全民健康保險研究資料庫論文 產出分析、研究方向及使用示範

1. 全民健康保險研究資料庫論文產出分析、研究方向及使用示範全民健康保險研究資料庫論文產出分析、研究方向及使用示範 陳曾基 國立陽明大學醫學院醫務管理研究所 台北榮民總醫院家庭醫學部

2. 今天在北醫權充一天和尚Der Prophet gilt nichts im eigenen Land.Nullus propheta in patria.An ass in Germany is a professor in Rome.

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5. Materials: Extract data from PubMed  ("insurance, health"[MeSH Terms] OR "national health programs"[MeSH Terms] OR health insurance[TW] OR national health[TW] OR national insurance[TW] OR claims data*[TW] OR claim data*[TW] OR insurance claim*[TW] OR insurance data*[TW] OR administrative data*[TW] OR nationwide data*[TW] OR national data*[TW] OR NHIRD[TW] OR NHI[TW] OR BNHI[TW] OR population based[TW] OR population*[ti] OR nationwide[ti] ) AND taiwan[All Fields] AND English[lang] AND 1996:2009[dp] 2010 * Accuracy not guaranteed !!! Courtesy of Yu-Chun Chen

6. Materials: Review of NHIRD Papers  383articles are included Courtesy of Yu-Chun Chen

7. NHIRD Papers Grows Exponentially Courtesy of Yu-Chun Chen

8. NHIRD Papers Increase In Both Quantity and Quality Courtesy of Yu-Chun Chen

9. Cumulative Number of Papers Using NHIRD, 2000-2009 a Annual growth rate=(no. of studies in current year – no. of studies in previous year) / no. of studies in previous year b Doubling time is estimated by fitted exponential model

10. Distribution of Study Topics Courtesy of Yu-Chun Chen

11. Average IF in SCI Fields Courtesy of Yu-Chun Chen

12. Productivity of authors: reproducible success? Courtesy of Yu-Chun Chen

13. Status: 6 Apr 2011

14. Distribution of NHIRD Papersby Journal Impact Factor and Year

15. Social Network Analysis as a Tool to Visualize Flow of InformationAnalysis of studies using health databases 德國海德堡大學醫療資訊研究所 陳 育 群 Sep 25, 2010

16. Collaboration Network: 2000-2009 • Chen YC et. al. Scientometrics (2010)Taiwan’s NHIRD: administrative health care database as study object in bibliometrics

17. Collaboration network: 2000 Collaboration network, 2000

18. Collaboration network: 2001 Collaboration network, 2001

19. Collaboration network: 2002 Collaboration network, 2002

20. Collaboration network: 2003 Collaboration network, 2003

21. Collaboration network: 2004 Collaboration network, 2004

22. Collaboration network: 2005 Collaboration network, 2005

23. Collaboration network: 2006 Collaboration network, 2006

24. Collaboration network: 2007 Collaboration network, 2007

25. Collaboration network: 2008 Collaboration network, 2008

26. Collaboration network: 2009 Collaboration network, 2009

27. Collaboration network: 2009 (label) Collaboration network, 2009

28. Design of Claims-Based Studies 資料處理 單純 複雜 低臨床 相關 高臨床 相關

29. Types of Study Designs / Computation • Simple description • Association / Relationship • Complex computation (Data mining)

30. Simple Description • Disease • Epidemiologic features of Kawasaki disease in Taiwan, 1996-2002. • A nationwide survey on epidemiological characteristics of childhood Henoch-Schönlein purpura in Taiwan. • Prevalence and risks of chronic airway obstruction: a population cohort study in Taiwan. • Drug • Utilization of hepatoprotectants within the National Health Insurance in Taiwan. • Demographics and patterns of acupuncture use in the Chinese population: the Taiwan experience. • Person • Risks and causes of hospitalizations among physicians in Taiwan • Specialty • Use frequency of traditional Chinese medicine in Taiwan. • Sector • Patterns of ambulatory care utilization in Taiwan.

31. Association / Relationship • A  B (no temporal consideration) • Association between physician volume and hospitalization costs for patients with stroke in Taiwan: a nationwide population-based study. • A  B (temporal change) • Seasonal variations in urinary calculi attacks and the association with climate: a population-based study. • A => B (temporal sequence) • Risk of extrapyramidal syndrome in schizophrenic patients treated with antipsychotics: a population-based study. • Sudden sensorineural hearing loss increases the risk of stroke: A 5-year follow-up study • Does elective caesarean section increase utilization of postpartum maternal medical care? * Control Group

32. Complex Computation • Association rule mining • Application of a data-mining technique to analyze coprescription patterns for antacids in Taiwan. • Frequent itemset mining • The prescriptions frequencies and patterns of Chinese herbal medicine for allergic rhinitis in Taiwan.

