• YAKHAK HOEJI
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• v.57 no.3
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• pp.199-204
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• 2013

This study aimed to quantify antibiotic consumption and expenditures for acute upper respiratory tract infections (URIs) (J00-J06) in outpatients from 2009 to 2011. We used WHO ATC classification and DDDs in measuring antibiotic consumption. National Health Insurance and Medical Aid claims data were analyzed. Antibiotic consumption has decreased from 4.44 DDD/1,000inhabitants/day in 2009, to 4.43 in 2010 and 3.74 in 2011. The estimated expenditures were 8,206 won/1,000inhabitants/day in 2009, 8,379 in 2010, and 7,004 in 2011. Clinics accounted for 89.8% and 86.0% of antibiotic consumption and expenditures respectively for the acute URIs in 2011. We need to monitor antibiotic consumption consistently, and promote judicious antibiotic use.

• Journal of Oriental Neuropsychiatry
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• v.30 no.1
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• pp.31-38
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• 2019

Objectives: To identify the cost effectiveness of early dementia diagnosis using the 2014 Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS). Methods: The medical costs of dementia between Western medical care and Korean medical care were compared through the reimbursement and non-reimbursement item code for dementia examination. In addition, the medical expenses of patients with dementia and mild cognitive impairment were compared and analyzed with respect to Western and Korean medical care. Results: There were 87,434 claims, of which 16,101 patients were diagnosed with dementia and 38,680,789,560 won was found to be the medical expenses. 12,881 patients (80.0%) with dementia, 3,144 patients (19.5%) with mild cognitive impairment, and 76 patients (0.5%) progressing from mild cognitive impairment to dementia. The proportion of medical expenses was 97.6% for dementia patients, 2.3% for mild cognitive impairment, and 1% for patients progressing from mild cognitive impairment to dementia. 86,070 claims (98.4%) were from Western medical care, with16,824 patients (98.2%), and the medical expenses was 38,546,895,400 won (99.7%). 1,361 claims (1.6%) were from Korean medical care, with 303 patients (1.8%), and the medical expenses was 133,894,160 won (0.3%). Conclusions: This study compared and analyzed the medical costs of dementia patients and the diagnosis of both Korean and Western medical care. The results of this study are expected to be used as basic research data for investigating cost effectiveness of developing early diagnosis of dementia.

• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.730-737
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• 2020

Objective : Spinal degeneration is a progressive disease, worsening over time. Lumbar degenerative disease (LDD) is a major spinal disease in elderly patients. Surgical treatment is considered for medically intractable patients with LDD and reoperation after primary surgery is not uncommon. The surgical outcome is occasionally unpredictable because of comorbidities. In the present study, the relationship between comorbidities and the incidence of reoperation for LDD over time was determined. Methods : The claims data of the health insurance national database were used to identify a cohort of patients who underwent spinal surgery for LDD in 2009. The patients were followed up until 2016. Medical comorbidity was assessed according to the Charlson comorbidity index (CCI). Cox proportional hazard regression modeling was used to identify significant differences in sex, surgery, age, causative disease, and comorbidity. Results : The study cohort included 78241 patients; 10328 patients (13.2%) underwent reoperation during the observation period. The reoperation rate was statistically higher (p<0.01) in males, patients 55-74 years and 65-74 years of age, and patients with decompression or discectomy. Significant association was found between increasing reoperation rate and CCI score (p<0.01). Based on multivariate analysis of comorbidities, the significantly higher reoperation rates were observed in patients with peripheral vascular disease, pulmonary lung disease, peptic ulcer, diabetes, and diabetes complications (p<0.01). Conclusion : The study results indicate the reoperation rate for LDD is associated with patient comorbidities. The comorbidities identified in this study could be helpful in future LDD studies.

