National reimbursement databases: Use and limitations for rheumatologic studies

Area of Science:

• Rheumatology
• Health Informatics
• Public Health

Background:

• National Reimbursement Databases (NRD) are increasingly utilized in medical research.
• Understanding their application and limitations in rheumatology is crucial for effective use.

Purpose of the Study:

• To review and analyze the current knowledge on the use and limitations of NRDs in rheumatology.
• To categorize NRDs based on available clinical data.

Main Methods:

• Categorization of NRDs into three groups based on data content: no clinical details, diagnosis details, or linkable to clinical databases.
• Review of existing literature and database structures.

Main Results:

• NRDs facilitate cohort construction, enabling powerful statistical analysis for epidemiological studies.
• Identified NRD categories include those without clinical details (e.g., French NRD), with diagnosis details (e.g., British NRD), and linkable to clinical databases (e.g., Swedish NRD).
• NRDs aid in understanding disease epidemiology, treatment risk-benefit, and economic impact, informing public health decisions and guidelines.

Conclusions:

• NRDs present significant opportunities for rheumatology research, particularly in epidemiology and health economics.
• Key limitations include the lack of exhaustive clinical and paraclinical data (e.g., disease activity, test results).
• Future efforts should focus on linking NRDs with clinical registers to overcome data deficiencies and enhance research capabilities.