• Title/Summary/Keyword: insurance big data

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Effects of Spatial Accessibility on the Number of Outpatient Visits for an Internal Medicine of a Hospital (공간적 접근성이 내과환자의 내원일수에 미치는 영향 분석: 대도시 일개 병원을 대상으로)

  • Lee, Eun-Joo;Moon, Kyeong-Jun;Lee, Kwang-Soo
    • Health Policy and Management
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    • v.26 no.3
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    • pp.233-241
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    • 2016
  • Background: This study purposed to analyze and understand how spatial accessibility of patients influenced the number of outpatient visits for the internal medicine of a hospital. Methods: A hospital with 100 beds in Seoul, South Korea provided data from 2013 January 1 to 2013 June 30. Euclidean distance and road ares were used to represent the spatial accessibility. Patient level data and dong level data were collected and used in spatial analysis. Dong level data was converted into grid level ($500{\times}500m$) for the multivariate analysis. Hot-spot analysis and generalized linear model were applied to the data collected. Results: Hot-spots of outpatient visits were found around the study hospital, and cold-spots were not found. Number of outpatient visits was varied by the distance between patient resident and hospitals, and about 80% of total outpatient visits was occurred in within the 5 km from study hospital, and 50% was occurred in within 1.6 km. Spatial accessibility had significant influences on the outpatient visits. Conclusion: Findings provide evidences that spatial accessibility had influences on the patients' behaviors in utilizing the outpatient care of internal medicine in a hospital. Results can provide useful information to health policy makers as well as hospital managers for their decision making.

The Status and Treatment Outcomes in Patients with Hypopharyngeal Cancer: A Nationwide Population-based Study (하인두암 환자들의 발생 현황 및 치료 방법에 따른 결과 분석: 국민건강보험공단 자료를 이용한 연구)

  • Kim, Hyun-Bum;Han, Kyung-Do;Joo, Young-Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.2
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    • pp.19-24
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    • 2021
  • Background/Objectives: The aim of this national population-based retrospective study was to analyze the status and treatment outcome in patients with hypopharyngeal cancer. Materials & Methods: Participants were included in the KNHIS national sample cohort who received a KNHIS health check-up in 2008 and 2009, and we followed these individuals until 2017. Patients were defined as having hypopharynx cancer if they had admissions records for hypopharynx cancer in their national health insurance data from 2010 to 2017. Results: The study cohort included 3,922 patients. According to our nationwide data, 3,533(90.1%) were male with a median age of 65.03±11.04 years at the time of diagnosis. Among parametric models for hypopharyngeal cancer prognosis, old age (Hazard ratio [HR]:1.92; 95% confidence interval[CI]:1.76-2.09), female (HR:0.77; 95% CI:0.66-0.89), and low socioeconomic status (HR:1.216; 95% CI:1.114-1.327) were significantly associated with survival. Compared with concurrent chemoradiotherapy, patients who received no treatment (HR, 1.88; 95% CI, 1.31-2.70), neoadjuvant chemotherapy followed by surgery (HR, 1.21; 95% CI, 1.04-1.41), and chemotherapy alone (HR, 1.16; 95% CI, 1.03-1.27) showed poor prognosis in hypopharyngeal cancer. Conclusion: Our data indicated that age, sex, and income were significant predictors of lifetime survival in patients with hypopharyngeal cancer. Treatment modalities were also associated with prognosis. The data have implications for treatment investigations and prevention strategies.

Effect of Gastric Cancer Screening on Patients with Gastric Cancer: A Nationwide Population-based Study (위암 환자에서 국가암검진의 효과)

  • Cho, Young Suk;Lee, Sang Hoon;So, Hyun Ju;Kim, Dong Wook;Choi, Yoon Jung;Jeon, Han Ho
    • Journal of Digestive Cancer Research
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    • v.8 no.2
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    • pp.102-108
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    • 2020
  • Background: This study was performed to evaluate the effect of gastric cancer screening through analysis of screening-related data. Methods: We investigated claims data of gastric cancer from 2009 to 2015. We evaluated whether the screening was performed to prior to registration as patients with gastric cancer. The effect of gastric cancer screening was also analyzed by gender. Results: We collected total 196,293 patients with gastric cancer. 74% of them had previous experience of gastric cancer screening. In patients with screening, early gastric cancer was 33.4% and advanced gastric cancer was 17.3%. 22,548 (15.5%) patients were diagnosed with gastric cancer within 2 years after screening. In the case of patients without screening, early gastric cancer was 15.1% and advanced gastric cancer was 25.3%. In case of men, 76% of them confirmed gastric cancer through screening, and 70.2% of women confirmed the gastric cancer. In both men and women, the rate of early gastric cancer was higher among those with screening than those without screening. Conclusion: In this study, we were able to indirectly confirm the stage shift of gastric cancer screening. However, within 2 years after screening, not a few patients with gastric cancer were diagnosed. Therefore, more studies are warranted to in the future.

