Towards Data Quality Assessment and Standardized Representability of German Healthcare Claims Data for Secondary Use

Research output: Contribution to book/Conference proceedings/Anthology/Report › Conference contribution › Contributed › peer-review

Abstract

German statutory health insurance (SHI) claims data are a major external data source for health research, enabling population-wide real-world evidence (RWE) across sectors. Their full potential is particularly relevant in federated healthcare research infrastructures, where linkage with clinically generated data may support more comprehensive and longitudinal analyses. However, routine claims data are collected primarily for reimbursement rather than research, and their reuse in such infrastructures requires systematic assessment of data suitability, particularly through the assessment of data quality and standardized representability. This work therefore presents a methodological concept to (i) develop a claims-specific data quality assessment (DQA) approach by synthesizing data quality challenges reported across diverse claims-based settings in the literature and operationalizing them through a rule-based validation pipeline for incoming claims data and (ii) assess the structural representability of SHI data elements in standardized HL7 FHIR profiles for enhancing structural interoperability. Expected outcomes include a healthcare claims data-specific catalog of data quality issues, evidence-informed validations, a mapping coverage analysis, and the identification of representational gaps. This proposed concept provides a structural methodological basis for assessing German SHI claims data suitability and may support future harmonization, linkage, and secondary use of claims data.

Details

Original languageEnglish
Title of host publicationHealth Sciences Informatics Leads and Empowers the Digital Health Transformation
EditorsJohn Mantas, Arie Hasman, Parisis Gallos, Reinhold Haux, Konstantinos Karitis
Pages16-20
Number of pages5
ISBN (electronic)978-1-64368-668-4
Publication statusPublished - 29 Jun 2026
Peer-reviewedYes

Publication series

SeriesStudies in health technology and informatics
Volume338
ISSN0926-9630

Conference

Title24th International Conference on Informatics, Management, and Technology in Healthcare
SubtitleHealth Sciences Informatics Leads and Empowers the Digital Health Transformation
Abbreviated titleICIMTH 2026
Conference number24
Duration3 - 5 July 2026
Website
LocationDivani Palace Acropolis
CityAthens
CountryGreece

External IDs

Scopus 105045004807
ORCID /0000-0002-5002-2676/work/228961605
ORCID /0000-0002-9888-8460/work/228961666

Keywords

Keywords

  • Data Accuracy, Germany, Humans, Insurance Claim Review/standards