Systematic Review
- Adjusting for Confounders in Outcome Studies Using the Korea National Health Insurance Claim Database: A Review of Methods and Applications
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Seung Jin Han, Kyoung Hoon Kim
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J Prev Med Public Health. 2024;57(1):1-7. Published online November 16, 2023
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DOI: https://doi.org/10.3961/jpmph.23.250
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Abstract
Summary
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- Objectives
Adjusting for potential confounders is crucial for producing valuable evidence in outcome studies. Although numerous studies have been published using the Korea National Health Insurance Claim Database, no study has critically reviewed the methods used to adjust for confounders. This study aimed to review these studies and suggest methods and applications to adjust for confounders.
Methods
We conducted a literature search of electronic databases, including PubMed and Embase, from January 1, 2021 to December 31, 2022. In total, 278 studies were retrieved. Eligibility criteria were published in English and outcome studies. A literature search and article screening were independently performed by 2 authors and finally, 173 of 278 studies were included.
Results
Thirty-nine studies used matching at the study design stage, and 171 adjusted for confounders using regression analysis or propensity scores at the analysis stage. Of these, 125 conducted regression analyses based on the study questions. Propensity score matching was the most common method involving propensity scores. A total of 171 studies included age and/or sex as confounders. Comorbidities and healthcare utilization, including medications and procedures, were used as confounders in 146 and 82 studies, respectively.
Conclusions
This is the first review to address the methods and applications used to adjust for confounders in recently published studies. Our results indicate that all studies adjusted for confounders with appropriate study designs and statistical methodologies; however, a thorough understanding and careful application of confounding variables are required to avoid erroneous results.
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Summary
Korean summary
건강보험청구자료를 사용한 성과연구에서는 교란요인 통제가 중요하다. 최근 발표된 연구들은
연구설계와 통계 분석 과정에 적절하게 교란요인을 통제하였다. 연구의 질을 높이기 위해서는 건강보험청구자료에서 수집 가능한 교란 요인에 대한 이해와 방법론적 가이드라인이 요구된다.
Key Message
All recently published studies using Health Insurance Claims Database adjusted for confounders with appropriate study designs and statistical methodologies.
The review suggests the need for careful application of confounding variables and the methodological guidance to improve the quality of outcome studies.
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Citations
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- Factors Associated With Receiving Early Post-Discharge Follow-up Care in Patients With Schizophrenia
Song Ee Che, Kyoung-Hoon Kim
Journal of Korean Medical Science.2025;[Epub] CrossRef - Worsening of health disparities across COVID-19 pandemic stages in Korea
Hyejin Lee, Hyunwoo Nam, Jae-ryun Lee, Hyemin Jung, Jin Yong Lee
Epidemiology and Health.2024; 46: e2024038. CrossRef - Trends in Regional Disparities in Cardiovascular Surgery and Mortality in Korea: A National Cross-sectional Study
Dal-Lae Jin, Kyoung-Hoon Kim, Euy Suk Chung, Seok-Jun Yoon
Journal of Preventive Medicine and Public Health.2024; 57(3): 260. CrossRef - Low household income increases risks for chronic obstructive pulmonary disease in young population: a nationwide retrospective cohort study in South Korea
Chiwook Chung, Kyu Na Lee, Dong Wook Shin, Sei Won Lee, Kyungdo Han
BMJ Open Respiratory Research.2024; 11(1): e002444. CrossRef - An epidemic of cataract surgery in Korea: the effects of private health insurance on the National Health Insurance Service
Hyejin Lee, Soo-Hee Hwang, Choon-Seon Park, Seol-Hee Chung, Catherine L. Chen, Jin Yong Lee, Jin Soo Lee
Epidemiology and Health.2024; 46: e2024015. CrossRef
Original Article
- Trends in the Quality of Primary Care and Acute Care in Korea From 2008 to 2020: A Cross-sectional Study
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Yeong Geun Gwon, Seung Jin Han, Kyoung Hoon Kim
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J Prev Med Public Health. 2023;56(3):248-254. Published online April 12, 2023
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DOI: https://doi.org/10.3961/jpmph.23.015
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2,753
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Abstract
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- Objectives
Measuring the quality of care is paramount to inform policies for healthcare services. Nevertheless, little is known about the quality of primary care and acute care provided in Korea. This study investigated trends in the quality of primary care and acute care.
