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      Background and data configuration process of a nationwide population-based study using the korean national health insurance system.

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          Abstract

          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.

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          Most cited references21

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          Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage.

          South Korea introduced mandatory social health insurance for industrial workers in large corporations in 1977, and extended it incrementally to the self-employed until it covered the entire population in 1989. Thirty years of national health insurance in Korea can provide valuable lessons on key issues in health care financing policy which now face many low- and middle-income countries aiming to achieve universal health care coverage, such as: tax versus social health insurance; population and benefit coverage; single scheme versus multiple schemes; purchasing and provider payment method; and the role of politics and political commitment. National health insurance in Korea has been successful in mobilizing resources for health care, rapidly extending population coverage, effectively pooling public and private resources to purchase health care for the entire population, and containing health care expenditure. However, there are also challenges posed by the dominance of private providers paid by fee-for-service, the rapid aging of the population, and the public-private mix related to private health insurance.
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            Healthcare System Types: A Conceptual Framework for Comparison

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              Korea's National Health Insurance--lessons from the past three decades.

              This study presents data on health care spending in South Korea in the three decades since 1977, the year its national health insurance--enacted in 1963--was enforced. National health insurance in South Korea is currently a single-payer program (that is both publicly and privately financed) that pays for privately provided health care. Universal coverage was achieved in 1989. As a result, the household share of total national health spending fell from 87.8 percent to 54.6 percent during the three decades, and the out-of-pocket share dropped from 87.2 percent to 38.0 percent. Although covered services have gradually expanded, benefits remain relatively low, and public funding is limited, leaving beneficiaries with relatively high copayments. Coupled with the fact that the government manages the schedule of fees paid to providers, the health care share of gross domestic product was a low 6.3 percent in 2007. An analysis such as this may be of particular interest in middle- or low-income countries contemplating expansions of coverage or undertaking insurance reforms.
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                Author and article information

                Journal
                Diabetes Metab J
                Diabetes & metabolism journal
                Korean Diabetes Association
                2233-6079
                2233-6079
                Oct 2014
                : 38
                : 5
                Affiliations
                [1 ] Division of Endocrinology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea. ; Department of Medicine, Yonsei University Graduate School of Medicine, Seoul, Korea.
                [2 ] Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
                [3 ] Division of Endocrinology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
                [4 ] Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
                [5 ] Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
                [6 ] Department of Medicine, Yonsei University Graduate School of Medicine, Seoul, Korea. ; Division of Endocrinology and Metabolism, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
                [7 ] Department of Internal Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
                Article
                10.4093/dmj.2014.38.5.395
                4209354
                25349827
                fa4c7f0a-03ed-4129-94d8-19fbf14d87f1
                History

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

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