Diabetes Metab J.  2014 Oct;38(5):395-403. 10.4093/dmj.2014.38.5.395.

Background and Data Configuration Process of a Nationwide Population-Based Study Using the Korean National Health Insurance System

• Song SO
• Jung CH
• Song YD
• Park CY
• Kwon HS
• Cha BS
• Park JY
• Lee KU
• Ko KS
• Lee BW

• KMID: 2280684
• DOI: http://doi.org/10.4093/dmj.2014.38.5.395

Abstract

BACKGROUND
The National Health Insurance Service (NHIS) recently signed an agreement to provide limited open access to the databases within the Korean Diabetes Association for the benefit of Korean subjects with diabetes. Here, we present the history, structure, contents, and way to use data procurement in the Korean National Health Insurance (NHI) system for the benefit of Korean researchers.
METHODS
The NHIS in Korea is a single-payer program and is mandatory for all residents in Korea. The three main healthcare programs of the NHI, Medical Aid, and long-term care insurance (LTCI) provide 100% coverage for the Korean population. The NHIS in Korea has adopted a fee-for-service system to pay health providers. Researchers can obtain health information from the four databases of the insured that contain data on health insurance claims, health check-ups and LTCI.
RESULTS
Metabolic disease as chronic disease is increasing with aging society. NHIS data is based on mandatory, serial population data, so, this might show the time course of disease and predict some disease progress, and also be used in primary and secondary prevention of disease after data mining.
CONCLUSION
The NHIS database represents the entire Korean population and can be used as a population-based database. The integrated information technology of the NHIS database makes it a world-leading population-based epidemiology and disease research platform.

Keyword

National Health Insurance; National Health Insurance Service; Population-based data; Korea

MeSH Terms

Aging
Chronic Disease
Data Mining
Delivery of Health Care
Epidemiology
Insurance, Health
Insurance, Long-Term Care
Korea
Metabolic Diseases
National Health Programs*
Secondary Prevention

Figure

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  Fig. 1 Operational structure of the National Health Insurance program.

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  Fig. 2 Plausible healthcare system types.

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