Proposal of Using Claims-Based Diagnoses and Prenatal Examinations to Identify Pregnancy in Taiwan: National Health Insurance Research Database
Author(s)
Hung-Wei Lin, MS, RPh1, Yu-Hsuan Kuo, MSc, PharmD1, Kai-Pei Chou, MSc1, Yuan-Liang Wen, PhD Candidate2, Sheng-Yin To, PhD2, Hui-Wen Yang, PhD2, Li-Ting Kao, PhD2.
1Real World Solutions, IQVIA Solutions Taiwan, Taipei, Taiwan, 2Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
1Real World Solutions, IQVIA Solutions Taiwan, Taipei, Taiwan, 2Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
OBJECTIVES: In Taiwan, the Birth Reporting Database (BRD) contains inclusive records of nationwide pregnant women with livebirth and stillbirth (i.e., weighing ≥500 g or with ≥20 weeks of pregnancy). Nevertheless, for pregnancy outcomes that are not included in the BRD (e.g., miscarriage, abortion, etc.), using diagnosis codes or payment codes for government-funded prenatal examinations may be alternative approaches. The study aimed to validate the two supplementary data sources for pregnancy identification.
METHODS: Pregnancies were identified using three approaches: (1) database-specific codes from the BRD, (2) International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) from the National Health Insurance Research Database (NHIRD), and (3) NHI payment codes for prenatal examinations from the NHIRD. All the identification numbers were encrypted and matchable between NHIRD and BRD. The data periods of both data sources were between 2022 and 2023.
RESULTS: A total of 264,844 pregnant women were identified in the BRD, with 99.1% giving live birth and 0.9% giving stillbirth; 97.8% of the pregnant women in BRD had at least one record with NHI payment codes of prenatal examination, and 74% had a relevant diagnosis (ICD-10-CM Z34). However, only a small proportion (8.7%) of pregnant women in the BRD were recorded with the ICD-10-CM codes for live birth or stillbirth in the NHIRD. We further identified 339,611 women who had undergone at least one prenatal examination in the NHIRD, and 31.7% of them were recorded with ICD-10-CM codes for live birth, stillbirth, miscarriage, or abortion. Notably, the ongoing pregnancies were not excluded due to being indistinguishable.
CONCLUSIONS: The findings suggest that the NHI payment codes of prenatal examination could be a potential source to identify pregnancies, especially for those who are not recorded in BRD. In addition, the routinely scheduled prenatal examinations could potentially serve as a surrogate for estimating gestational age for this population.
METHODS: Pregnancies were identified using three approaches: (1) database-specific codes from the BRD, (2) International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) from the National Health Insurance Research Database (NHIRD), and (3) NHI payment codes for prenatal examinations from the NHIRD. All the identification numbers were encrypted and matchable between NHIRD and BRD. The data periods of both data sources were between 2022 and 2023.
RESULTS: A total of 264,844 pregnant women were identified in the BRD, with 99.1% giving live birth and 0.9% giving stillbirth; 97.8% of the pregnant women in BRD had at least one record with NHI payment codes of prenatal examination, and 74% had a relevant diagnosis (ICD-10-CM Z34). However, only a small proportion (8.7%) of pregnant women in the BRD were recorded with the ICD-10-CM codes for live birth or stillbirth in the NHIRD. We further identified 339,611 women who had undergone at least one prenatal examination in the NHIRD, and 31.7% of them were recorded with ICD-10-CM codes for live birth, stillbirth, miscarriage, or abortion. Notably, the ongoing pregnancies were not excluded due to being indistinguishable.
CONCLUSIONS: The findings suggest that the NHI payment codes of prenatal examination could be a potential source to identify pregnancies, especially for those who are not recorded in BRD. In addition, the routinely scheduled prenatal examinations could potentially serve as a surrogate for estimating gestational age for this population.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD242
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Reproductive & Sexual Health