Trends in Ankyloglossia and Surgical Treatment among Pediatric Patients in South Korea (국내 소아청소년 환자에서의 혀유착증 진단과 설소대 수술 시행의 최근 경향)

  • Taehyun Kim;Daewoo Lee;Jae-Gon Kim;Yeonmi Yang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.2
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    • pp.229-238
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    • 2023
  • The objective of this study was to investigate trends in ankyloglossia and its surgical treatment among pediatric patients in South Korea from 2011 to 2020. Data from Health Insurance Review and Assessment Service (HIRA)'s Healthcare Bigdata Hub were used for analysis of the ankyloglossia diagnosis rate and frenum surgery rate. Considering annual population change, crude rates per 100,000 were calculated and analyzed. To investigate other factors of frenum surgery incidence besides gender and age, pediatric patient sample data from HIRA were used. The diagnosis rate of ankyloglossia increased from 204.4 in 2011 to 356.6 per 100,000 people in 2020, while the frenum surgery rate increased from 26.8 to 34.3 per 100,000 people. Males were more likely to receive frenum surgery than females. Surgeries were more likely to be done at a hospital instead of a clinic or a general hospital. In the age group of 0 - 4 years, the largest number of frenum surgeries were performed in pediatrics, and in the age group of 5 - 9 years, the largest number of surgeries were conducted in pediatric dentistry. In the older age groups, the largest proportion of frenum surgeries were performed in the departments of conservative dentistry and oral and maxillofacial surgery. The diagnosis of ankyloglossia and the operation of frenum surgery among South Korean children increased during the last decade. Since the function of the tongue can affect maxillofacial development in many aspects, pediatric dentists should pay more attention to the functional management of intraoral soft tissue in growing children.

The Prediction of Export Credit Guarantee Accident using Machine Learning (기계학습을 이용한 수출신용보증 사고예측)

  • Cho, Jaeyoung;Joo, Jihwan;Han, Ingoo
    • Journal of Intelligence and Information Systems
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    • v.27 no.1
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    • pp.83-102
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    • 2021
  • The government recently announced various policies for developing big-data and artificial intelligence fields to provide a great opportunity to the public with respect to disclosure of high-quality data within public institutions. KSURE(Korea Trade Insurance Corporation) is a major public institution for financial policy in Korea, and thus the company is strongly committed to backing export companies with various systems. Nevertheless, there are still fewer cases of realized business model based on big-data analyses. In this situation, this paper aims to develop a new business model which can be applied to an ex-ante prediction for the likelihood of the insurance accident of credit guarantee. We utilize internal data from KSURE which supports export companies in Korea and apply machine learning models. Then, we conduct performance comparison among the predictive models including Logistic Regression, Random Forest, XGBoost, LightGBM, and DNN(Deep Neural Network). For decades, many researchers have tried to find better models which can help to predict bankruptcy since the ex-ante prediction is crucial for corporate managers, investors, creditors, and other stakeholders. The development of the prediction for financial distress or bankruptcy was originated from Smith(1930), Fitzpatrick(1932), or Merwin(1942). One of the most famous models is the Altman's Z-score model(Altman, 1968) which was based on the multiple discriminant analysis. This model is widely used in both research and practice by this time. The author suggests the score model that utilizes five key financial ratios to predict the probability of bankruptcy in the next two years. Ohlson(1980) introduces logit model to complement some limitations of previous models. Furthermore, Elmer and Borowski(1988) develop and examine a rule-based, automated system which conducts the financial analysis of savings and loans. Since the 1980s, researchers in Korea have started to examine analyses on the prediction of financial distress or bankruptcy. Kim(1987) analyzes financial ratios and develops the prediction model. Also, Han et al.(1995, 1996, 1997, 2003, 2005, 2006) construct the prediction model using various techniques including artificial neural network. Yang(1996) introduces multiple discriminant analysis and logit model. Besides, Kim and Kim(2001) utilize artificial neural network techniques for ex-ante prediction of insolvent enterprises. After that, many scholars have been trying to predict financial distress or bankruptcy more precisely based on diverse models such as Random Forest or SVM. One major distinction of our research from the previous research is that we focus on examining the predicted probability of default for each sample case, not only on investigating the classification accuracy of each model for the entire sample. Most predictive models in this paper show that the level of the accuracy of classification is about 70% based on the entire sample. To be specific, LightGBM model shows the highest accuracy of 71.1% and Logit model indicates the lowest accuracy of 69%. However, we confirm that there are open to multiple interpretations. In the context of the business, we have to put more emphasis on efforts to minimize type 2 error which causes more harmful operating losses for the guaranty company. Thus, we also compare the classification accuracy by splitting predicted probability of the default into ten equal intervals. When we examine the classification accuracy for each interval, Logit model has the highest accuracy of 100% for 0~10% of the predicted probability of the default, however, Logit model has a relatively lower accuracy of 61.5% for 90~100% of the predicted probability of the default. On the other hand, Random Forest, XGBoost, LightGBM, and DNN indicate more desirable results since they indicate a higher level of accuracy for both 0~10% and 90~100% of the predicted probability of the default but have a lower level of accuracy around 50% of the predicted probability of the default. When it comes to the distribution of samples for each predicted probability of the default, both LightGBM and XGBoost models have a relatively large number of samples for both 0~10% and 90~100% of the predicted probability of the default. Although Random Forest model has an advantage with regard to the perspective of classification accuracy with small number of cases, LightGBM or XGBoost could become a more desirable model since they classify large number of cases into the two extreme intervals of the predicted probability of the default, even allowing for their relatively low classification accuracy. Considering the importance of type 2 error and total prediction accuracy, XGBoost and DNN show superior performance. Next, Random Forest and LightGBM show good results, but logistic regression shows the worst performance. However, each predictive model has a comparative advantage in terms of various evaluation standards. For instance, Random Forest model shows almost 100% accuracy for samples which are expected to have a high level of the probability of default. Collectively, we can construct more comprehensive ensemble models which contain multiple classification machine learning models and conduct majority voting for maximizing its overall performance.