Methods
Case-fatality rates and avoidable hospitalization rates were used as performance indicators to assess the quality of primary care and acute care. Admission data for the period 2008 to 2020 were extracted from the National Health Insurance Claims Database. Case-fatality rates and avoidable hospitalization rates were standardized by age and sex to adjust for patients’ characteristics over time, and significant changes in the rates were identified by joinpoint regression.
Results
The average annual percent change in age-/sex-standardized case-fatality rates for acute myocardial infarction was -2.3% (95% confidence interval, -4.6 to 0.0). For hemorrhagic and ischemic stroke, the age-/sex-standardized case-fatality rates were 21.8% and 5.9%, respectively in 2020; these rates decreased since 2008 (27.1 and 8.7%, respectively). The average annual percent change in age-/sex-standardized avoidable hospitalization rates ranged from -9.4% to -3.0%, with statistically significant changes between 2008 and 2020. In 2020, the avoidable hospitalization rates decreased considerably compared with the 2019 rate because of the coronavirus disease 2019 pandemic.
Conclusions
The avoidable hospitalization rates and case-fatality rates decreased overall during the past decade, but they were relatively high compared with other countries. Strengthening primary care is an essential requirement to improve patient health outcomes in the rapidly aging Korean population.
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Summary
Korean summary
본 연구에서는 급성심근경색증과 뇌졸중 치명률, 외래진료 민감질환의 예방 가능한 입원율을 사용하여 한국의 의료 질 수준을 분석하였다. 2008~2020년 동안 치명률과 예방 가능한 입원율은 감소하는 추세이다. 그러나, 예방 가능한 입원율은 다른 국가에 비해 상대적으로 높아 환자의 건강결과 향상을 위하여 일차의료 강화가 요구된다.
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- National Expenditures on Anticancer and Immunomodulating Agents During 2013–2022 in Korea
Jieun Yun, Youngs Chang, Minsol Jo, Yerin Heo, Dong-Sook Kim
Journal of Korean Medical Science.2025;[Epub] CrossRef - Mortality and Disparities of Acute Myocardial Infarction and Stroke in Korea, 2008–2019
Ji-Sook Choi, Soomin Kim, Choon-Seon Park, Hyejin Lee, Jin Yong Lee, Sun Min Kim
Yonsei Medical Journal.2024; 65(9): 534. CrossRef
COVID-19: Special Article
- COVID-19 International Collaborative Research by the Health Insurance Review and Assessment Service Using Its Nationwide Real-world Data: Database, Outcomes, and Implications
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Yeunsook Rho, Do Yeon Cho, Yejin Son, Yu Jin Lee, Ji Woo Kim, Hye Jin Lee, Seng Chan You, Rae Woong Park, Jin Yong Lee
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J Prev Med Public Health. 2021;54(1):8-16. Published online January 26, 2021
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DOI: https://doi.org/10.3961/jpmph.20.616
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5,957
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- This article aims to introduce the inception and operation of the COVID-19 International Collaborative Research Project, the world’s first coronavirus disease 2019 (COVID-19) open data project for research, along with its dataset and research method, and to discuss relevant considerations for collaborative research using nationwide real-world data (RWD). COVID-19 has spread across the world since early 2020, becoming a serious global health threat to life, safety, and social and economic activities. However, insufficient RWD from patients was available to help clinicians efficiently diagnose and treat patients with COVID-19, or to provide necessary information to the government for policy-making. Countries that saw a rapid surge of infections had to focus on leveraging medical professionals to treat patients, and the circumstances made it even more difficult to promptly use COVID-19 RWD. Against this backdrop, the Health Insurance Review and Assessment Service (HIRA) of Korea decided to open its COVID-19 RWD collected through Korea’s universal health insurance program, under the title of the COVID-19 International Collaborative Research Project. The dataset, consisting of 476 508 claim statements from 234 427 patients (7590 confirmed cases) and 18 691 318 claim statements of the same patients for the previous 3 years, was established and hosted on HIRA’s in-house server. Researchers who applied to participate in the project uploaded analysis code on the platform prepared by HIRA, and HIRA conducted the analysis and provided outcome values. As of November 2020, analyses have been completed for 129 research projects, which have been published or are in the process of being published in prestigious journals.
