• Korean Journal of Clinical Laboratory Science
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• v.52 no.1
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• pp.28-35
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• 2020

This study aimed to investigate the differences in the upper and lower limits of the 95% distribution of fasting blood glucose (FBG) by age groups. We also analyzed the changes in the mean values and dispersion of the data using the Korean Blood Glucose Reference Standard raw data published by the National Health Insurance Service (NHIS). Furthermore, the trends among 16 administrative districts were analyzed and any gender differences were determined. We also assessed whether the study results correlated with the relative standard uncertainty, as published by the NHIS. On the dispersion analysis using the differences between the upper and lower limits of the 95% distribution of FBG by age group, there were significant differences across gender and administrative districts (P<0.05). The gender differences in FBG measurements, as published by the NHIS, were significant across different administrative districts and age groups (P<0.001). This confirmed the need to recalculate the blood glucose reference standards for men and women. No significant correlation was observed between the relative standard uncertainty, as published by NHIS, and the dispersion and number of measurements analyzed in this study. However, it showed a high correlation with the measured mean value (R²=0.95). Therefore, further research on the reference standard and uncertainty is needed.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.3
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• pp.311-318
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• 2017

Several types of attachments have been used for implant supported and/or retained overdentures. Locator is one of the stud type attachments and it has been generally used. However, the colored matrix is resilient and vulnerable to wear, so frequent post-insertion maintenance is needed. To solve this problem, it is necessary to introduce innovative attachment system. Overdentures using Air Gap attachment (AGA) has improved masticatory function and facial esthetics. AGA is made of metal, so it could be more resistant to wear or friction than the other resilient attachments. Nevertheless, AGA plays a role in stress breakers because it allows movement during denture movement with predetermined gap. In addition, both pre-existing implants and natural teeth were successfully used for connection of AGA. AGA could replace other unsplinted type of attachments. Overdentures using AGA could provide satisfactory result in terms of function, esthetics and retention. However, long term follow up is needed.

• The Korean Journal of Applied Statistics
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• v.28 no.6
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• pp.1063-1073
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• 2015

In the long-term care insurance (LTCI) system, National Health Insurance Service (NHIS) provide counseling services for beneficiaries and their family caregivers, which help them use LTC services appropriately. The purpose of this study was to develop a Target Selection Model for the Counseling Services based on needs of beneficiaries and their family caregivers. To develope models, we used data set of total 2,000 beneficiaries and family caregivers who have used the long-term care services in their home in March 2013 and completed questionnaires. The Target Selection Model was established through various data-mining models such as logistic regression, gradient boosting, Lasso, decision-tree model, Ensemble, and Neural network. Lasso model was selected as the final model because of the stability, high performance and availability. Our results might improve the satisfaction and the efficiency for the NHIS counseling services.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.4
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• pp.423-430
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• 2016

The implant prosthesis can be divided into the screw retained prosthesis and cement retained prosthesis. Each type has advantages as well as disadvantages which is unfavorable to maintain the implants. To overcome these drawbacks, T-screw system was developed. T-screw system which utilizes a lingual direction of the screw to retain the implant prosthesis, has advantages of retrievability of the prosthesis, passive fit, and possibility to form esthetic and functional occlusal surface. The prior prosthesis which utilized horizontal screws had difficulty in fabrication especially in the case of multiple units, and also limited use with all-ceramic prosthesis. In this case, fabricating the implant prosthesis by using the T-screw system showed superior results in easy maintenance, esthetics, and also functions. In addition, we are to report the method of using the T-screw system in implant prosthesis, such as multiple units of implant prosthesis and all ceramic prosthesis.

• 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.

• Journal of Preventive Medicine and Public Health
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• v.56 no.4
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• pp.312-318
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• 2023