Changes in the Hosptal Length of Stay and Medical Cost between before and after the Applications of the DRG payment system using Health Insurance Big Data (건강보험 빅 데이터를 활용한 종합병원에서의 포괄수가제 적용 전·후 재원일수와 진료비의 변화)

  • Jeong, Su-Jin;Choi, Seong-Woo
    • The Journal of the Korea institute of electronic communication sciences
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    • v.12 no.2
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    • pp.401-410
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    • 2017
  • This study aimed to identify appropriateness and efficiency in the DRG payment system by analysing the hospital length of stay and changes in fees before and after the application of DRG payment system. The subjects of the study were a total of 398 patients consisting of 204 for the fee for service system and 194 for the DRG payment system. They received surgery in the Obstetrics and Gynecology (OBGY) department of a general hospital in G metropolitan city between January and December 2013. The mean hospital length of stay was significantly decreased after application of the DRG payment system(p=0.013). Total fees, insurance charges, and deductions increased significantly(p<0.001), and non-payment charges and total deductions decreased significantly(p<0.001). Application of the DRG payment system reduced length of stay, non-payment charges and total patient's cost sharing and increased out-of-pocket, insurance charges, and total fees.

Determinants of Long-Term Care Service Use by Elderly (노인장기요양서비스 이용형태 결정요인 연구)

  • Lee, Yun-kyung
    • 한국노년학
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    • v.29 no.3
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    • pp.917-933
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    • 2009
  • This study examined the factors affecting forms of long-term care service use by elderly and the forms of use are classified facility care service, home care service, and unused. It is used data from the 2nd pilot program for the Long Term Care Insurance scheme and it is analysed 5,497 cases. Multi-nominal regression is used. According to the results, women use formal service more than man do, and wowen use facility care than home care. Those who eligible for National Basic Livelihood Security System(NBLSS) are shown to have higher use of formal care(especially facility care) than the middle income class, and the low income class than the middle income class has lower use of formal care. In addition, higher the family care is available, lower the taking part in the service. The big cities and mid sized cities than rural are used the formal service and moreover mid sized cities are used facility care than home care. Furthermore, the level of care need is determinants of service use and function of ADL, IADL, and abnormal behavior is also determinants of formal service(especially facility care). But nursing need and rehabilitation need are not determinants of formal service use. Based on the results, the recommendations are developed and implemented for the improvement the elderly long-term care insurance.

