Osong Public Health Res Perspect.  2024 Feb;15(1):18-32. 10.24171/j.phrp.2023.0248.

Developing a national surveillance system for stroke and acute myocardial infarction using claims data in the Republic of Korea: a retrospective study

• Kim TJ
• Lee HS
• Kim SE
• Park J
• Kim JY
• Lee J
• Song JE
• Hong JH
• Lee J
• Chung JH
• Kim HC
• Shin DH
• Lee HY
• Kim BJ
• Seo WK
• Park JM
• Lee SJ
• Jung KH
• Kwon SU
• Hong YC
• Kim HS
• Kang HJ
• Lee J
• Bae HJ

• KMID: 2553786
• DOI: http://doi.org/10.24171/j.phrp.2023.0248

Abstract

Objectives
Limited information is available concerning the epidemiology of stroke and acute myocardial infarction (AMI) in the Republic of Korea. This study aimed to develop a national surveillance system to monitor the incidence of stroke and AMI using national claims data.
Methods
We developed and validated identification algorithms for stroke and AMI using claims data. This validation involved a 2-stage stratified sampling method with a review of medical records for sampled cases. The weighted positive predictive value (PPV) and negative predictive value (NPV) were calculated based on the sampling structure and the corresponding sampling rates. Incident cases and the incidence rates of stroke and AMI in the Republic of Korea were estimated by applying the algorithms and weighted PPV and NPV to the 2018 National Health Insurance Service claims data.
Results
In total, 2,200 cases (1,086 stroke cases and 1,114 AMI cases) were sampled from the 2018 claims database. The sensitivity and specificity of the algorithms were 94.3% and 88.6% for stroke and 97.9% and 90.1% for AMI, respectively. The estimated number of cases, including recurrent events, was 150,837 for stroke and 40,529 for AMI in 2018. The age- and sex-standardized incidence rate for stroke and AMI was 180.2 and 46.1 cases per 100,000 person-years, respectively, in 2018.
Conclusion
This study demonstrates the feasibility of developing a national surveillance system based on claims data and identification algorithms for stroke and AMI to monitor their incidence rates.

Keyword

Incidence; Myocardial infarction; Population characteristics; Population surveillance; Stroke