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DeSC database
2025 年 7 巻 2 号 p. 46-49
詳細
2025 年 7 巻 2 号 p. 46-49
The DeSC database is a commercially available administrative claims and health checkup database in Japan. The DeSC database contains health insurance claims data from three types of health insurers: the National Health Insurance (Kokuho), Health Insurance Societies (Kempo), and the Advanced Elderly Medical Service System. A previous study has shown that the population in the DeSC database is representative of the entire population of Japan. Our literature search identified 56 original articles conducted using the DeSC database between April 2022 and September 2024. Although the number of studies using the DeSC database is increasing, there are still opportunities to enhance research on various topics.
In a previous Annals of Clinical Epidemiology report, I discussed updated information on the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) of the Ministry of Health, Labour, and Welfare, Japan1). The NDB includes almost all administrative claims data from insurers across Japan and covers approximately 98% of the data on healthcare services provided by medical institutions. However, researchers currently face challenges in application for using the NDB and data handling.
Several commercially available databases have been established, including administrative claims data for various types of insurers. The use of such databases is recommended as an alternative to the NDB. This study describes the DeSC database, a commercially available administrative claims and health checkup database is Japan.
Almost all residents of Japan are insured by one of the public healthcare insurance systems listed in Table 1. Health Insurance (Kempo) has two types: one provided by the Japan Health Insurance Association for salaried employees in small- and medium-sized companies and their dependents below 75 years of age, and the other provided by Health Insurance Societies for salaried employees in large companies and their dependents under 75 years of age. The National Health Insurance (Kokuho) is provided by municipalities or National Health Insurance societies for the self-employed or unemployed and their dependents under 75 years of age. The Mutual Aid Association provides insurance to national and local government officers and their dependents under 75 years of age. The Advanced Elderly Medical Service System provides insurance to individuals aged 75 years or older. Table 1 shows the number of insurers, the insured, their dependents, and healthcare expenditures2).
| No. of Insurers | No. of the insured (104 persons) | No. of dependents (104 persons) | Healthcare expenditures (108 yen) | |
|---|---|---|---|---|
| Health Insurance (Kempo) | ||||
| Japan Health Insurance Association | 1 | 2,508 | 1,520 | 66,798 |
| Health Insurance Societies | 1,388 | 1,641 | 1,197 | 42,396 |
| National Health Insurance (Kokuho) | ||||
| Municipalities | 1,716 (cities, towns, and villages) | 2,537 | — | 87,107 |
| National Health Insurance Societies | 161 | 268 | — | 4,642 |
| Mutual Aid Association | 85 | 477 | 392 | 13,419 |
| Advanced Elderly Medical Service System | 47 (prefectures) | 1,843 | — | 157,556 |
The DeSC database (DeSC Healthcare, Inc., Tokyo, Japan) (https://desc-hc.co.jp/company) is a Japanese database of health checkups and healthcare administrative claims that was newly constructed by DeSC Healthcare, Inc. in 2020. One feature of the DeSC database is that it contains health insurance claims data from three types of health insurers: (i) the National Health Insurance for several municipalities, (ii) Kempo for several Health Insurance Societies, and (iii) an Advanced Elderly Medical Service System for several prefectures. Therefore, the DeSC database contains data from various generations, including children and adults (young, middle-aged, and older adults). The DeSC database includes data from approximately 12,500,000 individuals.
A previous study confirmed the population representativeness of the DeSC database3). In other words, the age distribution of the population in the DeSC database was similar to that of the population estimates. The estimated prevalences of diabetes mellitus and hypertension were comparable to those reported by the National Health and Nutrition Survey. The estimated prevalence of patients undergoing gastrectomy was comparable to that of the NDB Open Data.
Socioeconomic and health statuses differ between the Kempo and Kokuho populations. People covered by Kempo are mostly under 65 years old and are relatively financially stable because they are likely to be full-time employees. The insured under the Japan Health Insurance Association are employees of relatively small companies, whereas those under the Health Insurance Society are employees of large companies with relatively high incomes. In contrast, the insured under Kokuho tend to have no regular income because they include self-employed, freelancers, part-time workers, unemployed, or retired individuals aged 65–74 years.
A previous study showed that the prevalence of diabetes mellitus was 11.6%, 28.9 %, and 30.9% in the Kempo, Kokuho, and advanced older adult groups, respectively. The prevalence of hypertension in the Kempo, Kokuho, and advanced older adult groups were 11.1 %, 21.9%, and 57.1%, respectively. The prevalence of ischemic heart disease was 2.0%, 4.7%, and 20.1%; that of stroke was 0.8%, 2.9%, and 14.8%; and that of colorectal cancer was 0.3%, 0.8%, and 2.4%, in the Kempo, Kokuho, advanced older adult group, respectively. These findings suggest that those insured by Kokuho have poorer health than those insured by Kempo4).
Medical claims data of outpatients and inpatients were collected anonymously. The database includes the following information: (i) unique identifier of the individuals; (ii) birth month and sex; (iii) diagnoses recorded with the International Classification of Diseases, 10th Revision codes; (iv) procedures recorded with original Japanese procedure codes; (v) drug names and drug categories according to the Anatomical Therapeutic Chemical Classification System based on the World Health Organization or the European Pharmaceutical Market Research Association; (vi) dates of insurance registration and deregistration; and (vii) costs for examinations, procedures, surgery and anesthesia. Accurate mortality information can be obtained in the data from the National Health Insurance or the Advanced Elderly Medical Service System.
The DeSC database contains information on the annual health checkups for approximately 30% of the entire population. Health checkup data include information on height, weight, abdominal circumference, blood pressure, clinical laboratory tests (e.g., blood and urine tests), and questionnaires on lifestyle factors (e.g., smoking and alcohol habits, medical history of stroke or ischemic heart disease).
We searched for studies using the DeSC database in PubMed between April 2022 and September 2024 (2 years and 6 months). The search terms were “DeSC database” OR “DeSC Healthcare.” We included only original articles or short reports written in English. Review articles and non-English articles were excluded from the analysis.
Finally, we identified 56 studies that used the DeSC database during this period. A list of the 56 articles is provided in the Supplementary Material. Four articles were published in 2022, 18 in 2023, and 34 in 2024 (January to September).
Table 2 lists the subject areas of the 56 selected articles. Of these, 39 articles were included in internal medicine, four in psychiatry, four in orthopedic surgery, and four in pharmacy. We could not find studies on general surgery, dermatology, otolaryngology, anesthesiology, neurosurgery, plastic surgery, urology, radiology, rehabilitation medicine, or nursing care.
| Subject area | Number of articles (n = 56) |
|---|---|
| Internal Medicine | 39 |
| Neurology | 11 |
| Cardiology | 8 |
| Diabetes and metabolism | 8 |
| Oncology | 3 |
| Gastroenterology | 3 |
| Infectious diseases | 3 |
| Geriatrics | 1 |
| Allergy | 1 |
| Others | 1 |
| Psychiatry | 4 |
| Orthopedic Surgery | 4 |
| Pharmacy | 4 |
| Ophthalmology | 2 |
| Pediatrics | 1 |
| Obstetrics and Gynecology | 1 |
| Dentistry | 1 |
The results indicate that the number of studies using the DeSC database is steadily increasing; however, there is still an opportunity to enhance DeSC research across various topics.
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Hideo Yasunaga is one of the Editorial Board members of Annals of Clinical Epidemiology. This author was not involved in the peer-review or decision-making process for this paper.
