Ng Junice Yi Siu, Ramadani Royasia Viki, Hendrawan Donni, Duc Duong Tuan, Kiet Pham Huy Tuan
Real-World Insights, IQVIA Asia-Pacific, 79 Anson Road, #19-01, Singapore, 079906, Singapore.
Center for Health Economics and Policy Studies, Faculty of Public Health, Universitas Indonesia, Beji, Kota Depok, Jawa Barat, Indonesia.
Pharmacoecon Open. 2019 Dec;3(4):517-526. doi: 10.1007/s41669-019-0127-2.
Social health insurance administrative databases were established in Indonesia, Vietnam and the Philippines in 2014, 2017 and 2012, respectively; however, these databases have been scarcely used for research, if at all. This study explored the feasibility and accessibility of using these databases for scientific research, highlighting challenges and barriers in their use.
The databases included in this evaluation comprised the Jaminan Kesehatan Nasional (JKN) from Indonesia, Vietnam Health Insurance Scheme (VHIS) from Vietnam and PhilHealth from the Philippines. These databases were qualitatively assessed based on the data capture, potential linkage to other databases or registries, data access and extraction, privacy and security, and quality and validation procedures.
All databases contain population-based cohort data on the medical costs of reimbursed medical conditions, identified using International Classification of Diseases, Tenth Revision (ICD-10) codes. Linkage to other national databases, ensuring protection of patient privacy data, would improve their usability. Duration to database access and data extraction varies from country to country. The main limitations of all databases include the short span of data records, and the unknown degree of internal validity. Both JKN and PhilHealth databases capture bundled claims, inherently excluding information on prescriptions and out-of-pocket expenditure. Due to the recent establishment of the VHIS database, it may not be suitable for studies that intend to explore trends.
The JKN, VHIS and PhilHealth databases offer population-based, financial, utilization, and demographic data, which could provide valuable epidemiological and pharmacoeconomic insights if the findings are interpreted within the limitations of each database.
印度尼西亚、越南和菲律宾分别于2014年、2017年和2012年建立了社会医疗保险行政数据库;然而,这些数据库即便有被用于研究,也是极少的。本研究探讨了使用这些数据库进行科学研究的可行性和可及性,突出了使用过程中的挑战和障碍。
本评估纳入的数据库包括印度尼西亚的国民健康保险(JKN)、越南的越南健康保险计划(VHIS)和菲律宾的菲律宾健康保险公司(PhilHealth)。基于数据采集、与其他数据库或登记处的潜在关联、数据访问与提取、隐私与安全以及质量与验证程序,对这些数据库进行了定性评估。
所有数据库都包含基于人群的队列数据,涉及使用国际疾病分类第十版(ICD-10)编码确定的已报销医疗状况的医疗费用。与其他国家数据库建立关联,确保患者隐私数据得到保护,将提高其可用性。不同国家获取数据库和提取数据的时间各不相同。所有数据库的主要局限性包括数据记录跨度短,以及内部效度未知。JKN和PhilHealth数据库均记录捆绑式索赔,本质上不包括处方和自付费用信息。由于VHIS数据库建立时间较短,可能不适合用于探索趋势的研究。
JKN、VHIS和PhilHealth数据库提供了基于人群的财务、使用情况和人口统计数据,如果在每个数据库的局限性内解读研究结果,这些数据可以提供有价值的流行病学和药物经济学见解。