- 著者
- Daijun Kirigaya Takeo Nakayama Tatsuro Ishizaki Shunya Ikeda Toshihiko Satoh
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.50, no.22, pp.2793-2800, 2011 (Released:2011-11-15)
- 参考文献数
- 31
- 被引用文献数
- 13 33
Objective The aim of this study was to evaluate the adherence of guidelines for the management and treatment of glucocorticoid-induced osteoporosis, and to investigate whether it is associated with factors such as age, gender, glucocorticoid dose, physician specialty, and size of facility. Methods This was a cross-sectional study utilizing administrative data from a database of health insurance claims (2004-2007); 2,368 patients who received glucocorticoid treatment for≥90 days were extracted. The guideline adherence was determined by evaluations based on glucocorticoid prescription dose, prescription of anti-osteoporosis drugs, and whether or not bone mineral density was measured. Results Overall proportion of guideline adherence was 23.3%. In cases in which the equivalent dose of prednisolone was<5 mg/d and≥5 mg/d, the adherence was 8.3% and 30.5% respectively. Factors correlating with low adherence included young age, male gender, and lower glucocorticoid doses. Surgery and otolaryngology specialties had lower adherence than internal medicine. Smaller clinical facilities had lower adherence than larger facilities. Conclusion The adherence of guidelines for the management and treatment of glucocorticoid-induced osteoporosis is still low, and improvements in treatment quality can be expected through education of patient groups and medical care providers with large deviations from the guidelines.
- 著者
- Shinya Kimura Toshihiko Sato Shunya Ikeda Mitsuhiko Noda Takeo Nakayama
- 出版者
- 日本疫学会
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- vol.20, no.5, pp.413-419, 2010-09-05 (Released:2010-09-16)
- 参考文献数
- 17
- 被引用文献数
- 39 257
Background: Health insurance claims (ie, receipts) record patient health care treatments and expenses and, although created for the health care payment system, are potentially useful for research. Combining different types of receipts generated for the same patient would dramatically increase the utility of these receipts. However, technical problems, including standardization of disease names and classifications, and anonymous linkage of individual receipts, must be addressed.Methods: In collaboration with health insurance societies, all information from receipts (inpatient, outpatient, and pharmacy) was collected. To standardize disease names and classifications, we developed a computer-aided post-entry standardization method using a disease name dictionary based on International Classification of Diseases (ICD)-10 classifications. We also developed an anonymous linkage system by using an encryption code generated from a combination of hash values and stream ciphers. Using different sets of the original data (data set 1: insurance certificate number, name, and sex; data set 2: insurance certificate number, date of birth, and relationship status), we compared the percentage of successful record matches obtained by using data set 1 to generate key codes with the percentage obtained when both data sets were used.Results: The dictionary’s automatic conversion of disease names successfully standardized 98.1% of approximately 2 million new receipts entered into the database. The percentage of anonymous matches was higher for the combined data sets (98.0%) than for data set 1 (88.5%).Conclusions: The use of standardized disease classifications and anonymous record linkage substantially contributed to the construction of a large, chronologically organized database of receipts. This database is expected to aid in epidemiologic and health services research using receipt information.