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Estimation of disease incidence in claims data dependent on the length of follow-up: a methodological approach.

ABSTRACT: OBJECTIVE: To analyze the impact of the length of disease-free intervals on incidence estimation. DATA SOURCE: Statutory health insurance sample in Germany. STUDY DESIGN: Overestimation of the incidence in the first quarter of 2008 for three selected diseases, diabetes mellitus, colorectal cancer, and heart failure, depending on different lengths of preceding disease-free intervals. DATA COLLECTION/EXTRACTION METHODS: Continuously insured from 2000 until 2008 ? 18 years (N = 144,907). PRINCIPAL FINDINGS: Compared with an 8-year disease-free period, incidence overestimations for diabetes, colorectal cancer, and heart failure were 40, 23, and 43 percent defining a 1-year, and 5, 9, and 5 percent defining a 5-year disease-free period, respectively. CONCLUSIONS: Depending on the specific disease, caution has to be taken while using short disease-free periods because incidence estimates may be extremely overestimated.

SUBMITTER: Abbas S

PROVIDER: S-EPMC3419886 | biostudies-other | 2012 Apr

REPOSITORIES: biostudies-other

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Estimation of disease incidence in claims data dependent on the length of follow-up: a methodological approach.

Abbas Sascha S Ihle Peter P Köster Ingrid I Schubert Ingrid I

Health services research 20120401 2

<h4>Objective</h4>To analyze the impact of the length of disease-free intervals on incidence estimation.<h4>Data source</h4>Statutory health insurance sample in Germany.<h4>Study design</h4>Overestimation of the incidence in the first quarter of 2008 for three selected diseases, diabetes mellitus, colorectal cancer, and heart failure, depending on different lengths of preceding disease-free intervals.<h4>Data collection/extraction methods</h4>Continuously insured from 2000 until 2008 ≥ 18 years ...[more]

PMID: 21958217

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Project description:BackgroundRoutine skin cancer screening (SCS) is covered by the German statutory health insurance (SHI) since 2008. The objective of this study was to compare direct healthcare costs between patients in whom skin cancer was detected by routine SCS and patients in whom skin cancer was not detected by routine SCS.MethodsA retrospective observational study of administrative claims data from a large German SHI was performed. Patients with a diagnosis of malignant melanoma (MM) or non-melanoma skin cancer (NMSC) diagnosed in 2014 or 2015 were included. Costs were obtained for one year before and one year after diagnosis and analyzed in a difference-in-differences approach using regression models. Frequency matching was applied and risk adjustment was performed. Additional analyses were conducted, separately for specific age groups, excluding persons who died during the observation period and without taking costs for screening into consideration.ResultsA total of 131,801 patients were included, of whom 13,633 (10.3%) had a diagnosis of MM and 118,168 (89.7%) had a diagnosis of NMSC. The description of total costs (without risk adjustment) shows lower mean total costs among patients whose skin cancer was detected via routine SCS compared to patients in whom skin cancer was not detected by routine SCS (MM: €5,326 (95% confidence interval (CI) €5,073; €5,579) vs. €9,038 (95% CI €8,629; €9,448); NMSC: €4,660 (95% CI €4,573; €4,745) vs. €5,890 (95% CI €5,813; €5,967)). Results of the regression analysis show cost savings of 18.8% (95% CI -23.1; -8.4) through routine SCS for patients with a diagnosis of MM. These cost savings in MM patients were more pronounced in patients younger than 65 years of age. For patients with a diagnosis of NMSC, the analysis yields a non-substantial increase in costs (2.5% (95% CI -0.1; 5.2)).ConclusionCost savings were detected for persons with an MM diagnosed by routine SCS. However, the study could not detect lower costs due to routine SCS in the large fraction of persons with a diagnosis of NMSC. These results offer important insights into the cost structure of the routine SCS and provide opportunities for refinements.

Dataset Information

Estimation of disease incidence in claims data dependent on the length of follow-up: a methodological approach.

Publications

Estimation of disease incidence in claims data dependent on the length of follow-up: a methodological approach.

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