• Title/Summary/Keyword: Health insurance big data

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Current status of and trends in post-mastectomy breast reconstruction in Korea

  • Song, Woo Jin;Kang, Sang Gue;Kim, Eun Key;Song, Seung Yong;Lee, Joon Seok;Lee, Jung Ho;Jin, Ung Sik
    • Archives of Plastic Surgery
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    • v.47 no.2
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    • pp.118-125
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    • 2020
  • Since April 2015, post-mastectomy breast reconstruction has been covered by the Korean National Health Insurance Service (NHIS). The frequency of these procedures has increased very rapidly. We analyzed data obtained from the Big Data Hub of the Health Insurance Review and Assessment Service (HIRA) and determined annual changes in the number of breast reconstruction procedures and related trends in Korea. We evaluated the numbers of mastectomy and breast reconstruction procedures performed between April 2015 and December 2018 using data from the HIRA Big Data Hub. We determined annual changes in the numbers of total, autologous, and implant breast reconstructions after NHIS coverage commenced. Data were analyzed using Microsoft Excel. The post-mastectomy breast reconstruction rate increased from 19.4% in 2015 to 53.4% in 2018. In 2015, implant reconstruction was performed in 1,366 cases and autologous reconstruction in 905 (60.1% and 39.8%, respectively); these figures increased to 3,703 and 1,570 (70.2% and 29.7%, respectively) in 2018. Free tissue transfer and deep inferior epigastric perforator flap creation were the most common autologous reconstruction procedures. For implant-based reconstructions, the rates of directto-implant and tissue-expander breast reconstructions (first stage) were similar in 2018. This study summarizes breast reconstruction trends in Korea after NHIS coverage was expanded in 2015. A significant increase over time in the post-mastectomy breast reconstruction rate was evident, with a trend toward implant-based reconstruction. Analysis of data from the HIRA Big Data Hub can be used to predict breast reconstruction trends and convey precise information to patients and physicians.

Roles of Health Technology Assessment for Better Health and Universal Health Coverage in Korea (우리나라 보건의료 발전을 위한 의료기술평가의 역할)

  • Lee, Young Sung
    • Health Policy and Management
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    • v.28 no.3
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    • pp.263-271
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    • 2018
  • Health technology assessment (HTA) is defined as multidisciplinary policy analysis to look into the medical, economic, social, and ethical implications of the development, distribution, and use of health technology. Following the recent changes in the social environment, there are increasing needs to improve Korea's healthcare environment by, inter alia, assessing health technologies in an organized, timely manner in accordance with the government's strategies to ensure that citizens' medical expenses are kept at a stable level. Dedicated to HTA and research, the National Evidence-based Healthcare Collaborating Agency (NECA) analyzes and provides grounds on the clinical safety, efficacy, and economic feasibility of health technologies. HTA offers the most suitable grounds for decision making not only by healthcare professionals but also by policy makers and citizens as seen in a case in 2009 where research revealed that glucosamine lacked preventive and treatment effects for osteoarthritis and glucosamine was subsequently excluded from the National Health Insurance's benefit list to stop the insurance scheme from suffering financial losses and citizens from paying unnecessary medical expenses. For the development of HTA in Korea, the NECA will continue exerting itself to accomplish its mission of providing policy support by health technology reassessment, promoting the establishment and use of big data and HTA platforms for public interest, and developing a new value-based HTA system.

Analyzing Cancer Incidence among Korean Workers and Public Officials Using Big Data from National Health Insurance Service (건강보험 빅데이터를 통한 전체 근로자 및 공무원 근로자의 암 발생률 분석)

  • Baek, Seong-Uk;Lee, Wanhyung;Yoo, Ki-Bong;Lee, Woo-Ri;Lee, Won-Tae;Kim, Min-Seok;Lim, Sung-Shil;Kim, Jihyun;Choi, Jun-Hyeok;Lee, Kyung-Eun;Yoon, Jin-Ha
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.32 no.3
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    • pp.268-278
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    • 2022
  • Objectives: This study aimed to establish a control group based on the big data from National Health Insurance Service. We also presented presented the number of incidences for each cancer, and analyzed the cancer incidence rate among Korean workers. Methods: The cohort definition was separated by 'baseline cohort', 'dynamic cohort', and 'fixed- industry cohort' according to the definition. Cancer incidence was calculated based on the Korean Standard Classification of Disease code. Incidence rate was calculated among the group of all workers and public officials. Based on the study subjects and each cohort definition, the number of observations, incidences, and the incidence rate according to sex and age groups was calculated. The incidence rate was estimated based on the incidence per 100,000 person-year, and 95% confidence intervals calculated according to the Poisson distribution. Results: The result shows that the number of cancer cases in the all-worker group decreases after the age of 55, but the incidence rate tends to increase, which is attributed to the retirement of workers over 55 years old. Despite the specific characteristics of the workers, the trend and figures of cancer incidence revealed in this study are similar to those reported in previous studies of the overall South Korean population. When comparing the incidence rates of all workers and the control group of public officials, the incidence rate of public officials is generally observed to be higher in the age group under the age of 55. On the other hand, for workers aged 60 or older, the incidence rates were 1,065.4 per 100,000 person-year for all workers and 1,023.7 per 100,000 person-year for civil servants. Conclusions: This study analyzed through health insurance data including all workers in Korea, and analyzed the incidence of cancer of workers by sex and age. In addition, further in-depth researches are needed to determine the incidence of cancer by industry.

