Feasibility Evaluation of Claims Database: Best Practices and Case Study for a Comparative Analysis of Robotic-Assisted Colorectal Surgery in Germany
Author(s)
Joana Pestana, PhD1, Kathrin Gerchow, MPH2, Janina Röhrkaste, MSc2, Christian Jacob, PhD2, James Lavin, MSc3.
1Intuitive Surgical Deutschland GmbH, Freiburg, Germany, 2Cencora, Hannover, Germany, 3Intuitive Surgical, Aubonne, Switzerland.
1Intuitive Surgical Deutschland GmbH, Freiburg, Germany, 2Cencora, Hannover, Germany, 3Intuitive Surgical, Aubonne, Switzerland.
OBJECTIVES: Evaluating the feasibility of real-worlds data is crucial for ensuring its suitability in addressing specific research questions. This study aims to assess the feasibility of using a claims database for comparing long-term resource utilization and outcomes of colorectal surgeries—open, laparoscopic, and robotic-assisted—in Germany from the statutory health insurance perspective.
METHODS: Claims data aggregated by the Institute for Applied Health Research Berlin (InGef) were utilized, employing best practices for feasibility assessments regarding data adequacy, potential biases, and quality issues. The sample was benchmarked against raw hospital reimbursement data (InEK) and validated with peer-reviewed literature. Eligible sample included adults that had a prior colorectal cancer diagnosis, no other primary tumors, and continuous observability one year pre- and post-surgery. Key factors analyzed included patient demographics, comorbidities, procedural coding, and follow-up periods.
RESULTS: Procedural frequencies were consistent with incidence studies: around half of the patients underwent colonic resections, while smaller proportions underwent sigmoid or rectal resections. Notably, 85% of rectal resections involved sphincter preservation, aligning with national data. Trends indicated an increase in minimally invasive procedures, with hospitals performing laparoscopic and robotic colonic and rectal procedures rising over recent years. The follow-up period averages between 2.5 to 3 years for robotic-assisted procedures and extends from 3.1 to 3.7 years for other procedures, providing a reasonable window for observation. Colorectal surgeries were predominantly performed on men, corroborating previous findings. Coding practices were consistent with national standards, showing high correlation coefficients between OPS and DRG codes in the InGef dataset and those in the national InEK database for patients with identical diagnoses. Similarly, there was consistency in diagnosing comorbidities and complications for patients undergoing colorectal procedures.
CONCLUSIONS: The data quality is adequate for research purposes. The study suggests further exploration of data linkages between databases to perform rigorous feasibility assessments, which can inform healthcare policy and optimize resource allocation.
METHODS: Claims data aggregated by the Institute for Applied Health Research Berlin (InGef) were utilized, employing best practices for feasibility assessments regarding data adequacy, potential biases, and quality issues. The sample was benchmarked against raw hospital reimbursement data (InEK) and validated with peer-reviewed literature. Eligible sample included adults that had a prior colorectal cancer diagnosis, no other primary tumors, and continuous observability one year pre- and post-surgery. Key factors analyzed included patient demographics, comorbidities, procedural coding, and follow-up periods.
RESULTS: Procedural frequencies were consistent with incidence studies: around half of the patients underwent colonic resections, while smaller proportions underwent sigmoid or rectal resections. Notably, 85% of rectal resections involved sphincter preservation, aligning with national data. Trends indicated an increase in minimally invasive procedures, with hospitals performing laparoscopic and robotic colonic and rectal procedures rising over recent years. The follow-up period averages between 2.5 to 3 years for robotic-assisted procedures and extends from 3.1 to 3.7 years for other procedures, providing a reasonable window for observation. Colorectal surgeries were predominantly performed on men, corroborating previous findings. Coding practices were consistent with national standards, showing high correlation coefficients between OPS and DRG codes in the InGef dataset and those in the national InEK database for patients with identical diagnoses. Similarly, there was consistency in diagnosing comorbidities and complications for patients undergoing colorectal procedures.
CONCLUSIONS: The data quality is adequate for research purposes. The study suggests further exploration of data linkages between databases to perform rigorous feasibility assessments, which can inform healthcare policy and optimize resource allocation.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE462
Topic
Economic Evaluation, Medical Technologies, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Gastrointestinal Disorders, Oncology