensing data from 5.9 million inhabitants. Due to differences in database structures and recorded data, we could not develop a common procedure to estimate T2DM prevalence, but identified an algorithm specific to each database. Patients were identified using primary care diagnosis codes previously validated in Spanish databases and a combination of primary care diagnosis codes, hospital diagnosis codes, and data on exposure to oral antidiabetic drugs from the French database.

Results: Spanish and French databases (the latter termed Système National d'Information Inter-Régimes de l'Assurance Maladie [SNIIRAM]) included demographic, primary care diagnoses, hospital diagnoses, and outpatient drug-dispensing data. Diagnoses were encoded using the International Classification of Primary Care (version 2) and the International Classification of Diseases, version 9 and version 10 (ICD-9 and ICD-10) in the Spanish databases, whereas the SNIIRAM contained ICD-10 codes. All data were anonymized before transferring to researchers. T2DM prevalence in the population over 20 years was estimated to be 6.6-7.0% in the Spanish regions and 6.3% in the Midi-Pyrénées region with ~2% higher estimates for males in the three regions.

Conclusion: Tailored procedures can be designed to estimate the prevalence of T2DM in population-based studies from Spanish and French electronic health care records.

Keywords: cross-national study; electronic health care database; epidemiology; pharmacoepidemiology; population-based study; type 2 diabetes mellitus.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Simplified architecture of the SNIIRAM. Abbreviations: DCIR, Données de Consommation Inter-Régimes (Inter-Scheme Consumption Data); HAD, Hospitalisation à Domicile (home hospitalization); MCO, Médecine, Chirurgie, Obstétrique (medicine, surgery, obstetrics); PMSI, Programme de Médicalisation des Systèmes d’Information (Program for the Medicalization of Information Systems); PSY, psychiatry; SNIIRAM, Système National d’Information Inter-Régime de l’Assurance Maladie (National Health Insurance Information System); SSR, Services de Suite et de Réadaptation (after care and rehabilitation).
Figure 2
Figure 2
Simplified architecture of Spanish databases. Abbreviations: MBDS, Minimum Basic Data Set; PCIS, primary care information system.
Figure 3
Figure 3
Combination of three sources to identify 141,669 prevalent French patients with type 2 diabetes mellitus. Note: Numbers indicate the numbers and percentages of patients with type 2 diabetes mellitus identified using each source alone and combinations of sources. Abbreviations: LTD, long-term disease; PMSI, Programme de Médicalisation des Systèmes d’Information (Program for the Medicalization of Information Systems); OADs, oral antidiabetic drugs.
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