• 대한소아치과학회지
• /
• 제51권2호
• /
• pp.185-196
• /
• 2024

Temporomandibular joint disorders (TMDs) can occur at any age, including childhood and adolescence, and pain-related TMDs can affect growth and quality of life. In the present study, recent trends in the diagnosis and treatment of TMDs in children and adolescents were analyzed over a 10-year period. Using 10 years of data from the Health Insurance Review and Assessment Service (HIRA) and Jeonbuk National University (JBNU) Dental Hospital, patients between 0 and 19 years of age diagnosed with K07.6 (temporomandibular joint disorders) were analyzed by 5-year bins. Both datasets indicated a higher prevalence in females (1.2-fold in HIRA, 1.5-fold in JBNU) and in ages 15 to 19 years (72.1% in HIRA, 74.7% in JBNU). HIRA reported a 42.3% increase in prevalence per 100,000 people, from 651.4 in 2011 to 927.0 in 2020. JBNU reported K07.66 (masticatory muscle disorders) as the most common diagnosis in subjects under 10 years of age and K07.60 (internal derangement of temporomandibular joint) in those over 10 years of age. In addition, both were treated mainly by a combination of physical therapy and medication, and the treatment rate increased in accordance with age. Because TMDs can affect various structures in the orofacial region and cause pain that tends to differ with age, an early and specific diagnosis appropriate for age is important for treatment. Therefore, pediatric dentists need to promptly recognize TMDs in children and adolescents and consult with specialists as the prevalence increases.

• 한국임상약학회지
• /
• 제29권3호
• /
• pp.202-208
• /
• 2019

Objective: Suicide has recently become an important social problem. Thus, we analyzed prescription drugs that cause suicidal ideation. Methods: Of 156 drugs on the the Minister of Food and Drug Safty (MFDS) EZ-Drug site that had "suicide" listed as a side effect, 78 had "suicide" listed as a warning or contraindication; those 78 drugs were analyzed using data from the 2016 Health Insurance and Review and Assessment Services National Patient Sample (HIRA-NPS). Results: 51 "suicide risk" drugs was identified. Of all patients, 5.2% had received such drugs. The prescription rate was 0.8% of all prescriptions, accounting for 1.6% of all prescription days. From logistic regression analysis, the prescription rate for the drugs was approximately 1.1 times higher for women than for men. With regard to age, the prescription rate for patients 66 years and older was 15.5 times higher than those for patients 25-years and lower. With regard to medical departments, the prescription rates in psychiatry and dermatology departments were 8.1 times higher and 0.6 times lower than those in internal medicine departments, respectively. With regard to region, the prescription rates in Daegu and Jeju were 1.3 times higher and 0.79 times lower than those in Seoul, respectively. Conclusion: Drug-induced suicidal behavior is possible, and therefore efforts are needed to prevent it.

• 보건행정학회지
• /
• 제24권2호
• /
• pp.120-127
• /
• 2014

Background: Since December 2010, online computerized prospective drug utilization review (pDUR) has been implemented in Korea. pDUR involves the review of each prescription before the medication is dispensed to the individual patient. The pDUR is performed electronically by Health Insurance Review & Assessment Service (HIRA), which is a Korean governmental agency, and then HIRA provides medical institutions and pharmacies with information that can be helpful to them in preventing potential drug problems such as drug/drug interactions or ingredient duplication. The aim of this study was to assess the impact of the Korean pDUR implementation on the proportion of drug-drug interactions (DDIs) using claims data from HIRA. Methods: A before-after comparison of the prevalence of DDIs between prescription was conducted, using HIRA administrative claims data of medical institution from January 2010 to December 2011. The analysis unit was the prescription issued and pairs before and after. The main outcome measures were the proportion of DDIs within- (control group) or between- physician encounters. To examine the difference, a paired t-test was applied. Results: We found that DDIs proportion between prescription decreased significantly (t=3.04, p=0.0026) after the implementation of pDUR, whereas there is no significant reduction within prescription (t=1.15, p=0.2518). With respect to the prevalence of DDIs between drug groups, the most dramatic reduction was occurred between 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors and anti-fungal agents. Conclusion: It seems effective that giving a direct feedback to prescribers by a prospective DUR. Further research is needed to assess the impact of DUR to final outcomes such as hospitalization.

• 한국의료질향상학회지
• /
• 제26권2호
• /
• pp.95-103
• /
• 2020

Purpose: This study was to examine whether a health care model that provides comprehensive medical services based on population groups to members of the medical cooperative is applicable as a policy alternative in terms of medical use and cost. Methods: Data were derived from National Health Insurance claim data in 2019. We compared the medical volume and expenses of patients who visited social cooperative-type medical clinics with other patients, control group who visited other clinics in a local area. Results: The average number of visit days was 25.3 days in social cooperative-type medical clinics, more than 24.2 days in the control group (p=.004). However, the average medical cost per visit was KRW 46 thousand in social cooperative-type medical clinics, which was significantly lower than KRW 51 thousand in the control group (p<.001), and the total medical cost was also KRW 16.1 billion in social cooperative-type medical clinics and KRW 16.9 billion in the control group. Conclusion: We identified that a population-based health care model might change patients' behaviors to health care services and decrease total medical cost. Further population based experiment is needed to develop alternative healthcare model.

• Archives of Plastic Surgery
• /
• 제47권2호
• /
• pp.118-125
• /
• 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.

