Population-based observational studies using process-produced secondary data, such as health claims data, provide important information on health events. I will discuss to what extent the epidemiological measures obtained from them are a valid reflection of disease incidence. Our latest results based on data from the German statutory health and long-term care insurance show that rising life expectancy is accompanied by an increase in healthy life years and a compression of life years with dementia and need for long-term care. The presence of dementia is among the most important factors influencing survival into very old age. In Germany, population ageing and increasing life expectancy will lead to dementia being the leading disease at death for women and the second for men by 2060, when the morbidity profile will remain the same. Extrapolating the observed time trends in disease profiles into the projections, cancer will be the most common disease at the time of death for both sexes. Even though the administrative diagnoses in claims data, which are primarily used for billing, are unstandardised and dependent on legal and technical framework conditions, they give a largely valid picture of the extent of diseases such as dementia. From this, valuable conclusions can be drawn about the resulting need for care.

Professor Dr Gabriele Doblhammer is Professor of Empirical Methods in the Social Sciences and Demography at the University of Rostock and Head of the Demography Research Group at the German Centre for Neurodegenerative Diseases in Bonn. She is a former president of the German Demographic Society and is currently a Visiting Scholar at the School of Demography at the Australian National University.

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