Smoking-attributable Mortality in Korea, 2020: A Meta-analysis of 4 Databases

  • Eunsil Cheon;Yeun Soo Yang;Suyoung Jo;Jieun Hwang;Keum Ji Jung;Sunmi Lee;Seong Yong Park;Kyoungin Na;Soyeon Kim;Sun Ha Jee;Sung-il Cho
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.4
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    • pp.327-338
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    • 2024
  • Objectives: Estimating the number of deaths caused by smoking is crucial for developing and evaluating tobacco control and smoking cessation policies. This study aimed to determine smoking-attributable mortality (SAM) in Korea in 2020. Methods: Four large-scale cohorts from Korea were analyzed. A Cox proportional-hazards model was used to determine the hazard ratios (HRs) of smoking-related death. By conducting a meta-analysis of these HRs, the pooled HRs of smoking-related death for 41 diseases were estimated. Population-attributable fractions (PAFs) were calculated based on the smoking prevalence for 1995 in conjunction with the pooled HRs. Subsequently, SAM was derived using the PAF and the number of deaths recorded for each disease in 2020. Results: The pooled HR for all-cause mortality attributable to smoking was 1.73 for current men smokers (95% confidence interval [CI], 1.53 to 1.95) and 1.63 for current women smokers (95% CI, 1.37 to 1.94). Smoking accounted for 33.2% of all-cause deaths in men and 4.6% in women. Additionally, it was a factor in 71.8% of men lung cancer deaths and 11.9% of women lung cancer deaths. In 2020, smoking was responsible for 53 930 men deaths and 6283 women deaths, totaling 60 213 deaths. Conclusions: Cigarette smoking was responsible for a significant number of deaths in Korea in 2020. Monitoring the impact and societal burden of smoking is essential for effective tobacco control and harm prevention policies.

A prediction model of low back pain risk: a population based cohort study in Korea

  • Mukasa, David;Sung, Joohon
    • The Korean Journal of Pain
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    • v.33 no.2
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    • pp.153-165
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    • 2020
  • Background: Well-validated risk prediction models help to identify individuals at high risk of diseases and suggest preventive measures. A recent systematic review reported lack of validated prediction models for low back pain (LBP). We aimed to develop prediction models to estimate the 8-year risk of developing LBP and its recurrence. Methods: A population based prospective cohort study using data from 435,968 participants in the National Health Insurance Service-National Sample Cohort enrolled from 2002 to 2010. We used Cox proportional hazards models. Results: During median follow-up period of 8.4 years, there were 143,396 (32.9%) first onset LBP cases. The prediction model of first onset consisted of age, sex, income grade, alcohol consumption, physical exercise, body mass index (BMI), total cholesterol, blood pressure, and medical history of diseases. The model of 5-year recurrence risk was comprised of age, sex, income grade, BMI, length of prescription, and medical history of diseases. The Harrell's C-statistic was 0.812 (95% confidence interval [CI], 0.804-0.820) and 0.916 (95% CI, 0.907-0.924) in validation cohorts of LBP onset and recurrence models, respectively. Age, disc degeneration, and sex conferred the highest risk points for onset, whereas age, spondylolisthesis, and disc degeneration conferred the highest risk for recurrence. Conclusions: LBP risk prediction models and simplified risk scores have been developed and validated using data from general medical practice. This study also offers an opportunity for external validation and updating of the models by incorporating other risk predictors in other settings, especially in this era of precision medicine.

A Korean nationwide investigation of the national trend of complex regional pain syndrome vis-à-vis age-structural transformations

  • Lee, Joon-Ho;Park, Suyeon;Kim, Jae Heon
    • The Korean Journal of Pain
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    • v.34 no.3
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    • pp.322-331
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    • 2021
  • Background: The present study employed National Health Insurance Data to explore complex regional pain syndrome (CRPS) updated epidemiology in a Korean context. Methods: A CRPS cohort for the period 2009-2016 was created based on Korean Standard Classification of Diseases codes alongside the national registry. The general CRPS incidence rate and the yearly incidence rate trend for every CRPS type were respectively the primary and secondary outcomes. Among the analyzed risk factors were age, sex, region, and hospital level for the yearly trend of the incidence rate for every CRPS. Statistical analysis was performed via the chi-square test and the linear and logistic linear regression tests. Results: Over the research period, the number of registered patients was 122,210. The general CRPS incidence rate was 15.83 per 100,000, with 19.5 for type 1 and 12.1 for type 2. The condition exhibited a declining trend according to its overall occurrence, particularly in the case of type 2 (P < 0.001). On the other hand, registration was more pervasive among type 1 compared to type 2 patients (61.7% vs. 38.3%), while both types affected female individuals to a greater extent. Regarding age, individuals older than 60 years of age were associated with the highest prevalence in both types, regardless of sex (P < 0.001). Conclusions: CRPS displayed an overall incidence of 15.83 per 100,000 in Korea and a declining trend for every age group which showed a negative association with the aging shift phenomenon.