• 대한예방의학회:학술대회논문집
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• 2004.10a
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• pp.47.2-48
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• 2004

• The Korean Journal of Health Service Management
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• v.11 no.3
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• pp.65-78
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• 2017

Objectives : Obesity is a worldwide health concern due to an increasing obese population. This study proposed to analyze the differences in medical costs and care utilization between obese and normal group using propensity score matching. Methods : Data were collected from the sample cohort database by the Korea National Health Insurance Corporation. Propensity score matching(PSM) was applied to control selection bias, and factors affecting obesity were used as covariates in PSM. Results : The results showed higher medical costs and care utilization in the obese group than the normal group. According to gender and medical type, there were differences in the relationships between obesity and medical charges and utilization. In particular, the differences in the female population were larger in both outpatients and inpatients than the male population. Conclusions : It is important to manage obesity, because obesity has a negative effect on national health insurance costs. These findings suggest directions for future research.

• Health Policy and Management
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• v.30 no.4
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• pp.431-432
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• 2020

Coronavirus disease 2019 (COVID-19) has been going on for nearly a year. As of December 1, 2020, more than 60 million confirmed cases and 1.4 million deaths have occurred in 220 countries and territories. There is no effective treatment for COVID-19 so far, and vaccines are being developed. However, the vaccine of COVID-19 can be freed from COVID-19 only if there are positive answers to some questions: "Aren't there any major side effects from the vaccine?"; "Is the vaccine effective for enough time?"; "Does the vaccine sufficiently reduce the mortality rate?"; and "Does the vaccine sufficiently reduce the reproduction number?" The fight against COVID-19 will continue for a long time. Therefore, we need to respond by developing the evidence for control of COVID-19, the emerging infectious disease. Extensive quarantine measures in the early stages of COVID-19 need to be elaborated through developing the evidence. Korea Disease Control and Prevention Agency should establish a database for evidence developing COVID-19 control. In this database, based on more than 3 million tested individuals, epidemiological investigation results, health insurance claims data, and government data such as the Ministry of Public Administration and Security, etc. should be linked. It is necessary to disclose this database to academia, etc. to create the evidences of COVID-19 and manage COVID-19 through these. And through the developed evidences, guidelines for physical health and mental health in the era of Corona 19 should be developed.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.2
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• pp.67-75
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• 2017

Objectives The study of the clinical effects of traditional east asian medicine (TEAM) using Taiwan national health insurance claim dataset (NHIRD) is useful in Korean Medicine research. We reviewed the clinical studies of TEAM using NHIRD as a whole through this study. Methods We comprehensively searched PUBMED and NHIRD DB for clinical effects of TEAM study using NHIRD from inception to 17, January 2017. As a result, 40 studies investigating the contribution of TEAM intervention to health benefit have been confirmed. We analyzed publication time, target disease, sample size, outcome measurement and main result of 40 searched studies. Results The number of TEAM studies using NHIRD grdually increasing. The topics of the team study using NHIRD covered a wide range of subjects including cardiovascular disease, tumor, gynecological disease, diabetes and kidney disease. The studies have shown large samples and reported significant effects on severe diseases. Conclusions The results of this study suggest that the study of Korean Medicine using Big data will be useful for decision making related to health care in Korea. However, considering the limited domestic Korean health insurance data, it will be necessary to activate the big data research of Korean Medicine through the establishment of a separate cohort in Korea.

• Hip & pelvis
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• v.36 no.2
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• pp.144-154
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• 2024

Purpose: The objective of this study was to assess postoperative direct medical expenses and medical utilization of elderly patients who underwent either hemiarthroplasty (HA) or internal fixation (IF) for treatment of a femoral intertrochanteric fracture and to analyze differences according to surgical methods and age groups. Materials and Methods: Data from the 2011 to 2018 Korean National Health Insurance Review & Assessment Service database were used. Risk-set matching was performed for selection of controls representing patients with the same sex, age, and year of surgery. A comparative interrupted time series analysis was performed for evaluation of differences in medical expenses and utilization between the two groups. Results: A total of 10,405 patients who underwent IF surgery and 10,405 control patients who underwent HA surgery were included. Medical expenses were 18% lower in the IF group compared to the HA group during the first year after the fracture (difference-in-difference [DID] estimate ratio 0.82, 95% confidence interval [CI] 0.77-0.87, P<0.001), and 9% lower in the second year (DID estimate ratio 0.91, 95% CI 0.85-0.99, P=0.018). Length of hospital stay was significantly shorter in the IF group compared to the HA group during the first two years after time zero in the age ≥80 group. Conclusion: A noticeable increase in medical expenses was observed for patients who underwent HA for treatment of intertrochanteric fractures compared to those who underwent IF over a two-year period after surgery. Therefore, consideration of such findings is critical when designing healthcare policy support for management of intertrochanteric fractures.