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Summary
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- Symptoms and Conditions in Children and Adults up to 90 Days after SARS-CoV-2 Infection: A Retrospective Observational Study Utilizing the Common Data Model
Minjung Han, Taehee Chang, Hae-ryoung Chun, Suyoung Jo, Yeongchang Jo, Dong Han Yu, Sooyoung Yoo, Sung-il Cho
Journal of Clinical Medicine.2024; 13(10): 2911. CrossRef - Data Resource Profile: Health Insurance Review and Assessment Service Covid-19 Observational Medical Outcomes Partnership (HIRA Covid-19 OMOP) database in South Korea
Chungsoo Kim, Dong Han Yu, Hyeran Baek, Jaehyeong Cho, Seng Chan You, Rae Woong Park
International Journal of Epidemiology.2024;[Epub] CrossRef - Effect of changes in the hearing aid subsidy on the prevalence of hearing loss in South Korea
Chul Young Yoon, Junhun Lee, Tae Hoon Kong, Young Joon Seo
Frontiers in Neurology.2023;[Epub] CrossRef - Scalable Infrastructure Supporting Reproducible Nationwide Healthcare Data Analysis toward FAIR Stewardship
Ji-Woo Kim, Chungsoo Kim, Kyoung-Hoon Kim, Yujin Lee, Dong Han Yu, Jeongwon Yun, Hyeran Baek, Rae Woong Park, Seng Chan You
Scientific Data.2023;[Epub] CrossRef - Comparative risk of incidence and clinical outcomes of COVID-19 among proton pump inhibitor and histamine-2 receptor antagonist short-term users: a nationwide retrospective cohort study
Jimyung Park, Seng Chan You, Jaehyeong Cho, Chan Hyuk Park, Woon Geon Shin, Rae Woong Park, Seung In Seo
BMC Pharmacology and Toxicology.2022;[Epub] CrossRef - Decreased patient visits for ankle sprain during the COVID-19 pandemic in South Korea: A nationwide retrospective study
Youngsik Hwang, Dasom Kim, Sukhyun Ryu
Preventive Medicine Reports.2022; 26: 101728. CrossRef - Early Real-World Data to Assess Benefits and Risks of COVID-19 Vaccines: A Systematic Review of Methods
Tatiane B. Ribeiro, Fátima Roque, Fidelia Ida, Ana I. Plácido, Mai Vu, Jose J. Hernández-Muñoz, Maria Teresa Herdeiro
Vaccines.2022; 10(11): 1896. CrossRef - Challenges in evaluating treatments for COVID-19: The case of in-hospital anticoagulant use and the risk of adverse outcomes
Ya-Hui Yu, In-Sun Oh, Han Eol Jeong, Robert W. Platt, Antonios Douros, Ju-Young Shin, Kristian B. Filion
Frontiers in Pharmacology.2022;[Epub] CrossRef - Use of repurposed and adjuvant drugs in hospital patients with covid-19: multinational network cohort study
Albert Prats-Uribe, Anthony G Sena, Lana Yin Hui Lai, Waheed-Ul-Rahman Ahmed, Heba Alghoul, Osaid Alser, Thamir M Alshammari, Carlos Areia, William Carter, Paula Casajust, Dalia Dawoud, Asieh Golozar, Jitendra Jonnagaddala, Paras P Mehta, Mengchun Gong, D
BMJ.2021; : n1038. CrossRef
Original Article
- The Socioeconomic Burden of Coronary Heart Disease in Korea
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Hoo-Sun Chang, Han-Joong Kim, Chung-Mo Nam, Seung-Ji Lim, Young-Hwa Jang, Sera Kim, Hye-Young Kang
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J Prev Med Public Health. 2012;45(5):291-300. Published online September 28, 2012
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DOI: https://doi.org/10.3961/jpmph.2012.45.5.291
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13,784
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Abstract
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- Objectives
We aimed to estimate the annual socioeconomic burden of coronary heart disease (CHD) in Korea in 2005, using the National Health Insurance (NHI) claims data.
MethodsA prevalence-based, top-down, cost-of-treatment method was used to assess the direct and indirect costs of CHD (International Classification of Diseases, 10th revision codes of I20-I25), angina pectoris (I20), and myocardial infarction (MI, I21-I23) from a societal perspective.
