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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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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          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.

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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.

          Soonman Kwon (2009)
          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.
          Article 0 comments Cited 210 times – based on 0 reviews     Review now
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            Healthcare System Types: A Conceptual Framework for Comparison

            Claus Wendt, Lorraine Frisina, Heinz Rothgang (2009)
            Article 0 comments Cited 63 times – based on 0 reviews     Review now
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              Korea's National Health Insurance--lessons from the past three decades.

              Hii-Sun Jeong (2010)
              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
                Journal ID (nlm-ta): Diabetes Metab J
                Journal ID (iso-abbrev): Diabetes Metab J
                Journal ID (publisher-id): DMJ
                Title: Diabetes & Metabolism Journal
                Publisher: Korean Diabetes Association
                ISSN (Print): 2233-6079
                ISSN (Electronic): 2233-6087
                Publication date (Print): October 2014
                Publication date (Electronic): 17 October 2014
                Volume: 38
                Issue: 5
                Pages: 395-403
                Affiliations
                [1 ]Division of Endocrinology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
                [2 ]Department of Medicine, Yonsei University Graduate School of Medicine, Seoul, Korea.
                [3 ]Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 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 ]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.
                Author notes
                Corresponding author: Byung-Wan Lee. Division of Endocrinology and Metabolism, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. bwanlee@ 123456yuhs.ac
                Corresponding author: Kyung Soo Ko. Division of Endocrinology and Metabolism, Department of Internal Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-707, Korea. kskomd@ 123456paik.ac.kr

                *Sun Ok Song and Chang Hee Jung contributed equally to this study as first authors.

                Article
                DOI: 10.4093/dmj.2014.38.5.395
                PMC ID: 4209354
                PubMed ID: 25349827
                SO-VID: fa4c7f0a-03ed-4129-94d8-19fbf14d87f1
                Copyright © Copyright © 2014 Korean Diabetes Association
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 13 July 2014
                Date accepted : 16 August 2014
                Categories
                Subject: Original Article
                Subject: Others

                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: national health insurance,national health insurance service,population-based data,korea
                Data availability:
                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: national health insurance, national health insurance service, population-based data, korea

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