Universität zu Köln

Ditscheid, Bianka, Storch, Josephine, Krause, Markus, Meyer, Ingo and Freytag, Antje (2020). Date of Service Provision and Date of Payment in Claims Data: Dealing with Time Differences. Gesundheitswesen, 82. S. S20 - 9. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-4421

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Abstract

Aim The paper quantifies discrepancies between date of payment and date of service provision when doing analyses in relation to date of death and also in relation to the end of a calendar year. In analyses of this type, time differences between service provision and payment can lead to both under- and overestimation of service use. We aim to capture these phenomena in claims data from different sectors (primary care, medication prescription, prescription of remedies and medical aids, hospital care). Method We have used pre-structured claims data from a scientific data warehouse of a large German statutory health insurance covering people that died in 2016. We investigated the discrepancies in time between date of service provision and date of payment for different outpatient and inpatient services based on data from 2015 to 2017. An exact date (dd/mm/yyyy) was only available for data covering prescriptions of remedies and medical aids. Data covering medication prescriptions were only exact to the month of payment (mm/yyyy), whereas data covering outpatient physician care were only exact to the quarter of payment (q/yyyy). Results For both outpatient physician care and hospital care, less than 1% had a payment date after the date of death. The share is considerably higher (28-31%) for prescriptions of remedies and medical aids. The majority of payments occurred within 3 months after death (93% for prescriptions of remedies and medical aids, 67% for primary care services). Less than 1% of outpatient physician care and about 18% of remedies had been paid after the end of the calender year 2015. Here too, the majority of payments were made within the first 3 months of 2016 (100% of prescriptions of remedies and medical aids, 65% of primary care services). Conclusions Discrepancies in time between date of service provision and date of payment pose a challenge and are a potential source of under-/overestimation of health service utilization when doing analyses in relation to date of death or the end of a calendar year. This needs to be taken into account when requesting the data, but also in preparing and analysing them. The primary recommendation is to ensure that services with a payment date after death are included explicitly.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ditscheid, Bianka UNSPECIFIED UNSPECIFIED UNSPECIFIED Storch, Josephine UNSPECIFIED UNSPECIFIED UNSPECIFIED Krause, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Freytag, Antje UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-342278
DOI:	10.1055/a-1030-4223
Journal or Publication Title:	Gesundheitswesen
Volume:	82
Page Range:	S. S20 - 9
Date:	2020
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-4421
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Public, Environmental & Occupational Health Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34227