ResultsEstimated national spending on CHD in 2005 was $2.52 billion. The majority of the spending was attributable to medical costs (53.3%), followed by productivity loss due to morbidity and premature death (33.6%), transportation (8.1%), and informal caregiver costs (4.9%). While medical cost was the predominant cost attribute in treating angina (74.3% of the total cost), premature death was the largest cost attribute for patients with MI (66.9%). Annual per-capita cost of treating MI, excluding premature death cost, was $3183, which is about 2 times higher than the cost for angina ($1556).
ConclusionsThe total insurance-covered medical cost ($1.13 billion) of CHD accounted for approximately 6.02% of the total annual NHI expenditure. These findings suggest that the current burden of CHD on society is tremendous and that more effective prevention strategies are required in Korea.
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Evaluation Studies
- An Evaluation of Sampling Design for Estimating an Epidemiologic Volume of Diabetes and for Assessing Present Status of Its Control in Korea.
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Ji Sung Lee, Jaiyong Kim, Sei Hyun Baik, Ie Byung Park, Juneyoung Lee
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J Prev Med Public Health. 2009;42(2):135-142.
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DOI: https://doi.org/10.3961/jpmph.2009.42.2.135
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5,232
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- OBJECTIVES
An appropriate sampling strategy for estimating an epidemiologic volume of diabetes has been evaluated through a simulation. METHODS: We analyzed about 250 million medical insurance claims data submitted to the Health Insurance Review & Assessment Service with diabetes as principal or subsequent diagnoses, more than or equal to once per year, in 2003. The database was re-constructed to a 'patient-hospital profile' that had 3,676,164 cases, and then to a 'patient profile' that consisted of 2,412,082 observations. The patient profile data was then used to test the validity of a proposed sampling frame and methods of sampling to develop diabetic-related epidemiologic indices. RESULTS: Simulation study showed that a use of a stratified two-stage cluster sampling design with a total sample size of 4,000 will provide an estimate of 57.04% (95% prediction range, 49.83 - 64.24%) for a treatment prescription rate of diabetes. The proposed sampling design consists, at first, stratifying the area of the nation into "metropolitan/city/county" and the types of hospital into "tertiary/secondary/primary/clinic" with a proportion of 5:10:10:75. Hospitals were then randomly selected within the strata as a primary sampling unit, followed by a random selection of patients within the hospitals as a secondly sampling unit. The difference between the estimate and the parameter value was projected to be less than 0.3%. CONCLUSIONS: The sampling scheme proposed will be applied to a subsequent nationwide field survey not only for estimating the epidemiologic volume of diabetes but also for assessing the present status of nationwide diabetes control.
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Summary
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Citations
Citations to this article as recorded by

- Diabetes Epidemics in Korea: Reappraise Nationwide Survey of Diabetes "Diabetes in Korea 2007"
Ie Byung Park, Jaiyong Kim, Dae Jung Kim, Choon Hee Chung, Jee-Young Oh, Seok Won Park, Juneyoung Lee, Kyung Mook Choi, Kyung Wan Min, Jeong Hyun Park, Hyun Shik Son, Chul Woo Ahn, Hwayoung Kim, Sunhee Lee, Im Bong Lee, Injeoung Choi, Sei Hyun Baik
Diabetes & Metabolism Journal.2013; 37(4): 233. CrossRef - Development of a Sampling Strategy and Sample Size Calculation to Estimate the Distribution of Mammographic Breast Density in Korean Women
Jae Kwan Jun, Mi Jin Kim, Kui Son Choi, Mina Suh, Kyu-Won Jung
Asian Pacific Journal of Cancer Prevention.2012; 13(9): 4661. CrossRef
English Abstract
- Estimating the Economic Burden of Osteoporotic Vertebral Fracture among Elderly Korean Women.
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Hye Young Kang, Dae Ryong Kang, Young Hwa Jang, Sung Eun Park, Won Jung Choi, Seong Hwan Moon, Kyu Hyun Yang
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J Prev Med Public Health. 2008;41(5):287-294.
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DOI: https://doi.org/10.3961/jpmph.2008.41.5.287
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Abstract
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- OBJECTIVES
To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. METHODS: From 2002 to 2004, we identified all National Health Insurance claims records for women > or = 50 years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," Ysuch that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with > or = one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. RESULTS: During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. CONCLUSIONS: Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.
