Introduction to the Medical Research Using National Health Insurance Claims Database

Dong-Ryeol Ryu

doi:10.12771/emj.2017.40.2.66

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Introduction to the Medical Research Using National Health Insurance Claims Database

Dong-Ryeol Ryu

The Ewha Medical Journal 2017;40(2):66-70. Published online: April 28, 2017

DOI: https://doi.org/10.12771/emj.2017.40.2.66

Department of Internal Medicine, Ewha Womans University School of Medicine, Research Institute for Human Health Information, Ewha Womans University Mokdong Hospital, Seoul, Korea.

Corresponding author: Dong-Ryeol Ryu. Department of Internal Medicine, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea. Tel: 82-2-2650-2507, Fax: 82-2-2650-2501, drryu@ewha.ac.kr

• Received: January 13, 2017 • Accepted: April 10, 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
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Abstract

All Korean citizens should join the National Health Security System by law. The National Health Insurance Service (NHIS) and the Health Insurance Review and Assessment Service (HIRA) are one of major components to support this system, and all data about medical expenses for the medical claims are stored and managed in the institutions. Recently, medical research using administrative claims databases has dramatically progressed in Korea and worldwide, and the methods how to use them are briefly reviewed in this article. Research using these databases have several strengths. Researchers can perform the complete enumeration survey in a real world. They can get new valuable findings because the number in the database is usually large enough to detect the minute difference with a big statistical power. They can obtain more detailed and reproducible results. Moreover, they can investigate a very rare disease or infrequent side effects of drugs. However, we must recognize that research using administrative claims database also has several incoherent limitations. These databases have not been constructed originally for research, but for reimbursement. Therefore, there are no important data including medical history and laboratory findings of each patient, which are crucial to adjust baseline characteristics. In addition, it is hard to discover causal relationship and direct association with the included information. In spite of limitations, researchers can easily use these databases for their research now than ever, and the results may be utilized not only to expand the academic knowledge but also to influence the determination of national healthcare policy.
Keywords: Administrative claims; Database; Medical research

References

1. Jeong HS. Korea's National Health Insurance: lessons from the past three decades. Health Aff (Millwood) 2011;30:136-144.
Article
2. Kwon S. Thirty years of National Health Insurance in South Korea: lessons for achieving universal health care coverage. Health Policy Plan 2009;24:63-71.
Article
3. Korea Health Industry Development InstituteMajor statistics in National Health Insurance, 2015 [Internet] Cheongju, Korea Health Industry Development Institute. 2016;cited 2017 Apr 12. Available from: http://www.nhis.or.kr/bbs7/boards/B0074/17042?boardKey=29&sort=sequence&order=desc&rows=10&messageCategoryKey=&pageNumber=1&viewType=generic&targetType=12&targetKey=29&status=&period=&startdt=&enddt=&queryField=&query=
4. Kim H, Kim KH, Park K, Kang SW, Yoo TH, Ahn SV, et al. A population-based approach indicates an overall higher patient mortality with peritoneal dialysis compared to hemodialysis in Korea. Kidney Int 2014;86:991-1000.
Article
5. Lee S, Ryu JH, Kim H, Kim KH, Ahn HS, Hann HJ, Cho Y, et al. An assessment of survival among Korean elderly patients initiating dialysis: a national population-based study. PLoS One 2014;9:e86776.
Article
PubMed
PMC
6. Jo MW. An evaluation of national screening program for chronic kidney disease; Cheongju, Korea: Centers for Disease Control & Prevention; 2016.
7. Ji E, Kim YS. Prevalence of chronic kidney disease defined by using CKD-EPI equation and albumin-to-creatinine ratio in the Korean adult population. Korean J Intern Med 2016;31:1120-1130.
Article
PDF
8. Health Insurance Review and Assessment ServiceHIRA report: [Internet] Seoul, Health Insurance Review and Assessment Service. 2011;cited 2017 Apr 12. Available from: http://www.mohw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&PAGE=1&CONT_SEQ=250266&SEARCHKEY=TITLE&SEARCHVALUE=%B8%B8%BC%BA%BD%C5%BA%CE%CO%FC
9. National Health Insurance Service.Health Insurance Review & Assessment Service.2014 National Health Insurance statistical yearbook; Seoul: National Health Insurance Service; 2015.
10. Kim H, Kim KH, Ahn SV, Kang SW, Yoo TH, Ahn HS, et al. Risk of major cardiovascular events among incident dialysis patients: a Korean national population-based study. Int J Cardiol 2015;198:95-101.
Article
11. Ryu JH, Kim H, Kim KH, Hann HJ, Ahn HS, Lee S, et al. Improving survival rate of Korean patients initiating dialysis. Yonsei Med J 2015;56:666-675.
Article
12. Choi H, Kim M, Kim H, Lee JP, Lee J, Park JT, et al. Excess mortality among patients on dialysis: comparison with the general population in Korea. Kidney Res Clin Pract 2014;33:89-94.
Article
PubMed
PMC
13. Health Insurance Review and Assessment ServiceHIRA report: [Internet] Seoul, Health Insurance Review and Assessment Service. 2015;cited 2017 Apr 12. Available from: http://www.mohw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=318523&SEARCHKEY=TITLE&SEARCHVALUE=%C7%F7%BE%D7%C5%F5%BC%AE%20%C8%AF%C0%DA%BE%C8%C0%FC%20%C1%F6%C7%A5%BF%A1%20%B6%D1%B7%C7%C7%D1%20%B0%B3%BC%B1%20%C8%BF%B0%FA%20%B3%AA%C5%B8%B3%AA

Fig. 1

Structure of the national health insurance program in Korea. NHIS, national health insurance service; HIRA, health insurance review and assessment service.

Table 1

Summary of major results on CKD and ESRD analyzed using healthcare database in Korea

CKD, chronic kidney disease; ESRD, end-stage renal disease; PY, patient-years; PD, peritoneal dialysis; HD, hemodialysis.

Figure & Data

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Introduction to the Medical Research Using National Health Insurance Claims Database

Ewha Med J. 2017;40(2):66-70. Published online April 28, 2017

DOI: https://doi.org/10.12771/emj.2017.40.2.66

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Introduction to the Medical Research Using National Health Insurance Claims Database

Ewha Med J. 2017;40(2):66-70. Published online April 28, 2017

DOI: https://doi.org/10.12771/emj.2017.40.2.66

Figure

Introduction to the Medical Research Using National Health Insurance Claims Database

Fig. 1 Structure of the national health insurance program in Korea. NHIS, national health insurance service; HIRA, health insurance review and assessment service.

Fig. 1

Introduction to the Medical Research Using National Health Insurance Claims Database

Table 1

Summary of major results on CKD and ESRD analyzed using healthcare database in Korea

CKD, chronic kidney disease; ESRD, end-stage renal disease; PY, patient-years; PD, peritoneal dialysis; HD, hemodialysis.

Table 1 Summary of major results on CKD and ESRD analyzed using healthcare database in Korea

CKD, chronic kidney disease; ESRD, end-stage renal disease; PY, patient-years; PD, peritoneal dialysis; HD, hemodialysis.

Articles

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Introduction to the Medical Research Using National Health Insurance Claims Database

Full Article

Abstract

References

Structure of the national health insurance program in Korea. NHIS, national health insurance service; HIRA, health insurance review and assessment service.

Summary of major results on CKD and ESRD analyzed using healthcare database in Korea

Figure & Data

References

Citations

CITE

Download Citation

Format:

Include:

Figure

Fig. 1

Summary of major results on CKD and ESRD analyzed using healthcare database in Korea

Table 1

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