Dumb question- what would it take to have a large, centralized national healthcare database in the US that we could use to carry out massive epidemiological investigations on?
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This is similar to what happens in the Netherlands and Germany I believe
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Confirmed. Eg, BIPS Bremen is working with a database with 25m people (GePaRD). I know that some colleagues use big databases from the US, but I don't know the details.
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Sure — but what I mean is you need massive standards on how thousands of pieces of data are submitted. Blood pressure. Okay, is it the average blood pressure? The best? The worst? Do you include or exclude patients with pre-eclampsia? Is it just outpatient? Or also inpatient? etc
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In this context, you wouldn't be extracting that sort of data at all - ICD codes and demographics give you a lot of info
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Ask companies like United Healthcare, Blue Cross, or IQVIA, they have impressive amounts of data. Blue Cross insures 106M Americans, United 45M.
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It would certainly undersample the uninsured and undocumented.
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Absolutely true - national databases are subject to the issues inherent in the health system, and those issues are *vast* in the US. I imagine there are many people who have serious issues who never interact with any health databases at all most of the time
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