CC BY-NC-ND 4.0 · Gesundheitswesen 2020; 82(S 02): S94-S100
DOI: 10.1055/a-0883-5098
Übersichtsarbeit
Eigentümer und Copyright ©Georg Thieme Verlag KG 2019

Data Privacy Compliant Validation of Health Insurance Claims Data: the IDOMENEO Approach

Datenschutzkonforme Validierung von Routinedaten – Die IDOMENEO Methode
Christian-Alexander Behrendt
1   Department of Vascular Medicine, Work Group GermanVasc, University Medical Center Hamburg-Eppendorf, Hamburg
,
Thea Schwaneberg
1   Department of Vascular Medicine, Work Group GermanVasc, University Medical Center Hamburg-Eppendorf, Hamburg
,
Sandra Hischke
2   Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg
1   Department of Vascular Medicine, Work Group GermanVasc, University Medical Center Hamburg-Eppendorf, Hamburg
,
Tobias Müller
3   Department of Informatics, University of Hamburg, Hamburg
,
Tom Petersen
3   Department of Informatics, University of Hamburg, Hamburg
,
Ursula Marschall
4   BARMER, Healthcare Research, Wuppertal
,
Sebastian Debus
1   Department of Vascular Medicine, Work Group GermanVasc, University Medical Center Hamburg-Eppendorf, Hamburg
,
Levente Kriston
2   Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg
› Author Affiliations
Funding The IDOMENEO study is funded by the German Joint Federal Committee (Gemeinsamer Bundesausschuss, G-BA) (01VSF16008) and the GermanVasc registry is co-funded by the German Stifterverband as well as by the CORONA foundation (S199/10061/2015).
Further Information

Publication History

Publication Date:
23 May 2019 (online)

Abstract

Recently, health insurance claims have regained the attention of the scientific community as a source of real-world evidence in health care research and quality improvement. To date, very few studies are available which investigate the validity of health insurance claims; these may be affected by bias from several sources, such as possible upcoding of co-morbidities and complications for reimbursement advantages. The IDOMENEO study investigates the inpatient treatment of peripheral arterial disease (PAD) comprehensively using various data sources with a consortium involving experts from health care research and data privacy, a large health insurance fund, biostatisticians, jurists, and computer scientists. Prospective registry data were collected from 30–40 vascular centres in Germany using the GermanVasc registry. In addition, health insurance claims data were prospectively collected from BARMER, the second largest health insurance fund in Germany. The consortium is currently developing a data privacy compliant method of health insurance claims data validation, the methodological foundations of which are described here.

Zusammenfassung

Routinedaten gewinnen zunehmend an Aufmerksamkeit durch die wissenschaftliche Community bei Projekten der Versorgungsforschung und Qualitätsentwicklung. Bis heute sind allerdings nur wenige Studien verfügbar, die sich mit der Validität von Routinedaten beschäftigen; Diese können einem Bias unterliegen, z. B. durch Fehlkodierungen von Komorbiditäten oder Komplikationen, um Vorteile bei der Erlösabrechnung zu erreichen. Die IDOMENEO-Studie untersucht die stationären Behandlungen von Patienten mit peripherer arterieller Verschlusskrankheit (PAVK) und nutzt dafür verschiedene Datenquellen. Das Studienkonsortium umfasst Experten aus den Bereichen Versorgungsforschung, Datenschutz, Kostenträger, Biostatistik, Rechtswissenschaften und Informatik. Primärdaten aus Registern werden an 30–40 Gefäßzentren prospektiv über das GermanVasc-Register erhoben. Zusätzlich werden Routinedaten der BARMER, der zweitgrößten gesetzlichen Krankenversicherung in Deutschland, analysiert. Das Konsortium entwickelt derzeit datenschutzkonforme Methoden, um die Routinedaten zu validieren. Die methodischen Grundlagen werden in diesem Artikel beschrieben.

 
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