Promoting Epidemiological, and Health Policy Research on Specialized Diseases at Each NC Using the NDB through 6NC Collaboration

Abstract

NDB (National Database) contains anonymized Medical Insurance Claims and Health Checkup Data, provided by the Ministry of Health, Labour and Welfare. NDB is an essential resource for policy-based evidence-making by investigating disease occurrence or clinical practice. This database is used in various ways, such as developing indicators for health policy plans and monitoring antibiotic usage.

In recent years, the scope of NDB utilization has expanded. In 2018, it was integrated with long-term care data; in 2022, it was linked with death certificates. Moreover, the revised Next-Generation Medical Infrastructure Law in 2023 enabled more comprehensive data analysis across various sources. Since 2024, the ministry has started to provide new data sets on the cloud, which is expected to reduce the time required for applications and approval of NDB data to about one week.

Our research team began this initiative in 2019 as part of a project to establish an NDB research framework in collaboration with 6 National Centers (6NC). While unexpected challenges arose during the data application process, by September 2023, special extracted data was delivered to all NCs. Currently, the findings are open to the public via our web page, whereas data analysis is still ongoing. By the end of the fiscal year, foundational analyses will be completed, paving the way for advanced studies on priority diseases and those spanning multiple NCs.

Our team is committed to conducting fundamental research to monitor disease distribution and trends in medical practices. This effort aims to identify medical and policy challenges at an early stage. Additionally, the data obtained will serve as evidence for policy recommendations and support the advancement of clinical and epidemiological studies. As the demand for timely data provision increases, we will also focus on building a robust framework for promoting NDB research and nurturing skilled personnel to meet these growing needs.

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Perspectives

Establishing clinical/epidemiological/health Policy related evidence

Disease-related information, such as prevalence and incidence rates, will be disseminated through our website and academic papers. This data will contribute to enhanced surveillance and understanding of various diseases.

Policy evaluation and proposal using our research findings

The project will produce highly policy-relevant insights by analyzing disease risk, healthcare quality, and medical costs. These findings will support evidence-based policy making (EBPM) through information from agencies like the Ministry of Health, Labour and Welfare, and the Children and Family Agency.

Preparation of resources in NDB and support for researchers

In addition to disease information, the project will utilize claim data to establish disease definitions, conduct scoping reviews, and develop master data creation tools. Relevant software and information will be made publicly available to support research.

Training Professionals for NDB Research

A robust framework will be built to sustain ongoing NDB analysis. Active efforts will be made to cultivate talent within and beyond the 6 National Centers (6NC), promoting the effective use of NDB among the world's leading medical claims databases.

Analysis in response to government requests during health crisis

In emergencies requiring quick reporting on trends, risk factors, and other critical data, a system will be in place to deliver timely and accurate analyses. This capacity will enable swift and informed responses to urgent government requests.

Comments from principal researcher

Hiroyasu Iso
National Center for Global Health and Medicine, Bureau of International Health Cooperation, the Institute for Global Health Policy Research (iGHP)
Director of the Institute for Global Health Policy Research (iGHP)

The Six National Centers (6NC) each specialize in cancer and malignant neoplasms, cardiovascular diseases, mental and neurological disorders, infectious and other diseases, pediatric conditions, and age-related diseases. In addition to their specific expertise, these centers play a shared role in clinical care, research, and human resource development. They are also tasked with contributing to healthcare policy recommendations from their respective perspectives. The research team leverages the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) to investigate disease prevalence, healthcare quality, medical costs, and health checkup results. Through collaborative efforts, the team analyzes trends, forecasts future challenges, and disseminates findings. The project aims to establish a robust foundation of information to support medical policy planning and enhance public understanding. Efforts are also directed toward building a sustainable research framework and fostering talent to advance NDB-based research across the 6NC.

Shared Researchers

National Cancer Center

Division of the Health Services Research, Institute for Cancer Control
Taisuke Ishii

National Cerebral and Cardiovascular Center

Department of Preventive Medicine and Epidemiology
Kunihiro Nishimura

National Center of Neurology and Psychiatry

Translational Medical Center
Hirofumi Komaki

Department of Public Mental Health Research, National Institute of Mental Health
Naoaki Kuroda
Kentaro Usuda

National Center for Global Health and Medicine

Clinical Epidemiology, AMR Clinical Reference Center
Nobuaki Matsunaga

Division of Training in Liver Diseases, Hepatitis Information Center, The　Research Center for Hepatitis and Immunology
Masaaki Korenaga

Medical Policy Research, Diabetes Information Center
Takehiro Sugiyama

National Center for Child Health and Development

Department of Health Policy
Kenji Takehara

Department of Social Medicine/Division of Women's Health Promotion
Naho Morisaki

National Center for Geriatrics and Gerontology

Department of Preventive Gerontology, Center for Gerontology and Social Science
Takehiko Doi

Department of Health Economics, Center for Gerontology and Social Science
Shosuke Ohtera