Background And Aim: In Japan, screening colonoscopy for colorectal cancer is expected to reduce colorectal cancer mortality, although its complication rate has not been sufficiently examined. The aim of this study is to analyze severe complications due to colonoscopy.
Methods: As a study population, we retrospectively used commercially anonymized health insurance claims data covering 5.71 million patients from January 2005 to August 2018. We extracted patients who received colonoscopy with lesions resection or without treatment. Main outcomes were rates of hemorrhage, perforation, fatal events, and their risk factors.
Results: Among 341 852 colonoscopy without treatment in 260 128 patients (mean age: 49.6 ± 11.7 years), the rates of hemorrhage, perforation, and fatal events were 0.0059% (95% confidence interval [CI] 0.0031-0.0085), 0.0032% (95% CI 0.0011-0.0052), and 0.00029% (95% CI 0-0.0012), respectively. Regarding hemorrhage, compared with the rate for patients <50 years old (0.0050%), the rates for those 50-59, 60-69, and ≥70 years old were 0.0095% (P = 0.17), 0.0031% (P = 0.17), and 0%, respectively. Regarding perforation, compared with patients <50 years old (0.0056%), the rates for those 50-59, 60-69, and ≥70 years old were 0%, 0.0015% (P = 0.99), and 0.0102% (P = 0.99), respectively. A multivariate analysis for risk factors showed no significant findings for hemorrhage and perforation without treatment. Among 123 087 colonoscopy with lesions resection in 102 058 patients (mean age: 53.7 ± 9.3 years), the rates of hemorrhage, perforation, and fatal events were 0.136% (95% CI 0.1157-0.1572), 0.033% (95% CI 0.0228-0.0437), and 0.00081% (95% CI 0-0.0035), respectively.
Conclusions: The analysis using health insurance claims data demonstrated the safety of colonoscopy.
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http://dx.doi.org/10.1111/jgh.15531 | DOI Listing |
J Med Internet Res
January 2025
Working Group for Data-Driven Innovation, Hamburg University of Technology, Hamburg, Germany.
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Amal N. Trivedi, Brown University and Providence Veterans Affairs Medical Center, Providence, Rhode Island.
Black and Hispanic patients who receive care from Black and Hispanic physicians have greater use of preventive care. However, receiving care from racially concordant physicians requires that such physicians are included in private insurance plan networks. Using data from 2019, we examined the extent to which racially concordant physicians are available in the Medicare Advantage (MA) program, which disproportionately enrolls Black and Hispanic Medicare beneficiaries, by linking MA physician networks to physician race and ethnicity to measure the diversity of in-network physicians.
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January 2025
Aaron L. Schwartz University of Pennsylvania and Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania.
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Global Emergency Medicine Innovation and Implementation (GEMINI) Research Center, Duke University, Durham, North Carolina, United States of America.
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View Article and Find Full Text PDFPLoS One
January 2025
Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Bremen, Germany.
Objective: The German Health Data Lab is going to provide access to German statutory health insurance claims data ranging from 2009 to the present for research purposes. Due to evolving data formats within the German Health Data Lab, there is a need to standardize this data into a Common Data Model to facilitate collaborative health research and minimize the need for researchers to adapt to multiple data formats. For this purpose we selected transforming the data to the Observational Medical Outcomes Partnership Common Data Model.
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