Prediction model for dental implants utilization in the elderly after the national health insurance coverage of dental implants: focusing on socioeconomic factors (치과 임플란트 국민건강보험 급여화 이후 노인의 치과 임플란트 이용에 대한 예측 모형: 사회경제적 요인 중심으로)

  • Sang-Hee Lee;Kyu-Seok Kim;Hye-Young Mun;Jung-Yun Kang
    • Journal of Korean society of Dental Hygiene
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    • v.24 no.1
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    • pp.9-16
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    • 2024
  • Objectives: The demand for dental care is expected to increase as the population ages. This study aimed to predict the utilization of dental implant care following the expansion of national health insurance benefits for dental implants. Methods: Multiple linear regression analysis was performed on HIRA big data open portal data and DNN-based artificial intelligence models to forecast the utilization of dental care in relation to the national health insurance coverage for dental implants. Results: National health insurance coverage of dental implants was found to be associated with the number of patients using dental implant services and demonstrated a statistical significance. The dental implant services utilization increased with the increased dental implant health insurance benefits for the elderly population, increased mean by region, increased number of dental institutions by region, and increased health insurance coverage rate for dental implants. However, the dental implant services utilization decreased with the increased number of older people living alone and increased size of dental institutions. Conclusions: With the expansion of the national health insurance coverage for dental implants, it is predicted that the utilization of dental implant medical services will increase in the future.

Canonical correlation between body information and lipid-profile: A study on the National Health Insurance Big Data in Korea

  • Jo, Han-Gue;Kang, Young-Heung
    • Journal of the Korea Society of Computer and Information
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    • v.26 no.1
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    • pp.201-208
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    • 2021
  • This study aims to provide the relevant basis upon which prediction of dyslipidemia should be made based on body information. Using the National Health Insurance big data (3,312,971 people) canonical correlation analysis was performed between body information and lipid-profile. Body information included age, height, weight and waist circumference, while the lipid-profile included total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol. As a result, when the waist circumference and the weight are large, triglycerides increase and HDL cholesterol level decreases. In terms of age, weight, waist circumference, and HDL cholesterol, the canonical variates (the degree of influence) were significantly different according to sex. In particular, the canonical variate was dramatically changed around the forties and fifties in women in terms of weight, waist circumference, and HDL cholesterol. The canonical correlation results of the health care big data presented in this study will help construct a predictive model that can evaluate an individual's health status based on body information that can be easily measured in a non-invasive manner.

Impact of Korea's reform for separation between prescribing and dispensing of drugs on profits of doctor's clinics and pharmacies (의약분업이 의원 및 약국의 영업이익에 미친 영향)

  • 정형선
    • Health Policy and Management
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    • v.14 no.1
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    • pp.44-64
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    • 2004
  • As of 1 July 2000 a big reform was introduced into the Korean health care system: the separation between prescribing and dispensing of drugs (SPD reform). There was, however, a big financial stake associated with pharmaceuticals, particularly before the reform, because physicians as well as pharmacists were allowed to purchase drugs at much lower costs than the insurance reimbursement. In this respect, this study focuses on the change in income and profit of both doctor's clinics and pharmacies after the reform. Data from National Health and Nutritional Survey by the ministry of health and welfare were used to estimate the income or expenditure that are financed by out-of-pocket payment of the patients, while national health insurance data etc. were used for the estimation of the income or expenditure that is financed by insurers. Average annual income per doctor's clinic increased from 299 million won to 338 million won for the three years between 1998 and 2001, whereas average annual income per pharmacy increased enormously from 60 million won to 305 million won for the same period. Average annual 'profit' increase per each doctor's clinic caused by the reform itself was estimated to range from 50 to 83 million won, while that per each pharmacy, from 23 to 87 million won. In sum, while both doctor's clinics and pharmacies are beneficiaries of the SPD reform, its positive impact is particularly prominent on the latter.

Big Data Education Contents for Healthcare Officials (보건의료담당 공무원을 위한 빅데이터 교육콘텐츠)

  • Kim, Yang-Woo
    • The Journal of the Korea Contents Association
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    • v.20 no.5
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    • pp.236-242
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    • 2020
  • Big data technology has been rising as a leading technology in the healthcare paradigm. As a world-class big data nation including National Health Insurance data, Korea has been focused on health policies and sustainability through database forecasting and policy establishment. So the need for education of big data by public officials in healthcare sector is increasing. However, there has not yet been National Competency Standards(NCS) or education modules, in this study, healthcare big data education module and content have been developed for the public servants with confidence.