• Journal of Digital Convergence
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• v.11 no.9
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• pp.289-299
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• 2013

The aim of this study was to enhance the NHI claims data-based tuberculosis classification rule of KCDC(Korea centers for disease control & prevention) for an effective TB surveillance system. 8,118 cases, 10% samples of 81,199 TB cases from NHI claims data during 2009, were subject to the Medical Record Survey about whether they are real TB patients. The final study population was 7,132 cases whose medical records were surveyed. The decision tree model was evaluated as the most superior TB patients detection model. This model required the main independent variables of age, the number of anti-tuberculosis drugs, types of medical institution, tuberculosis tests, prescription days, types of TB. This model had sensitivity of 90.6%, PPV of 96.1%, and correct classification rate of 93.8%, which was better than KCDC's TB detection model with two or more NHI claims for TB and TB drugs(sensitivity of 82.6%, PPV of 95%, and correct classification rate of 80%).

• Journal of Preventive Medicine and Public Health
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• v.48 no.6
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• pp.301-309
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• 2015

Objectives: To investigate trends in the prevalence of allergic disease over a 9-year period. Methods: Using National Health Insurance Service (NHIS) data, the annual number of patients with allergic disease was obtained for each regional subdivisions (small cities, counties, and districts) from 2003 to 2011. Annual populations for each sub-region were obtained and used to calculate the standardized prevalence. To compare prevalence within the study period, data was standardized spatially and temporally. For standardization, demographic data was used to obtain the registered population and demographic structure for 2010, which was used to perform direct standardization of previous years. In addition, a geographic information system (GIS) was used to visualize prevalence for individual sub-regions, and allergic diseases were categorized into five groups according to prevalence. Results: The nationwide outpatient prevalence of allergic rhinitis increased approximately 2.3-fold, from 1.27% in 2003 to 2.97% in 2013, while inpatient prevalence also increased approximately 2.4-fold,. The outpatient prevalence of asthma increased 1.2-fold, and inpatient prevalence increased 1.3-fold. The outpatient prevalence of atopic dermatitis decreased approximately 12%, and inpatient prevalence decreased 5%. Conclusions: There was a large difference between prevalence estimated from actual treatment data and prevalence based on patients' self-reported data, particularly for allergic rhinitis. Prevalence must continually be calculated and trends should be analyzed for the efficient management of allergic diseases. To this end, prevalence studies using NHIS claims data may be useful.

• Journal of Pharmacopuncture
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• v.25 no.3
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• pp.276-289
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• 2022

Objectives: Child and adolescent sleep is an important factor for brain and physical development. Therefore, it is necessary to investigate the prevalence of sleep disorders and nonorganic sleep disorders in children and adolescents and determine the type of utilization of medical institutions. This study analyzed the prevalence and type of medical institutions in Korean children and adolescents with sleep disorders and nonorganic sleep disorders. Methods: This study used data recorded in the Health Insurance Review and Assessment-National Patient Sample (HIRA-NPS) database from 2010 to 2017. Details of medical institution type and patient's sex, age, and treatment type were extracted for patients younger than 20 years with sleep disorders and nonorganic sleep disorders. Results: Among 2,536,478 patients under age 20, we identified 3,772 patients with sleep disorders or nonorganic sleep disorders. From 2010 to 2017, the prevalence of sleep disorders in children and adolescents was 0.07% to 0.09%. The utilization rate of Korean medical institutions was 30.47%. The prevalence of nonorganic sleep disorders and the utilization rate of Korean medical institutions were 0.06% to 0.08% and 45.99%, respectively. Conclusion: The prevalence of sleep disorders and nonorganic sleep disorders in the under-20 population was 0.14% to 0.16%. More than 70% of patients with nonorganic sleep disorder who were younger than 9 years used Korean medical institutions.

• Health Policy and Management
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• v.18 no.4
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• pp.66-84
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• 2008

Objectives: This study aimed to. offer some fundamental evidences for the stroke management policy by investigating the trends of medical care utilization and regionalization in stroke inpatients. Methods: We used the National Health Insurance claims and registry data for stroke inpatients from 1998 to 2005. Among all stroke inpatient claims data, self-employed insured and their dependents were only included in this study. The classification of stroke was based on ICD-10(I60-I69) and its subtype was divided by hemorrhage(I60-I62) and infarction(I63-I64) type. To evaluate regionalization of medical care utilization, relevance index was calculated by regions. The regions were classified 8 large catchment areas and 163 self authorized areas. Results: The overall medical care utilization rate of stroke inpatient has been increased, especially infarction subtype. Among medical care institutions, the utilization of hospital has been the most rapidly increased. Although considered annual rate of interest, total medical cost of stroke inpatients has been increased, Totally, more than 84% of stroke inpatient were admitted to medical care institutions in their own large catchment area during 1998-2005. The relevance indices in their own large catchment area (self sufficiency rates) were more than 70% in most areas regardless of stroke subtype except Chungbuk catchment area. Self sufficiency rates of stroke inpatients among 163 self authorized areas in 1998 and 2005 were 84.2% and 83.1% in metropolitan, 46.7% and 45.5% in urban, and 19.5% and 22.6% in rural areas, respectively. Conclusion: Stroke management policy for improvement of distribution at the district level, especially in rural areas, may be helpful for reducing regional inequality in stroke.

