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Medical Market Research: Disease and Procedure Incidence

Introduction

Determining the incidence rates of diseases and procedures and insurance reimbursement rates are usually the most difficult steps of conducting medical market research. This is involves several steps that, depending on how rare and specific your request is, can be very time-consuming. A breakdown of each step is below.

Determining Incidence Rates

There are three main increasingly complicated ways to get incidence rates for specific diseases and procedures:

  • Locate national societies or organizations devoted to your subject (such as the National Cancer Institute, American Heart Association, etc). These organizations usually conduct their own research and/or break down the large national datasets and extract only information pertinent to their mission. In short, they do a lot of the heavy lifting for you.
  • Conduct a literature search on your topic and track down the references/statistics cited in the background of the paper. This always needs to be verified as often authors do not use the most up-to-date information.
  • If all else fails, you can go to the raw national or regional data. In addition to the resources in the Demographics tab, the following datasets are important sources of medical incidents:

Medical Coding

Incidence rates are often tied to medical codes instead of full names of diseases or procedures. The following are two primary coding systems that you will need to be familiar with:

  • ICD-10 (browser) - coding system used by medical professionals to describe and report patient disease and procedure information, often found in electronic health records
  • CPT/HCPCS - Centers for Medicare & Medicaid (CMS) - Coding system needed to navigate CMS reimbursement fees and incidence rates.

Estimating Cost

Though it is very tricky to definitely determine the cost of a procedure, there are a few somewhat reliable ways to estimate this: