• Title, Summary, Keyword: National Health Insurance Research Database

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Retrospective Drugs Utilization Review Study for Chronic Kidney Disease Using National Health Insurance Database (건강보험 자료를 이용한 만성신부전 환자의 신독성 약물사용 현황)

  • Kim, Dong-Sook;Lee, Hyun-Jeong;Son, In-Ja;Kim, Gui-Sook;Shin, Joo-Young;Lee, Kun-Sei
    • YAKHAK HOEJI
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    • v.53 no.3
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    • pp.138-144
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    • 2009
  • The purpose was to implement drug utilization review (DUR) for whom were diagnosed with chronic kidney disease (CKD) population using health insurance claim data. This study constructed drug utilization database using Health Insurance Review and Assessment Service (HIRA) database and selected contraindicated drugs with kidney based on previously developed drug utilization guide and reviewing other countries' examples. Main outcome measures were the proportion of prescription for 1 or more drugs of concern. The cohort included 115,948 subjects, who were diagnosed with chronic kidney disease. Inappropriate drugs with CKD patients was some used, and the most commonly prescribed classes were aluminum drugs. However it is difficult to find problems with inappropriate drug because claims data doesn't have laboratory data. Based on the result of retrospective drug utilization review study, more studies should be analysed drug utilization patterns and monitoring system should be developed.

Using the National Health Information Database of the National Health Insurance Service in Korea for Monitoring Mortality and Life Expectancy at National and Local Levels

  • Bahk, Jinwook;Kim, Yeon-Yong;Kang, Hee-Yeon;Lee, Jeehye;Kim, Ikhan;Lee, Juyeon;Yun, Sung-Cheol;Park, Jong Heon;Shin, Soon-Ae;Khang, Young-Ho
    • Journal of Korean Medical Science
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    • v.32 no.11
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    • pp.1764-1770
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    • 2017
  • This study explores whether the National Health Information Database (NHID) can be used to monitor health status of entire population in Korea. We calculated the crude mortality rate and life expectancy (LE) at birth across the national, provincial, and municipal levels using the NHID eligibility database from 2004 to 2015, and compared the results with the corresponding values obtained from the Korean Statistical Information Service (KOSIS) of Statistics Korea. The study results showed that the ratio of crude mortality rate between the two data was 0.99. The absolute difference between the LE of the two data was not more than 0.5 years, and did not exceed 0.3 years in gender specific results. The concordance correlation coefficients (CCC) between the crude mortality rates from NHID and the rates from KOSIS ranged 0.997-0.999 among the municipalities. For LE, the CCC between the NHID and KOSIS across the municipalities were 0.990 in 2004-2009 and 0.985 in 2010-2015 among men, and 0.952 in 2004-2009 and 0.914 in 2010-2015 among women, respectively. Overall, the NHID was a good source for monitoring mortality and LE across national, provincial, and municipal levels with the population representativeness of entire Korean population. The results of this study indicate that NHID may well contribute to the national health promotion policy as a part of the health and health equity monitoring system.

Developing the Inpatient Sample for the National Health Insurance Claims Data (입원 환자 표본 개발에 관한 연구: 국민건강보험 청구자료를 중심으로)

  • Kim, Logyoung;Sakong, Jin;Kim, Yoon;Kim, Sera;Kim, Sookyeong;Tchoe, Byongho;Jeong, Hyoungsun;Lee, Taerim
    • Health Policy and Management
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    • v.23 no.2
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    • pp.152-161
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    • 2013
  • Korea has a single National Health Insurance program and all citizens are covered under this program, accounting 97% of the population, approximately 50 million people. Claims submitted by Health care providers are reviewed by Health Insurance Review and Assessment (HIRA) for the reimbursement. HIRA database contains not only individual beneficiary's information, but also healthcare service information such as diagnosis, procedures, prescriptions and tests for them. HRA database has gained attention as importance source for research due to its rich healthcare information and the demand of HIRA database has increased. Due to its tremendous size, however, researchers have had problems in accessing the database to conduct research. To meet this demand, we conducted a study to develop the inpatient sample data from HIRA database for research. This study has two purposes: 1) to determine a needed sample size; 2) to test reliability and validity of the sample data. We determined an adequate sample size to ensure representativeness and generality with additional consideration for convenience of calculation. The minimum sample size was 729,904 for the generality, and 488,861 for representativeness. After considering the convenience of calculation, our final sample size was 13% of the population, which was about 7.7 million beneficiaries. Age (5 years interval) and gender were used as stratification variables for sampling. In order to examine whether this sample data appropriately reflect population, we tested the reliability and validity of the sample data. From the sample data, we computed average expenditure of total claims per inpatient for 2011, frequency of top 30 disease, estimation of the number of stroke patients from the sample data, and then compared them to those from the population. Results confirmed reliability and validity of the sample data.

Nationwide Analysis of Treatment Patterns for Korean Breast Cancer Survivors Using National Health Insurance Service Data

  • Chung, Il Yong;Lee, Jihyoun;Park, Suyeon;Lee, Jong Won;Youn, Hyun Jo;Hong, Jung Hwa;Hur, Ho
    • Journal of Korean Medical Science
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    • v.33 no.44
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    • pp.276.1-276.10
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    • 2018
  • Background: The National Health Insurance Service (NHIS) established a healthcare claim database for all Korean citizens. This study aimed to analyze the NHIS data and investigate the patterns of breast cancer treatments. Methods: We constructed a retrospective female breast cancer cohort by analyzing annual incident cases. The annual number of newly diagnosed female breast cancer was compared between the NHIS data and Korea National Cancer Incidence Database (KNCIDB). The annual treatment patterns including surgery, chemotherapy, radiation therapy, endocrine therapy and targeted therapy were analyzed. Results: A total of 148,322 women with newly diagnosed invasive breast cancer during 2006-2014 was identified. The numbers of newly diagnosed invasive breast cancer cases were similar between the NHIS data and KNCIDB, which demonstrated a strong correlation (r = 0.995; P < 0.001). The age distribution of the breast cancer cases in the NHIS data and KNCIDB also showed a strong correlation (r = 1.000; P < 0.001). About 85% of newly diagnosed breast cancer patients underwent operations. Although the proportions of chemotherapy use have not changed during 2006-2014, the total number of chemotherapy prescriptions sharply increased during this period. The proportions of radiotherapy and anti-hormonal therapy increased. Among the anti-hormonal agents, tamoxifen was the most frequently prescribed medication, and letrozole was the most preferred endocrine treatment in patients aged ${\geq}50$ years. Conclusion: Along with the increased breast cancer incidence in Korea, the frequencies of breast cancer treatments have increased. The NHIS data can be a feasible data source for future research.

The Effect of Converting Health Insurance Qualification on Medical Use (건강보험가입자의 의료급여 자격변동에 따른 의료이용행태 변화 연구)

  • Na, Young-Kyoon;Cha, Yerin;Kim, Nayoung;Lee, Youngjae;Lee, Yong-Gab;Lim, Seungji
    • Health Policy and Management
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    • v.30 no.4
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    • pp.460-466
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    • 2020
  • Background: The purpose of this study is to analyze whether there is a change in patterns of medical use among those likely to be converted their health insurance qualifications when the family support rule is alleviated. There is no empirical analysis that converting health insurance qualification will affect the increase in medical use. Methods: For analysis, data were extracted from the national health insurance eligibility and medical care database. To identify analysis targets similar to that of medical aids' characteristics among health insurance coverage, we compared income, property level, and medical use patterns through basic statistical analysis and used a difference-in-difference (DID) analysis to estimate the net effect of changes in medical use following the change of qualifications. Results: The main results are as follows. The results show that those who are under the 5% income group (1st income group) of health insurance coverage are the most similar to the medical aids group. DID analysis shows that changes in the medical use of people who maintain their national insurance qualification and who are not. As a results, the number of hospitalized days of converting group was reduced by 3.5 days while outpatient days were increased by 1.8 days. Conclusion: As a result, there was not much difference in the patterns of medical use for the under 5% income group who are likely to be eligible for expanded medical aids when the family support rule is alleviated. In addition, more than 30% of them are in arrears with their health insurance premiums, causing inconvenience in using medical services. These findings suggest the need of abolishing the criteria obligated to support family, and great efforts should be made to contribute to non-paid poor and remove their medical blind spot.

Prenatal care utilization and expenditure among pregnant women (임부의 산전진찰 의료이용양상 및 진료비 분석)

  • Kim, Kyung-Ha;Hwang, Rah-Il;Yoon, Ji-Won;Kim, Jin-Soo
    • Health Policy and Management
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    • v.19 no.4
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    • pp.53-65
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    • 2009
  • Purpose: This study was conducted to identify the prenatal heath care utilization and expenditure among pregnant women. Method: This was a 5-month follow-up study using a stratified sampling and the data were drawn from the "nationwide claim database of Korean National Health Insurance Corporation". Result: This study found that pregnant women were first diagnosed with pregnancy when they were 7.1 weeks pregnant, received 12.7 times of prenatal examinations and 10.6 times of ultrasonogram. It was revealed that 67.5% of the subjects continued to receive prenatal care at the same medical institutions from the diagnosis of pregnancy to the delivery. The study also showed that the total expenditure of prenatal care per pregnant woman was 700,000 Korean Won (KRW) on average and the insurance coverage rate stood at only 20%. Pregnant women living in metropolitan area spent more on prenatal healthcare expenditure than those who living in medium-sized city or rural area. Conclusion: The results of this study implies that the government needs to provide pregnant women with continuous support by increasing health insurance coverage for prenatal care. Especially, it is considered to provide more support to the pregnant women residing in medically underserved areas.

A visual query database system for the Sample Research DB of the National Health Insurance Service (국민건강보험공단의 표본연구DB를 위한 비주얼 쿼리 데이터베이스 시스템 개발 연구)

  • Cho, Sang-Hoon;Kim, HeeChan;Kang, Gunseog
    • The Korean Journal of Applied Statistics
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    • v.30 no.1
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    • pp.13-24
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    • 2017
  • The Sample Cohort DB supplied by the National Health Insurance Service is a valuable resource for statistical studies as well as for health and medical studies. It takes significant time and effort to extract data from this Cohort DB having a large size. As such, we introduce a database system, conveniently called the National Health Insurance Service Cohort DB Extract Tool (NICE Tool), which supports several useful operations for effectively and efficiently managing the Cohort DB. For example, researchers can extract variables and cases related with study by simply clicking a computer mouse without any prior knowledge regarding SAS DATA step or SQL. We expect that NICE Tool will facilitate the faster extraction of data and eventually lead to the active use of the Cohort DB for research purposes.

Screening of Workers with Presumed Occupational Methanol Poisoning: The Applicablility of a National Active Occupational Disease Surveillance System

  • Eom, Huisu;Lee, Jihye;Kim, Eun-A
    • Safety and Health at Work
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    • v.10 no.3
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    • pp.265-274
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    • 2019
  • Background: Methyl alcohol poisoning in mobile phone-manufacturing factories during 2015-2016 was caused by methyl alcohol use for cleaning in computerized numerical control (CNC) processes. To determine whether there were health complications in other workers involved in similar processes, the Occupational Safety and Health Research Institute conducted a survey. Methods: We established a national active surveillance system by collaborating with the Ministry of Employment and Labor and National Health Insurance Service. Employment and national health insurance data were used. Overall, 12,048 employees of major domestic mobile phone companies and CNC process dispatch workers were surveyed from 2016 to 2017. We investigated methyl alcohol poisoning by using the national health insurance data. Questionnaires were used to investigate diseases due to methyl alcohol poisoning. Results: Overall, 24.9% of dispatched workers were employed in at least five companies, and 23.9% of dispatched workers had missing employment insurance history data. The prevalence of blindness including visual impairment, optic neuritis, visual disturbances, and alcohol toxicity in the study participants was higher than that reported in the national health insurance database (0.02%, 0.07%, 0.23%, and 0.03% versus 0.01%, 0.07%, 0.13%, and 0.01%, respectively, in 2015). Moreover, 430 suspicious workers were identified; 415 of these provided an address and phone number, of whom 48 responded (response rate, 11.6%). Among the 48 workers, 10 had diseases at the time of the survey, of whom 3 workers were believed to have diseases related to methyl alcohol exposure. Conclusion: This study revealed that active surveillance data can be used to assess health problems related to methyl alcohol poisoning in CNC processes and dispatch workers.

The trend of national health insurance service use among pregnant and postpartum women aged 35 years and older (35세 이상 고령 임산부 진료실적 추이에 관한 연구)

  • Hwang, Rah-Il;Kim, Kyung-Ha;Yoon, Ji-Won;Lee, Jung-Suk
    • Health Policy and Management
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    • v.21 no.4
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    • pp.585-598
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    • 2011
  • This study was conducted to examine the trend of national health insurance service use with relation to pregnancy, childbirth, and the puerperium among pregnant and postpartum women older than 35 over the last decade. A descriptive analysis was conducted, using the data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation(NHIC)". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium (International Classification of Disease, $10^{th}$revision [ICD-10] codes O00-O99) from 2001 to 2008. During 2001-2008, the number of pregnant and postpartum women older than 35 had continuously increased and the percentage of them also had increased in both hospital and ambulatory care. There are similar trends in their total use of national health insurance service and total expenditure. According to demographic characteristics, there was the biggest increase of the percentage in residents in large cities, self-employed workers, ones in the highest income level. According to ICD-10 codes, there was the biggest increase of the percentage in O10-O16 (oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium). According to the major prevalent disease, there was the biggest increase of the percentage in O60 (preterm labor and delivery). Throughout the past decade, the necessity has been emphasized of supporting pregnant and postpartum women older than 35. But in maternal and child health care, they are in an early stage of development. The findings of this study would be helpful in developing the support programs for the aged pregnant and postpartum women.

Disability Registration State of Children With Cerebral Palsy in Korea

  • Kim, Seong Woo;Jeon, Ha Ra;Kim, Yoon;Choi, Soo Jin;Youk, Taemi;Kim, Jiyong
    • Annals of Rehabilitation Medicine
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    • v.42 no.5
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    • pp.730-736
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    • 2018
  • Objective To investigate the disability registration state of children with cerebral palsy (CP) in Korea. Methods Based on the National Health Information Database, the disability registration state was examined for brain lesion disability and other possible complicated disabilities accompanying brain disorder in children diagnosed with CP aged up to 5 years old who were born between 2002 and 2008. Results Of children diagnosed with CP, 73.1% were registered as having brain lesion disability for the first time before they turned 2 years old. The younger the children, the more likely they will have 1st and 2nd degree disability. However, when the age of children is increased, such likelihood is decreased. The percentage of children registered as having overlapping disabilities was 7%-20%. Conclusion It is important to establish a more accurate standard to rate disability and provide national support systems for children with CP with various severities and multiple disabilities. By reorganizing the current disability registration system for pediatric brain lesions, the system could serve as a classification standard to provide medical and social welfare services.