Analysis of the evidence-practice gap to facilitate proper medical care for the elderly: investigation, using databases, of utilization measures for National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB)

作者：Nakayama Takeo; Imanaka Yuichi; Okuno Yasushi; Kato Genta; Kuroda Tomohiro; Goto Rei; Tanaka Shiro; Tamura Hiroshi; Fukuhara Shunichi; Fukuma Shingo; Muto Manabu; Yanagita Motoko; Yamamoto Yosuke

来源：Environmental Health and Preventive Medicine, 2017, 22(1): UNSP 51.

DOI：10.1186/s12199-017-0644-5

• Claims data
• Database
• Elderly
• Evidence-practice gap
• Validation

As Japan becomes a super-aging society, presentation of the best ways to provide medical care for the elderly, and the direction of that care, are important national issues. Elderly people have multi-morbidity with numerous medical conditions and use many medical resources for complex treatment patterns. This increases the likelihood of inappropriate medical practices and an evidence-practice gap. The present study aimed to: derive findings that are applicable to policy from an elucidation of the actual state of medical care for the elderly; establish a foundation for the utilization of National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), and present measures for the utilization of existing databases in parallel with NDB validation.
Cross-sectional and retrospective cohort studies were conducted using the NDB built by the Ministry of Health, Labor and Welfare of Japan, private health insurance claims databases, and the Kyoto University Hospital database (including related hospitals). Medical practices (drug prescription, interventional procedures, testing) related to four issues-potential inappropriate medication, cancer therapy, chronic kidney disease treatment, and end-of-life care-will be described. The relationships between these issues and clinical outcomes (death, initiation of dialysis and other adverse events) will be evaluated, if possible.

• 出版日期2017-12