• Health Policy and Management
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• v.31 no.1
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• pp.91-99
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• 2021

Background: The Korean government introduced National Cancer Control Program and strengthening national health insurance coverage for cancer patients. Although many positive effects have been observed, there are also many concerns about cancer management such as patient concentration or time-to-treatment. Thus, we investigated the association between the time-to-treatment and survival of cancer patients, and compared regional differences by time trend. Methods: The data used in this study were national health insurance claims data that included patients diagnosed with lung cancer and received surgical treatment between 2005 and 2015. We conducted survival analysis with Cox proportional hazard model for the association between time-to-treatment and survival in lung cancer. Additionally, we compared the regional differences for time-to-treatment by time trend. Results: A total of 842 lung cancer patients were included, and 52.3% of lung cancer patients received surgical treatment within 30 days. Patients who received surgical treatment after 31 days had higher 5-year or 1-year mortality compared to treatment within 30 days (5-year: hazard ratio [HR], 1.566; 1-year: HR, 1.555; p<0.05). There were some regional differences for time-to-treatment, but it was generally reduced after 2010. Conclusion: Delayed surgical treatment after diagnosis can negatively affect patient outcomes in cancer treatment. To improve cancer control strategies, there are needed to analyze the healthcare delivery system for cancer care considering the severity and types of cancer.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.3
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• pp.1920-1927
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• 2015

This study examined health insurance costs of occupational therapy in stroke patients. The subjects were stroke patients, who underwent occupational therapy by hospitalization or out-patient centers in 2010. The cost of occupational therapy was analyzed from the insurance claims data of Health Insurance Review and Assessment Service in 2010. The kinds of occupational therapy were divided according to the insurance fee of occupational therapy in 2010. In-patients who received occupational therapy paid the highest rehabilitation treatment fee, whereas outpatients paid the highest nervous system function test fee. The cost of occupational therapy in the special rehabilitation treatment fee was highest by 25.3 billion won. The number of uses of general hospitals was the highest by 180 thousand but the total cost of long-term care hospital was highest by 10.4 billion won. The number of uses and cost by regional groups was highest in Seoul and Gyeonggi-do province. This study is meaningful in that a cost analysis of occupational therapy in stroke patients was performed for the first time using the stroke data from the whole country. The result can be used to provide basic data to improve the insurance fee in the future.

• The Journal of Korean Obstetrics and Gynecology
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• v.23 no.1
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• pp.72-82
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• 2010

Purpose: This study was conducted to estimate the annual socioeconomic costs of menopausal syndrome treated with oriental medicine in Korea 2008. Methods: Study subjects selected were patients aged 40 years or older who had national health insurance(NHI) claims record with menopausal syndrome(KCDO codes: K04, K04.0, K04.2, K04.3, K04.4) for oriental medicine treatment in 2008. Direct medical cost of oriental medicine treatment for menopausal syndrome were measured from NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting hospitals. Indirect costs were defined as patients' productivity loss associated with office visits or hospitalization. Also, the costs of unpaid-household chores were calculated. Results: The total cost for the oriental medicine treatment of menopausal syndrome in the nation was estimated to be 743,091,219 Korean won(KRW) which included direct costs at 442,971,637 KRW and indirect costs at 300,119,583 KRW. Conclusion: This study provides an important perspective of socioecnomic influence due to menopausal syndrome treated with oriental medicine. And this results can be used as elementary data for menopausal syndrome-related health policy of oriental medicine.