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- A Study of Prevalence and Awareness of Low Bone Density of Female Utilizing Dental Panoramic Radiographs
Sung Jin Kim, In-Ja Song, Eun Joo Lee, Suk-Ja Yoon
The Korean Journal of Oral and Maxillofacial Pathology.2024; 48(3): 23. CrossRef - A Review of Domestic and International Clinical Research Trends on Pharmacopuncture Treatment for Fractures
Hea Sun Chun
Journal of Physiology & Pathology in Korean Medicine.2023; 37(6): 185. CrossRef - Absolute Bed Rest Duration of 3 Days for Osteoporotic Vertebral Fractures: A Retrospective Study
Sung Tan Cho, Seung Joo Kim, Bum Joon Nam, Kun Woo Kim, Gyu Hyeon Lee, Jin Hwan Kim
Asian Spine Journal.2022; 16(6): 898. CrossRef - Estimating the future clinical and economic benefits of improving osteoporosis diagnosis and treatment among women in South Korea: a simulation projection model from 2020 to 2040
Micah Jackson, Kyu Hyun Yang, Matthew Gitlin, Zachary Wessler
Archives of Osteoporosis.2021;[Epub] CrossRef - Healthcare Resource Utilization and Direct Medical Costs for Patients With Osteoporotic Fractures in China
Jing Wu, Yi Qu, Ke Wang, Yu Chen
Value in Health Regional Issues.2019; 18: 106. CrossRef - A meta-analysis of breastfeeding and osteoporotic fracture risk in the females
X. Duan, J. Wang, X. Jiang
Osteoporosis International.2017; 28(2): 495. CrossRef - Economic Burden of Osteoporotic Fracture of the Elderly in South Korea: A National Survey
Jinhyun Kim, Eunhee Lee, Sungjae Kim, Tae Jin Lee
Value in Health Regional Issues.2016; 9: 36. CrossRef - Lifestyle and Genetic Predictors of Stiffness Index in Community-dwelling Elderly Korean Men and Women
Kyung-Ae Park, Yeon-Hwan Park, Min-Hee Suh, Smi Choi-Kwon
Asian Nursing Research.2015; 9(3): 251. CrossRef - The Epidemiology and Importance of Osteoporotic Spinal Compression Fracture in South Korea
Hun-Kyu Shin, Jong-Hyon Park
Journal of Korean Society of Spine Surgery.2015; 22(3): 99. CrossRef - The Socioeconomic Burden of Coronary Heart Disease in Korea
Hoo-Sun Chang, Han-Joong Kim, Chung-Mo Nam, Seung-Ji Lim, Young-Hwa Jang, Sera Kim, Hye-Young Kang
Journal of Preventive Medicine and Public Health.2012; 45(5): 291. CrossRef - Epidemiology and Economic Burden of Osteoporosis in South Korea
Yong-Chan Ha
Journal of the Korean Fracture Society.2011; 24(1): 114. CrossRef - How Much Amount of Socioeconomic Loss Is Caused by Digestive Diseases?
Kyung Sik Park
The Korean Journal of Gastroenterology.2011; 58(6): 297. CrossRef - Study of the Level of Osteoporosis Awareness among Women Dwelling in Urban Area
Miyoung Chung, Kyunghye Hwang, Euysoon Choi
Korean Journal of Women Health Nursing.2009; 15(4): 362. CrossRef
Original Articles
- Impacts of DRG Payment System on Behavior of Medical Insurance Claimants.
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Beom Man Ha, Gilwon Kang, Hyoung Keun Park, Chang Yup Kim, Yong Ik Kim
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Korean J Prev Med. 2000;33(4):393-401.
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Abstract
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- OBJECTIVES
To evaluate the impacts of the DRG payment system on the behavior of medical insurance claimants. Specifically, we evaluated the case-mix index, the numbers of diagnosis and procedure codes utilized, and the corresponding rate of diagnosis codes before, during and after implementation of the DRG payment system. METHODS: In order to evaluate the case-mix index, the number of diagnosis and procedure codes utilized, we used medical insurance claim data from all medical facilities that participated in the DRG-based Prospective Payment Demonstration Program. This medical insurance claim data consisted of both pre-demonstration program data (fee-for-service, from November, 1998 to January, 1999) and post-demonstration program data (DRG-based Prospective Payment, from February, 1999 to April, 1999). And in order to evaluate the corresponding rate of diagnosis codes utilized, we reviewed 820 medical records from 20 medical institutes that were selected by random sampling methods. RESULTS: The case-mix index rate decreased after the DRG-based Prospective Payment Demonstration Program was introduced. The average numbers of different claim diagnosis codes used decreased (new DRGs from 2.22 to 1.24, and previous DRGs from 1.69 to 1.21), as did the average number of claim procedure codes used (new DRGs from 3.02 to 2.16, and previous DRGs from 2.97 to 2.43). With respect to the time of participation in the program, the change in number of claim procedure codes was significant, but the change in number of claim diagnosis codes was not. The corresponding rate of claim diagnosis codes increased (from 57.9% to 82.6%), as did the exclusion rate of claim diagnosis codes (from 16.5% to 25.1%). CONCLUSIONS: After the implementation of the DRG payment system, the corresponding rate of insurance claim codes and the corresponding exclusion rate of claim diagnosis codes both increased, because the inducement system for entering the codes for claim review was changed.
