Stroke Research Using Administrative Claims Database in Japan: A Narrative Review

Abstract

Aims: Although administrative claims databases have recently been used for clinical research in Japan, no detailed description of their utilization in stroke research is available. We reviewed stroke studies using the Diagnosis Procedure Combination (DPC), the National Database of Health Insurance Claims and Specific Health Checkups (NDB), and several commercial databases sourced from social health insurance associations, focusing on their applications and limitations.

Methods: Original articles on stroke published by April 2024 using the DPC, NDB, and commercial databases were identified in Ovid MEDLINE. The characteristics of each database were compared in terms of comprehensiveness, traceability, baseline information, and outcome assessment in stroke research.

Results: A total of 114 studies were included (83 for DPC, 6 for NDB, and 25 for commercial databases). The number of stroke studies using administrative databases in Japan is still approximately 10 per year, although there is a slowly increasing trend. The DPC database was utilized for short-term outcome studies because of its detailed baseline and outcome information, although the inability to track patients once they changed facilities limits their use in long-term studies. The NDB database is potentially useful for long-term studies because of its comprehensiveness and traceability, but difficulties in data access restrict its usage. The most commonly used commercial database utilizes baseline information on lifestyle and blood test data, although the lack of coverage for those over 75 years old may limit its generalizability.

Conclusions: Administrative claims databases are beginning to be used in stroke research in Japan but are not yet fully utilized. Researchers need to understand their applications and limitations.

Keywords: Administrative claims database; Diagnosis Procedure Combination (DPC) database; National Database of Health Insurance Claims; Specific Health Checkups (NDB) database; Stroke.

Fig.1. Flow diagram of the study selection

Abbreviations: DPC, Diagnosis Procedure Combination (DPC) database; NDB, National Database of Health Insurance Claims and Specific Health Checkups. The commercial database included Japanese commercial databases sourced from social health insurance associations.

Fig.2. The number of articles obtained from the DPC, NDB, and commercial databases published and included in Ovid MEDLINE up to April 1, 2024

DPC, the Diagnosis Procedure Combination database; NDB, the National Database of Health Insurance Claims and Specific Health Checkups.