Development of the TCDB-NHIRD Linked Database: what can we learn from the SEER-Medicare Database in the United States?

In the United States, the SEER-Medicare data link cancer patients in the SEER (Surveillance, Epidemiology, and End Results) Program with Medicare enrollment to identify cancer patients who are eligible for Medicare and to provide Medicare Claims for these patients. Statistics from the National Cancer Institute show that there are over 650 peer-reviewed publications using the SEER -Medicare database. This database has been the primary data source for health services research in oncology since its inception, and it has made tremendous contributions to policies related to cancer control, treatment, and surveillance in the United States. The National Health Insurance Research Database (NHIRD), established at the initiation of the Taiwan's National Health Insurance program in 1995, is a claims database. The Taiwan Cancer Database (TCDB), based on the Taiwan Cancer Registry, was established in 2002. The creation of a TCDB-NHIRD linked database could produce a SEER-Medicare-like database and has the potential to become an invaluable resource for cancer as well as policy researchers in Taiwan. This paper introduces the SEER-Medicare database, including data collection, software, applications of the database, data elements, structure, validation, the data request and application process, limitations of the database, and privacy and confidentiality issues. We then use a previously published breast cancer study to demonstrate the procedures involved in generating research from the SEER-Medicare database, followed by recommendations for the future development of a database that links TCDB to the NHIRD. [ABSTRACT FROM AUTHOR]