• Journal of Preventive Medicine and Public Health
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• v.50 no.1
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• pp.29-37
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• 2017

Objectives: The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. Methods: We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. Results: In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. Conclusions: Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.

• Journal of Intelligence and Information Systems
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• v.6 no.1
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• pp.73-82
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• 2000

This study examined the characteristicso f the knowledge discovery and data mining algorithms to demonstrate how they can be used to predict health outcomes and provide policy information for hypertension management using the Korea Medical Insurance Corporation database. Specifically this study validated the predictive power of data mining algorithms by comparing the performance of logistic regression and two decision tree algorithms CHAID (Chi-squared Automatic Interaction Detection) and C5.0 (a variant of C4.5) since logistic regression has assumed a major position in the healthcare field as a method for predicting or classifying health outcomes based on the specific characteristics of each individual case. This comparison was performed using the test set of 4,588 beneficiaries and the training set of 13,689 beneficiaries that were used to develop the models. On the contrary to the previous study CHAID algorithm performed better than logistic regression in predicting hypertension but C5.0 had the lowest predictive power. In addition CHAID algorithm and association rule also provided the segment characteristics for the risk factors that may be used in developing hypertension management programs. This showed that data mining approach can be a useful analytic tool for predicting and classifying health outcomes data.

• 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.30 no.3
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• pp.418-429
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• 2020

Background: This study aims to analyze the cost and the length of stay (LOS) of acute myocardial infarction (AMI) patients with coronary artery stenting according to the characteristics of individuals and institutions. Methods: The data was collected from Korean National Health Insurance Service's customized database in 2010 and 2015. Chi-square test, t-test, analysis of variance, and multilevel analysis were performed. Results: The intraclass correlation coefficients for cost were 7.02% in 2010, 5.61% in 2015 and for LOS were 3.17%, 1.40%, respectively. The average costs were 9,067,000 won in 2010 and 9,889,000 won in 2015 (p<0.0001). However, the cost in 2015 was lower than the cost applying increased fee. The costs increased in aged 50-59 years, 60-69 years, and aged ≥70 years versus in aged under 49 years. The cost was higher in Charlson comorbidity index (CCI) 3 to 4 and ≥5 than in CCI 0. The costs were lower in male, medical aid recipients, metropolises, and local hospitals in other regions in 2010. LOS decreased from 8.1 days in 2010 to 7.4 days in 2015. It decreased in male, high income group, and the group of admission via emergency room. However, it increased in higher ages and medical aid recipients, and it also increased when CCI rose. The Internal Herfindahl Index was related to LOS in 2010. Conclusion: The variation of hospital level was small compared to the patient level. Therefore, it is important to implement applicable policies at the patient level in order to reduce cost and LOS of AMI patients.

• Journal of Oriental Neuropsychiatry
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• v.25 no.4
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• pp.411-422
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• 2014

Objectives: A large number of patients require psychiatric therapy. We attempted to determine the present situation regarding psychotherapy and neuropsychological tests for dementia in Korean medicine for the benefit of the Health Insurance Review and Assessment Service (HIRAS). The aim of this study was to aware of the current status about psychotherapy and neuropsychological test for dementia in Korean medicine. Methods: We searched the medical practice records for psychotherapy and neuropsychological tests in oriental neuropsychiatry between 2009 and 2013 using the Health Insurance Review and Assessment Service (HIRAS) database. The search categories were: IJeongByunGi (Medical practice code:59001), JiUnGoRoen (59002), Kyungjapyungji (59003), OhJiSangSeung (59004), neuropsychological test for dementia (29005). Results: 1. The number of patients treated with Korean Medical Psychotherapy increased annually by 151%. The total number of patients treated with Korean Medical Psychotherapy was 4,289 in 2013. 2. The total cost for patients treated with Korean medical Psychotherapy in the public health medical insurance budget was 268,032,000 won in 2013. The average medical cost for one therapy was 17,000 won in 2013. 3. The number of patients in local clinics is increasing faster than the number in Korean medical hospitals. 4. The age group between 20~30 years of age, for both men and women, is the group with the greatest density in Korean Medical Psychotherapy. 5. Neuropsychological Testing for Dementia in Korean Medicine is slowly decreasing. Conclusions: The prevalence of mental illness in Korea is increasing, therefore, the demand for Korean Medical Psychotherapy has increased recently. Authorizing Korean Medical psychiatrists to utilize Korean mental Health resources is essential. This study could be helpful in understanding the current status for the purpose of expanding Korean Medical Psychotherapy.