Utilization of Medical Big Data

　The YoMDB (Yokohama Original Medical Data Base) is a collection of medical, nursing, and health data held by Motoichi for use in medical policies, deletes personal information as much as possible, and creates a database (March 2018) Operation).

　　　　　　[Target]
　　　　　　　Medical: Receipt data for National Health Insurance, Medical Care System for Elderly Elderly, and Medical Aid (from April 2014)
　　　　　　　※The number of data for a single year is approximately 30 million.
　　　　　　　※Cover 35% of citizens (approximately 100% for those aged 75 and over)
　　　　　　　Nursing care: Nursing care receipt data, information on certification for long-term care, etc. (after April 2012)
　　　　　　　Health: Specific medical examination / specific health guidance data (after April 2014)

　In order to solve the 2025 problem, various medical policy issues such as cancer control, palliative care, measures against five other diseases (stroke, cardiovascular disease, diabetes, mental illness), and enhancement of home medical care We grasp the actual situation from big data analysis and plan specific measures.

　We will create a basic tabulation table with high versatility from YoMDB and publish it as "YMDB Open Data".
YoMDB Open Data (FY2019)

　An analysis was conducted to clarify how many elderly people need nursing care after a fracture. In addition, an academic paper summarizing the results was published in an international journal in November 2021.

　We conducted an analysis to clarify how much treatment has been started for high-risk osteoporosis groups in Yokohama. In addition, an academic paper summarizing the results was published in an international journal in April 2021.

　Real World Data was able to clarify the incidence of diabetic nephropathy in patients with type 2 diabetes in two insurers (National Health Insurance / Late term). The results were presented at the 78th Annual Meeting of the Japanese Society of Public Health held in October 2019.
　　In addition, an academic paper summarizing the results was published in an international journal in July 2021.

　An analysis was conducted for cancer patients who received terminal care at home. As a result, we found the actual situation of home terminal care patients, such as the number of emergency home visits. It also became clear about the duration of life after moving to home.
The results were presented at the 2nd Japan Clinical Epidemiology Association held in September 2018 and the 61st Japan Gynecological Oncology Association Academic Lecture held in July 2019.

　Using YoMDB, we analyzed the use of home medical care and multiplied the future population estimate of Yokohama City to estimate the future demand for home medical care. As a result, it was found that demand will double in the next 20 years. In addition, an academic paper summarizing the results was published in an international journal in November 2018.

　Based on the "Comprehensive Partnership Agreement on Data Utilization" concluded on May 22, 2018, Yokohama City and Yokohama City University signed a memorandum of understanding (MOU) on September 14, 2020 for the use of health data science policies. Based on this MOU, we conducted joint research using YoMDB and published an academic paper summarizing the results in an international journal. For details, please refer to the press release of Yokohama City University.

●Treatment of Super Elderly People: Survey of residents aged 75 and over in urban areas using the Yokohama Original Medical Database (outside site)： Published in April 2022
●Study the division of care for the elderly: Total survey of residents aged 75 and over using the Yokohama Original Medical Database (outside site)： Published in August 2022

　Using NDB (Receipt Information and Specific physical checkup Information Database), a representative example of medical big data, we compiled the results of analyzing the actual situation of cancer treatment performed at medical institutions in the city. The analysis was conducted in collaboration with Yokohama City University.
The summary of the analysis results report is as follows.

　Using NDB data, we analyzed patients who received cancer treatment (pharmacological therapy, surgical therapy, radiation therapy) at a medical institution in the city from April 2014 to March 2016. .

• Approximately 52,000 people were treated for cancer at city medical institutions annually.
• In the working generation, women were treated twice as much as men. In the elderly, men were treated 1.5 times more than women.
• In cancer treatment, nearly 70% of patients received medication.
• Nearly 70% of patients who were over 80 years old had chemotherapy.
• Outpatient chemotherapy was given an average of about 4.5 months, with 85% of patients receiving less than twice a month.
• Among the working generations, cancer patients receiving outpatient chemotherapy required an average of 13.8 visits per year.
  In addition, 74% of patients went to the hospital more than 10 times a year, and 18% of patients went to the hospital more than 20 times a year.

• A comprehensive analysis focused on patients treated for cancer has revealed for the first time the actual situation of patients being handled by medical institutions in the city.
• The percentage of patients who received chemotherapy is higher than surgical or radiation therapy, and it has been found that chemotherapy plays a significant role in cancer treatment.
• It can be important basic data for flexible institutional design for balancing work and treatment.
• Palliative care did not include data from general wards and homes, and did not understand the actual situation.

　In addition, for research that uses only information such as medical information without invasive or intervention, such as medical big data analysis, it is necessary to obtain direct consent from each target person based on the guidelines set by the government. There is no need, but it is necessary to disclose information about the implementation, including the purpose of research, etc.
　If you have any questions, consultation, etc., please contact the following inquiry / consultation desk.

　Inquiries about research and contact information: Medical Policy Division Medical Data Utilization Promotion Section (045-671-4872)