• The Korean Journal of Applied Statistics
• /
• v.30 no.1
• /
• pp.13-24
• /
• 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.

• The Korean Journal of Applied Statistics
• /
• v.29 no.7
• /
• pp.1329-1346
• /
• 2016

Korea Health Panel (KHP) data and Korea National Health and Nutrition Examination Survey (KNHANES) data are collected by self-assess and self-report for individual's health status and medical use. Previous studies have claimed that the reliability for prevalence rates and health life expectancies obtained from these data should be validated. National Health Insurance Services in Korea recently released a sample cohort DB that contain all data related to the use of medical facilities for all entire Korea citizens. It has been shown that disease-specific prevalence rates calculated from these data are representative and reliable for the entire population. In this paper, we evaluate the reliability of prevalence rates derived from self-reported data such as KHP and KNHANES by comparing to the prevalence rates from the sample cohort DB. We found that both KHP and KNHANES underestimate prevalence rates and in turn overestimate health life expectancies. Moreover, the general trends of health life expectancies might be distorted (except for the sample cohort DB) because of sampling and non-sampling errors.

• The Korean Journal of Applied Statistics
• /
• v.28 no.4
• /
• pp.663-683
• /
• 2015

The change of the population pyramid due to low fertility and rapid aging threatens the financial sustainability of National Health Insurance. We construct statistical models for prevalence rates and medical expenses using National Health Insurance Service (NHIS) sample cohort data from 2002-2013. We then project yearly expenditures and income of national health insurance until 2060 that considers various assumptions in regards to future population structure and economic conditions. We adopt a VECM-LC model for prevalence rates and the double exponentially smoothing method for the per capita co-payment of healthcare expense (in which the two models are institution-disease-sex-age specific) to project of national health insurance expenditures. We accommodate various assumptions of economic situations provided by the national assembly and government to produce a financial projection for national health insurance. Two assumptions of dependents ratios are used for the projection of national health insurance income to conduct two future population structures by the two assumptions of aging progresses and various assumptions on economic circumstances as in the expenditure projection. The health care deficit is projected to be 20-30 trillion won by 2030 and 40-70 trillion won by 2060 in 2015 constant price.

• Journal of the Economic Geographical Society of Korea
• /
• v.21 no.1
• /
• pp.1-19
• /
• 2018

This study aims to analyze the regional patterns of user-provider in medical services for spatial improvement of national health care delivery system in south Korea. By using the National Health Insurance Service National Sample Cohort DB, the characteristics and changes in the medical service cases served outside of residing regions are found. In 2013 the rate of the cases served outside of residing regions was declined slightly and users of medical institutions outside of their residing area tended to have high income level relatively and to visit hospitals than clinics. And departments visited have changed from 2002.

• The Korean Journal of Applied Statistics
• /
• v.30 no.3
• /
• pp.475-486
• /
• 2017

This paper estimates the health life expectancies for Korean people based on a sample cohort database collected through objective measurements by the National Health Insurance Service. Health life expectancy is estimated using the single-state approach of Sullivan (1971). The 9-order correction factor method of Greville (1945) and Brass-logit model of Brass (1971) are also adopted for unobserved or incompletely observed age-specific morbidity and mortality. Based on the mortality and morbidity estimated from sample cohort DB, men and women in Korea are expected to live a 'healthy life' for 61 and 60 years in 2013, respectively, whereas life expectancies of men and women are 80 and 87, respectively. We also estimate certain disease-free life expectancies for each of genders, income levels, and types of insurance from 2003 to 2013 in Korea. We found that there exists an inequality of healthy life expectancy in Korea for different genders, income levels, and types of insurance.

• The Korean Journal of Applied Statistics
• /
• v.33 no.3
• /
• pp.239-256
• /
• 2020

Health is an important issue due to increased life expectancy. As a result, the demand for industry and services associated with individual health, health-related programs and services will be facilitated by a method to evaluate and classify the health level of an individual based on various factors. This study suggests a methodology to measure and score an individual health level. A credit scoring model was introduced to implement the categorization of variables, construct a prediction model, and to score individual health level. Cohort DB provided by National Health Insurance Service was used to illustrate overall procedures. It is expected that the suggested model can be utilized in designing and managing health care services as well as other health-related programs.

• Korean Journal of Head & Neck Oncology
• /
• v.37 no.1
• /
• pp.11-16
• /
• 2021

Background/Objectives: To analyze changes in the incidence of thyroid cancer for Korean population using big data from the National Health Insurance Service. Materials & Methods: Sample cohort database between January 2004 and December 2013 with 1,000,000 cases for each year was enrolled in this study. Thyroid cancer incidence was analyzed by sex, age and by region. Public health insurance payment was used to reflect socioeconomic status. Results: The incidence of thyroid cancer in Korea increased for 10 years annually. There are 3 times increasing in the incidence rate of thyroid cancer from 2004, 0.03% to 2013, 0.09%. The sex ratio in the incidence rate of thyroid cancer was male : female = 1:7.2 in 2004 and male : female = 1:3.6 in 2013 that suggest decreased gap between the sex ratio. Between 2004 and 2010, the incidence rates of those in their 40s were found to be the highest, whereas the incidence rates for those in their 50s were found to be highest from 2011 and thereafter. Every year the high socioeconomic status group showed a higher incidence of thyroid cancer than low socioeconomic status group. Some specific region showed continuous high incidence of thyroid cancer, not all city and state. Conclusion: The incidence rate of thyroid cancer for 10 years had special feature by sex, age, socioeconomic status and especially by region. This results will be a barometer for further epidemiologic study about the incidence of thyroid cancer for Korean population

• Journal of the Korean Data and Information Science Society
• /
• v.28 no.5
• /
• pp.1027-1041
• /
• 2017

Hyperlipidemia, the status of blood with high level of low-density lipoprotein cholesterol (LDL-C), is known as a main cause of coronary artery diseases such as myocardiac infarction or brain infarct. Statin is the representative prescription to hyperlipidemia and the effects of it depend on the patient's individual conditions such as health-caring habits or adherence to medication. The main effect of statin is reducing LDL-C, which should reach the target range based on National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) guideline. In this research, the reduction of LDL-C and attainment to patient's target range are considered effects of statin. The association between factors - individual conditions and adherence to medication of patients - and the effects of statin is analyzed with National Health Insurance Service-National Sample Cohort (NHIS-NSC).

• The Journal of the Korean dental association
• /
• v.54 no.8
• /
• pp.604-612
• /
• 2016

The aim of this study was to evaluate the effect of national health insurance coverage of periodontal scaling using the National Health Insurance Service-National Sample Cohort for 2009-2013. After the enforcement of periodontal scaling covered by national health insurance, the number of patients diagnosed with periodontal disease and received treatment, has increased from 35,234 to 99,576 people in the last 4 years. Further, the number of patients who received the treatment of periodontal disease more than once, have also increased to around 69% in 2013 when compared to 2012. Moreover, the number of patients receiving periodontal scaling has been steadily increasing every year. Among the patients who visited hospital for periodontal disease, there has been an increase of 280%. As a result, continuous public relations and long-term research on the effect of periodontal scaling as a prophylactic treatment is necessary.

• The Journal of Korean Medicine
• /
• v.40 no.3
• /
• pp.1-20
• /
• 2019

Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.