Correlation between Internet Search Query Data and the Health Insurance Review & Assessment Service Data for Seasonality of Plantar Fasciitis (족저 근막염의 계절성에 대한 인터넷 검색어 데이터와 건강보험심사평가원 자료의 연관성)

  • Hwang, Seok Min;Lee, Geum Ho;Oh, Seung Yeol
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.3
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    • pp.126-132
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    • 2021
  • Purpose: This study examined whether there are seasonal variations in the number of plantar fasciitis cases from the database of the Korean Health Insurance Review & Assessment Service and an internet search of the volume data related to plantar fasciitis and whether there are correlations between variations. Materials and Methods: The number of plantar fasciitis cases per month was acquired from the Korean Health Insurance Review & Assessment Service from January 2016 to December 2019. The monthly internet relative search volumes for the keywords "plantar fasciitis" and "heel pain" were collected during the same period from DataLab, an internet search query trend service provided by the Korean portal website, Naver. Cosinor analysis was performed to confirm the seasonality of the monthly number of cases and relative search volumes, and Pearson and Spearman correlation analysis was conducted to assess the correlation between them. Results: The number of cases with plantar fasciitis and the relative search volume for the keywords "plantar fasciitis" and "heel pain" all showed significant seasonality (p<0.001), with the highest in the summer and the lowest in the winter. The number of cases with plantar fasciitis was correlated significantly with the relative search volumes of the keywords "plantar fasciitis" (r=0.632; p<0.001) and "heel pain" (r=0.791; p<0.001), respectively. Conclusion: Both the number of cases with plantar fasciitis and the internet search data for related keywords showed seasonality, which was the highest in summer. The number of cases showed a significant correlation with the internet search data for the seasonality of plantar fasciitis. Internet big data could be a complementary resource for researching and monitoring plantar fasciitis.

Recent trends in intensity-modulated radiation therapy use in Korea

  • Huh, Seung Jae;Park, Won;Choi, Do Ho
    • Radiation Oncology Journal
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    • v.37 no.4
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    • pp.249-253
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    • 2019
  • Purpose: We aimed to analyze the trend in intensity-modulated radiation therapy (IMRT) use in Korea from 2011 to 2018. Materials and Methods: We collected data from the Health and Insurance Review and Assessment Service (HIRA) big data based on the National Health Insurance Service claims and reimbursements records using primary treatment planning codes (HD 041) for IMRT from 2011 to 2018. We analyzed the changing patterns in clinical application to specific tumor sites and regional differences in IMRT utilization. Results: The use of IMRT has exhibited an 18-fold steep rise from 1,921 patients in 2011 to 34,759 in 2018. With regard to IMRT in 2018, 70% of patients (24,248/34,759) were treated in metropolitan areas (Seoul, Incheon, and Gyeonggi Province). IMRT was most commonly used to treat breast, lung, and prostate cancers in 2018. Among these, the use of IMRT for breast cancer shows the most remarkable increase from 2016 when the National Health Insurance began to cover IMRT for all solid tumors. Conclusion: The use of IMRT is steadily increasing to treat cancer and is concentrated in metropolitan areas.

Analysis of changes and trends in the use of sedatives in dental sedation using data from the National Health Insurance in Korea

  • Kim, Hyuk;Ryoo, Seung-Hwa;Karm, Myong-Hwan;Seo, Kwang-Suk;Kim, Hyun Jeong
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.1
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    • pp.49-60
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    • 2022
  • Background: Although dental sedation helps control anxiety and pain, side effects and serious complications related to sedation are gradually increasing. Due to the introduction of new drugs and sedation methods, insurance rates, legal regulations, drugs, and methods used for dental sedation are inevitably changed. In the Republic of Korea, National Health Insurance is applied to all citizens, and this study investigated changes in the use of sedatives using this big data. Methods: This study used customized health information data provided by the Healthcare Insurance Review & Assessment Service of Korea. Among patients with a record of use of at least one of eight types of sedatives for dental sedation between January 2007 and September 2019 were selected; the data of their overall insurance claims for dental treatment were then analyzed. Results: The number of patients who received dental sedation was 786,003, and the number of dental sedation cases was 1,649,688. Inhalational sedation using nitrous oxide (N2O) accounted for 86.8% of all sedatives that could be claimed for drugs and treatment. In particular, it was confirmed that the number of requests for sedation using N2O sharply increased each year. Midazolam showed an increasing trend, and in the case of chloral hydrate, it gradually decreased. Conclusion: According to our analysis, the use of N2O and midazolam gradually increased, while the use of chloral hydrate gradually decreased.