Objectives: We reviewed the operational definitions of colorectal cancer (CRC) from studies using the Korean National Health Insurance Service (NHIS) and compared CRC incidence derived from the commonly used operational definitions in the literature with the statistics reported by the Korea Central Cancer Registry (KCCR). Methods: We searched the MEDLINE and KoreaMed databases to identify studies containing operational definitions of CRC, published until January 15, 2021. All pertinent data concerning the study period, the utilized database, and the outcome variable were extracted. Within the NHIS-National Sample Cohort, age-standardized incidence rates (ASRs) of CRC were calculated for each operational definition found in the literature between 2005 and 2019. These rates were then compared with ASRs from the KCCR. Results: From the 62 eligible studies, 9 operational definitions for CRC were identified. The most commonly used operational definition was "C18-C20" (n=20), followed by "C18-C20 with claim code for treatment" (n=3) and "C18-C20 with V193 (code for registered cancer patients' payment deduction)" (n=3). The ASRs reported using these operational definitions were lower than the ASRs from KCCR, except for "C18-C20 used as the main diagnosis." The smallest difference in ASRs was observed for "C18-C20," followed by "C18-C20 with V193," and "C18-C20 with claim code for hospitalization or code for treatment." Conclusions: In defining CRC patients utilizing the NHIS database, the ASR derived through the operational definition of "C18-C20 as the main diagnosis" was comparable to the ASR from the KCCR. Depending on the study hypothesis, operational definitions using treatment codes may be utilized.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.31 no.2
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• pp.80-87
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• 2020

Objectives: The prevalence of psychiatric disorders among young adults is different from that among younger or older age groups because of biological and environmental changes. The purpose of this study was to analyze the diagnostic distribution of psychiatric disorders in 19-30-year-old Koreans based on their age and gender using data from the Korean National Health Insurance Service (NHIS). Methods: From the 2011 medical claims sample data of NHIS of 1,375,842 people, we extracted the data of 221,038 people aged 19-30 years, including 106,232 (48.1%) men and 114,806 (51.9%) women. We evaluated the overall changes in the diagnostic distribution of psychiatric disorders over a 3-year period. Results: The diagnostic frequency in women was 13,627 (59.0%), which was significantly higher than that in men. "Other anxiety disorders" was the most common psychiatric disorder in both genders, followed by depressive episodes, somatoform disorders, "other neurotic disorders," and nonorganic sleep disorders. In men, attention-deficit/hyperactivity disorder or intellectual disabilities were not among the top 10 disorders. In women, no significant changes in major psychiatric disorders were seen over the 3-year period. Conclusion: These results reveal the trends of diagnostic distribution of mental illnesses depending on the development, particularly in young adulthood. It is necessary to identify whether such trends are due to biological or environmental factors, aging processes, or complex influences.

• Journal of health informatics and statistics
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• v.43 no.4
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• pp.318-328
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• 2018

Objectives: People are living longer, but often with diseases or chronic conditions. As a consequence, interest in resolving insurance blind spots is growing. This study provides substandard risk-relevant statistics to help substandard risks who are likely to fall in insurance blind spots obtain insurance coverage, such as the reimbursement of medical costs, as well as to stimulate insurance product development. Methods: This study uses National Health Insurance Service (NHIS) cohort data to determine the relevant statistics. The incidence rates of severe diseases are derived and compared against standard risks to establish a set of relative risk factors. These incidence rates of standard and substandard risks are then compared. Results: Currently, an individual's cancer history is used in the underwriting process for simplified issue insurance. However, underwriting focusing on hospitalization and procedures related to serious illnesses could lower premiums for substandard risks. Moreover, the statistical results could be used to expand the coverage of health insurance products. Conclusions: This study's relative risk factors can be used to derive simplified issue premium rates for substandard risks. They can also be used to implement discount and loading schemes for medical reimbursement insurance and help insurance companies implement proactive risk management.

• Journal of Korean Biological Nursing Science
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• v.20 no.4
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• pp.261-269
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• 2018

Purpose: The purpose of this study was to investigate the prevalence of metabolic syndrome and diagnostic components in adult women. Methods: The subjects of this study were 12,016 women that were aged twenty years or older and underwent an annual health check-up for National Health Insurance Service (NHIS) from 2009 to 2013. Data including blood pressure, waist circumstance, fasting glucose, triglyceride, and high density lipoprotein cholesterol (HDL-C) were received from the NHIS. This data was analyzed through the use of descriptive statistics, ${\chi}^2$-test, and multiple logistic regression. Results: The prevalence of metabolic syndrome and diagnostic components increased with age. In the five diagnostic components of the metabolic syndrome, the prevalence of low HDL-C was highest in 20s to 40s. The prevalence of high blood pressure was highest in the people aged fifty or older. The risk of metabolic syndrome in 2013 was higher in women with abnormal diagnostic component of metabolic syndrome in 2009 and highest in women with abnormal waist circumstance in 2009. Conclusion: There was a need to investigate the prevalence of metabolic syndrome components according to age. Education on metabolic syndrome was required for those that had one or two abnormal diagnostic components. The risk of abdominal obesity related to metabolic syndrome needs to be emphasized. Moreover the education for management of abdominal obesity also needs to be emphasised.

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