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08-11-2017 | Original Article – E‑Learning | Uitgave 1/2018 Open Access

Netherlands Heart Journal 1/2018

Nationwide claims data validated for quality assessments in acute myocardial infarction in the Netherlands

Netherlands Heart Journal > Uitgave 1/2018
D. C. Eindhoven, L. N. van Staveren, J. A. van Erkelens, D. E. Ikkersheim, S. C. Cannegieter, V. A. W. M. Umans, A. Mosterd, J. van Wijngaarden, M. J. Schalij, C. J. W. Borleffs
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Authors’ contributions D.C. Eindhoven, C.J.W. Borleffs, J.A. van Erkelens and M.J. Schalij conceived and designed the study; D.C. Eindhoven, C.J.W. Borleffs, S.C. Cannegieter and J.A. van Erkelens performed statistical analysis; D.C. Eindhoven, C.J.W. Borleffs and M.J. Schalij handled funding; D.C. Eindhoven and C.J.W. Borleffs drafted the manuscript; C.J.W. Borleffs and M.J. Schalij handled supervision; D.C. Eindhoven, C.J.W. Borleffs and J.A. van Erkelens acquired the national data; D.C. Eindhoven and L.N. van Staveren acquired the validation data; V.A.W.M. Umans, A. Mosterd, J. van Wijngaarden facilitated the acquirement of the validation data; D.C. Eindhoven, J.A. van Erkelens, D.E. Ikkersheim, S.C. Cannegieter, V.A.W.M. Umans, A. Mosterd, J. van Wijngaarden, M.J. Schalij, C.J.W. Borleffs did critical revisions of the manuscript.



Since health insurance is compulsory in the Netherlands, the centrally registered medical claims data might pose a unique opportunity to evaluate quality of (cardiac) care on a national level without additional collection of data. However, validation of these claims data has not yet been assessed.


Retrospective cohort study.


National claims data (‘national registry’) were compared with data collected by patient records reviews in four representative hospitals (‘validation registry’). In both registries, we extracted the national diagnosis codes for ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction of 2012 and 2013. Additionally, data on medication use at one year after acute myocardial infarction (AMI) was extracted from the Dutch pharmacy information systems and also validated by local patient records reviews. The data were compared at three stages: 1) validation of diagnosis and treatment coding; 2) validation of the hospital where follow-up has taken place; 3) validation of follow-up medical treatment after 365 days.


In total, 3,980 patients (‘national registry’) and 4,014 patients (‘validation registry’) were compared at baseline. After one-year follow-up, 2,776 and 2,701 patients, respectively, were evaluated. Baseline characteristics, diagnosis and individual medication were comparable between the two registries. Of all 52,672 AMI patients in the Netherlands in 2012 and 2013, 81% used aspirin, 76% used P2Y12 inhibitors, 85% used statins, 82% used beta-blockers and 74% angiotensin converting enzyme inhibitors/angiotensin II antagonists. Optimal medical treatment was achieved in 49% of the patients with AMI.


Nationwide routinely collected claims data in patients with an acute myocardial infarction are highly accurate. This offers an opportunity for use in quality assessments of cardiac care.

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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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