33. Simple Description Pediatrics : IF 4.789, Ranking 2 / 86 (Pediatrics) • Disease • Epidemiologic features of Kawasaki disease in Taiwan, 1996-2002. • A nationwide survey on epidemiological characteristics of childhood Henoch-Schonlein purpura in Taiwan. • Prevalence and risks of chronic airway obstruction: a population cohort study in Taiwan. • Drug • Utilization of hepatoprotectants within the National Health Insurance in Taiwan. • Demographics and patterns of acupuncture use in the Chinese population: the Taiwan experience. • Specialty • Use frequency of traditional Chinese medicine in Taiwan. • Sector • Patterns of ambulatory care utilization in Taiwan. Rheumatology : IF 4.136, Ranking 7 / 22 (Rheumatology) Chest : IF 5.154, Ranking 4 / 40 (Respiratory system)

34. Association / Relationship Stroke : IF 6.499, Ranking 6 / 156 (Clinical Neurology) • A  B (no temporal consideration) • Association between physician volume and hospitalization costs for patients with stroke in Taiwan: a nationwide population-based study. • A  B (temporal change) • Seasonal variations in urinary calculi attacks and the association with climate: a population-based study. • A => B (temporal sequence) • Risk of extrapyramidal syndrome in schizophrenic patients treated with antipsychotics: a population-based study. • Sudden sensorineural hearing loss increases the risk of stroke: A 5-year follow-up study • Does elective caesarean section increase utilization of postpartum maternal medical care? J Urology : IF 3.952, Ranking 9 / 57 (Urology …) Clin Pharmacol Ther : IF 7.586, Ranking 9 / 219 (Pharmacology …) Stroke : IF 6.499, Ranking 6 / 156 (Clinical Neurology) Med Care : IF 3.194, Ranking 5 / 62 (Health Care Sciences ...)

35. Complex Computation • Association rule mining • Application of a data-mining technique to analyze coprescription patterns for antacids in Taiwan. • Frequent itemset mining • The prescriptions frequencies and patterns of Chinese herbal medicine for allergic rhinitis in Taiwan. Allergy : IF 6.204, Ranking 2 / 17 (Allergy)

36. 使用示範 （陳育群醫師製作）

37. NHIRD Datasets

38. 健保資料庫長得這樣…

39. 變成這樣…

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41. File Structures of Datasets to Process • Single file • Multiple files: • Of the same format • Of similar formats in different years • Of different formats, but connected through • Primary key / foreign key • Loop-up table

43. Main Tasks 1.資料轉換 READ 2.變數處理 SELECT, FILTER APPEND, UNION JOIN, SORT 3.結果分析 AGGREGATE OUTPUT STATISTICS

44. 程式語言 統計套裝軟體 資料管理系統

45. 1.資料轉換      2.變數處理      3.結果分析    

46. 由資料來源讀取出資料，將它們轉換成適合分析的型態，並且將它們匯入資料庫內。由資料來源讀取出資料，將它們轉換成適合分析的型態，並且將它們匯入資料庫內。 通常還要搭配著資料清潔 (Data Cleaning) 將系統源頭許多未經整合的、不允許的、遺失的或者錯誤的資料，在匯入之前重新整頓(Garbage In, Garbage Out) 資料轉換 1.資料轉換 READ

47. 把分別儲存於不同表格的原始資訊，如醫院層級、藥物分類、疾病分類、重大傷病等等「串連」許多個資料表把分別儲存於不同表格的原始資訊，如醫院層級、藥物分類、疾病分類、重大傷病等等「串連」許多個資料表 資料加值 變數處理 2.變數處理 SELECT, FILTER APPEND, UNION JOIN, SORT

48. 以SAS為例

49. 已知某個族群 (ID_Cohort)，想了解這個族群在2000年到2006年的就診情形（醫院層級、醫院所在地點、看診日期） 實際上的例子 (1)

50. 已知某個族群 (ID_Cohort)， 排除掉(exclusion criteria)，想了解這個族群在2000年到2006年內第一次就診日期 實際上的例子 (2)