• 보건행정학회지
• /
• 제23권2호
• /
• pp.152-161
• /
• 2013

Korea has a single National Health Insurance program and all citizens are covered under this program, accounting 97% of the population, approximately 50 million people. Claims submitted by Health care providers are reviewed by Health Insurance Review and Assessment (HIRA) for the reimbursement. HIRA database contains not only individual beneficiary's information, but also healthcare service information such as diagnosis, procedures, prescriptions and tests for them. HRA database has gained attention as importance source for research due to its rich healthcare information and the demand of HIRA database has increased. Due to its tremendous size, however, researchers have had problems in accessing the database to conduct research. To meet this demand, we conducted a study to develop the inpatient sample data from HIRA database for research. This study has two purposes: 1) to determine a needed sample size; 2) to test reliability and validity of the sample data. We determined an adequate sample size to ensure representativeness and generality with additional consideration for convenience of calculation. The minimum sample size was 729,904 for the generality, and 488,861 for representativeness. After considering the convenience of calculation, our final sample size was 13% of the population, which was about 7.7 million beneficiaries. Age (5 years interval) and gender were used as stratification variables for sampling. In order to examine whether this sample data appropriately reflect population, we tested the reliability and validity of the sample data. From the sample data, we computed average expenditure of total claims per inpatient for 2011, frequency of top 30 disease, estimation of the number of stroke patients from the sample data, and then compared them to those from the population. Results confirmed reliability and validity of the sample data.

• Archives of Plastic Surgery
• /
• 제45권5호
• /
• pp.441-448
• /
• 2018

Background Previously, surveys have been used to investigate breast reconstruction statistics. Since 2015, breast reconstruction surgery after mastectomy has been covered by the National Health Insurance Service in Korea, and data from breast reconstruction patients are now available from the Health Insurance Review and Assessment Service (HIRA). We investigated statistics in breast reconstruction in Korea through statistics provided by the HIRA Big Data Hub. Methods We investigated the number of cases in mastectomy and breast reconstruction methods from April 1, 2015 to December 31, 2016. Data were furnished by the HIRA Big Data Hub and accessed remotely online. Results were tabulated using SAS Enterprise version 6.1. Results The 31,155 mastectomy cases included 7,088 breast reconstruction cases. Implant-based methods were used in 4,702 cases, and autologous methods in 2,386. The implant-based reconstructions included 1,896 direct-to-implant and 2,806 tissue-expander (2-stage) breast reconstructions. The 2-stage tissue-expander reconstructions included 1,624 expander insertions (first stage) and 1,182 expander-to-permanent-implant exchanges (second stage). Of the autologous breast reconstructions, 705 involved latissimus dorsi muscle flaps, 498 involved pedicled transverse rectus abdominis myocutaneous (TRAM) flaps, and 1,183 involved free-tissue transfer TRAM flaps, including deep inferior epigastric perforator free-tissue transfer flaps. There were 1,707 nipple-areolar complex reconstructions, including 1,565 nipple reconstructions and 142 areola reconstructions. The 1-year mean number of breast reconstructions was 4,050. Conclusions This was the first attempt to evaluate the total number of breast reconstruction procedures using accurate, comprehensive data, and our findings may prove valuable as a foundation for future statistical studies of breast reconstruction procedures in Korea.

• Clinical and Experimental Pediatrics
• /
• 제64권4호
• /
• pp.141-148
• /
• 2021

There are very scant data on the epidemiology of primary immunodeficiency diseases (PIDs) in Korea. Here we attempted to estimate the PID epidemiology and disease burden in Korea. A systematic review was performed of studies retrieved from the PubMed, KoreaMed, and Google Scholar databases. Studies on PIDs published in Korean or English between January 2001 and November 2018 were analyzed. The number of PID patients and the healthcare costs were estimated from Health Insurance Review and Assessment Service (HIRA) Korea data for 2017. A total of 398 PID patients were identified from 101 reports. Immunodeficiencies affecting cellular and humoral immunity were reported in 11 patients, combined immunodeficiency with associated or syndromic features in 40, predominantly antibody deficiencies in 144, diseases of immune dysregulation in 58, congenital defects of phagocytes in 104, defects in the intrinsic and innate immunity in 1, auto-inflammatory disorders in 4, complement deficiencies in 36, and phenocopies of PID in none. From the HIRA reimbursement data, a total of 1,162 outpatients and 306 inpatients were treated for 8,166 and 6,149 days, respectively. In addition, reimbursement was requested for 8,200 outpatient and 1,090 inpatient cases and $1,924,000 and $4,715,000 were reimbursed in 2017, respectively. This study systematically reviewed published studies on PID and analyzed the national open data system of the HIRA to estimate the disease burden of PID, for the first time in Korea.

• Tuberculosis and Respiratory Diseases
• /
• 제80권3호
• /
• pp.221-225
• /
• 2017

Since 2015, the Health Insurance Review and Assessment Service (HIRA) has performed annual qualitative assessments of asthma management provided by all medical institutions that care for asthma patients in Korea. According to the third report of qualitative assessment of asthma management in 2017, the assessment appears to have contributed to improving the quality of asthma care provided by medical institutions, especially primary clinics. However, there is still a gap between the ideal goals of asthma management and actual health care policies/regulations in real clinical settings, which leads to the state of standstill with respect to the quality of asthma management despite considerable efforts such as the qualitative assessment of asthma management by national agencies such as the HIRA. At this point, a harmonized approach is needed to raise the level of asthma management among several components including medical policies, efforts of academic associations such as education and distribution of the guideline for management, and reliable financial support by the government.

• Journal of Preventive Medicine and Public Health
• /
• 제45권3호
• /
• pp.148-155
• /
• 2012

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poorquality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.