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Summary
- The Accuracy of ICD codes for Cerebrovascular Diseases in Medical Insurance Claims.
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Jong Ku Park, Ki Soon Kim, Chun Bae Kim, Tae Yong Lee, Kang Sook Lee, Duk Hee Lee, Sunhee Lee, Sun Ha Jee, Il Suh, Kwang Wook Koh, So Yeon Ryu, Kee Ho Park, Woonje Park, Seungjun Wang, Hwasoon Lee, Yoomi Chae, Hyensook Hong, Jin Sook Suh
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Korean J Prev Med. 2000;33(1):76-82.
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We attempted to assess the accuracy of ICD codes for cerebrovascular diseases in medical insurance claims (ICMIC) and to investigate the reasons for error. This study was designed as a preliminary study to establish a nationwide surveillance system. METHODS: A total of 626 patients with medical insurance claims who indicated a diagnosis of cerebrovascular diseases during the period from 1993 to 1997 was selected from the Korea Medical Insurance Corporation cohort (KMIC cohort: 115,600 persons). The KMIC cohort was 10% of those insured who had taken health examinations in 1990 and 1992 consecutively. The registered medical record administrators were trained in the survey technique and gathered data from March to May 1999. The definition of cerebrovascular diseases in this study included cases which met one of two criteria (Minnesota, WHO) or 'definite stroke' in CT/MRI finding. We questioned the medical record administrators to explain the error if the final diagnoses were not coded as stroke. RESULTS: The accuracy rate of the ICMIC was 83.0% (425 cases). Medical records were not available for 8.2% (51 cases) due to the closing of hospitals, the absence of a computer system or omission of medical record, etc. Sixty-three cases (10.0%) were classified as impossible to interpret due to insufficient records in 'major clinical symptoms' or 'neurological deficits'. The most common reason was 'to meet review criteria of medical insurance benefits (52.9%)'. The department where errors in the ICMIC occurred most frequently was the department for medical insurance claims in the hospital. CONCLUSION: The accuracy rate of the ICMIC was 83.0%.
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Summary
- Industry of Employment and Spontaneous Abortion of Female Workers.
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Joung Soon Park, Myung Chae Na, Do Myung Paek, Ok Ryun Moon
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Korean J Prev Med. 1994;27(2):242-257.
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- In Korea, female workforce has reached more than 40% of total working population but the effects of work on spontaneous abortion are yet to be examined. This study was conducted to investigate the occupational effects on spontaneous abortion. Medical insurance claim data were used to examine the effects of the employment status and industry of employment on spontaneous abortion The study population was composed of females, aged 15~44, who were the beneficiary of medical insurance in the month of June, 1993. The working females covered by medical insurance for industrial workers, hand the highest age-adjusted Spontaneous Abortion rate(SAB rate=claim frequency of spontaneous abortion/claim frequency of complication of pregnancy, childbirth and the puerperium), 6.65% whereas female dependants of medical insurance for industrial workers had the lowest age-adjusted SAB rate, 4.54%. Among industrial workers, the workers in manufacturing industry had the highest age-adjusted Spontaneous Abortion ratio(SAB ratio=claim frequency of spontaneous abortion/claim frequency of completely normal delivery), 43.2/100 whereas those in financing and service industry had age-adjusted SAB ratio, 16.2/100 and 20.5/100, respectively. The results of the study suggest the adverse effect of manufacturing industry on reproduction. Work environment such as chemical exposures, overwork, awkward posture, and job stress should be further studied for their effects on reproductive functions of female.
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Summary
TOP