Journal of Korean Medical Science

Korean Acad Medical Sciences (대한의학회)
권호 표지
DOI QR코드

DOI QR Code

Towards Actualizing the Value Potential of Korea Health Insurance Review and Assessment (HIRA) Data as a Resource for Health Research: Strengths, Limitations, Applications, and Strategies for Optimal Use of HIRA Data

  • Kim, Jee-Ae (Pharmaceutical Policy Research Team, Health Insurance Review & Assessment Service) ;
  • Yoon, Seokjun (Department of Preventive Medicine, College of Medicine, Korea University) ;
  • Kim, Log-Young (Pharmaceutical Policy Research Team, Health Insurance Review & Assessment Service) ;
  • Kim, Dong-Sook (Pharmaceutical Policy Research Team, Health Insurance Review & Assessment Service)
  • Received : 2016.09.04
  • Accepted : 2017.01.28
  • Published : 2017.05.10
⟨ Previous Next ⟩

Abstract

Health Insurance and Review Assessment (HIRA) in South Korea, also called National Health Insurance (NHI) data, is a repository of claims data collected in the process of reimbursing healthcare providers. Under the universal coverage system, having fee-for-services covering all citizens in South Korea, HIRA contains comprehensive and rich information pertaining to healthcare services such as treatments, pharmaceuticals, procedures, and diagnoses for almost 50 million beneficiaries. This corpus of HIRA data, which constitutes a large repository of data in the healthcare sector, has enormous potential to create value in several ways: enhancing the efficiency of the healthcare delivery system without compromising quality of care; adding supporting evidence for a given intervention; and providing the information needed to prevent (or monitor) adverse events. In order to actualize this potential, HIRA data need to actively be utilized for research. Thus understanding this data would greatly enhance this potential. We introduce HIRA data as an important source for health research and provide guidelines for researchers who are currently utilizing HIRA, or interested in doing so, to answer their research questions. We present the characteristics and structure of HIRA data. We discuss strengths and limitations that should be considered in conducting research with HIRA data and suggest strategies for optimal utilization of HIRA data by reviewing published research using HIRA data.

Keywords

References

  1. Booth CM, Cescon DW, Wang L, Tannock IF, Krzyzanowska MK. Evolution of the randomized controlled trial in oncology over three decades. J Clin Oncol 2008; 26: 5458-64. https://doi.org/10.1200/JCO.2008.16.5456
  2. Dans AL, Dans LF, Guyatt GH, Richardson S. Users' guides to the medical literature: XIV. How to decide on the applicability of clinical trial results to your patient. Evidence-Based Medicine Working Group. JAMA 1998; 279: 545-9. https://doi.org/10.1001/jama.279.7.545
  3. Meyer RM. Generalizing the results of cancer clinical trials. J Clin Oncol 2010; 28: 187-9. https://doi.org/10.1200/JCO.2009.25.8608
  4. Arana A, Rivero E, Egberts TC. What do we show and who does so? An analysis of the abstracts presented at the 19th ICPE. Pharmacoepidemiol Drug Saf 2004; 13: S330-1.
  5. Cook C, Sheets C. Clinical equipoise and personal equipoise: two necessary ingredients for reducing bias in manual therapy trials. J Manual Manip Ther 2011; 19: 55-7. https://doi.org/10.1179/106698111X12899036752014
  6. Garcia Rodriguez LA, Perez Gutthann S. Use of the UK General Practice Research Database for pharmacoepidemiology. Br J Clin Pharmacol 1998; 45: 419-25.
  7. Chen YC, Wu JC, Chen TJ, Wetter T. Reduced access to database. A publicly available database accelerates academic production. BMJ 2011; 342: d637. https://doi.org/10.1136/bmj.d637
  8. Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 1992; 45: 613-9. https://doi.org/10.1016/0895-4356(92)90133-8
  9. Elixhauser A, Steiner C, Harris DR, Coffey RM. Comorbidity measures for use with administrative data. Med Care 1998; 36: 8-27. https://doi.org/10.1097/00005650-199801000-00004
  10. Kendler KS, Gallagher TJ, Abelson JM, Kessler RC. Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample. The National Comorbidity Survey. Arch Gen Psychiatry 1996; 53: 1022-31. https://doi.org/10.1001/archpsyc.1996.01830110060007
  11. Park BJ, Sung J, Park K, Seo SW, Kim SH. Studying on diagnosis accuracy for health insurance claims data in Korea. Seoul: Seoul National University, 2003.
  12. Cho J, Lee WJ, Moon KT, Suh M, Sohn J, Ha KH, Kim C, Shin DC, Jung SH. Medical care utilization during 1 year prior to death in suicides motivated by physical illnesses. J Prev Med Public Health 2013; 46: 147-54. https://doi.org/10.3961/jpmph.2013.46.3.147
  13. Chung K, Kim K, Jung J, Oh K, Oh Y, Kim S, Kim J, Kim Y. Patterns and determinants of COPD-related healthcare utilization by severity of airway obstruction in Korea. BMC Pulm Med 2014; 14: 27. https://doi.org/10.1186/1471-2466-14-27
  14. Jung JY, Kang YA, Park MS, Oh YM, Park EC, Kim HR, Lee SD, Kim SK, Chang J, Kim YS. Chronic obstructive lung disease-related health care utilisation in Korean adults with obstructive lung disease. Int J Tuberc Lung Dis 2011; 15: 824-9. https://doi.org/10.5588/ijtld.10.0432
  15. Shin JY, Park MJ, Lee SH, Choi SH, Kim MH, Choi NK, Lee J, Park BJ. Risk of intracranial haemorrhage in antidepressant users with concurrent use of non-steroidal anti-inflammatory drugs: nationwide propensity score matched study. BMJ 2015; 351: h3517.
  16. Lee JY, Jo MW, Yoo WS, Kim HJ, Eun SJ. Evidence of a broken healthcare delivery system in Korea: unnecessary hospital outpatient utilization among patients with a single chronic disease without complications. J Korean Med Sci 2014; 29: 1590-6. https://doi.org/10.3346/jkms.2014.29.12.1590
  17. Kim J, Kim K, Kim Y, Yoo KH, Lee CK, Yoon HK, Kim YS, Park YB, Lee JH, Oh YM, et al. The association between inhaled long-acting bronchodilators and less in-hospital care in newly-diagnosed COPD patients. Respir Med 2014; 108: 153-61. https://doi.org/10.1016/j.rmed.2013.08.003
  18. Kim SY, Park JH, Kim SG, Woo HK, Park JH, Kim Y, Park EC. Disparities in utilization of high-volume hospitals for cancer surgery: results of a Korean population-based study. Ann Surg Oncol 2010; 17: 2806-15. https://doi.org/10.1245/s10434-010-1133-x
  19. Shin S, Jang S, Lee TJ, Kim H. Association between non-adherence to statin and hospitalization for cardiovascular disease and all-cause mortality in a national cohort. Int J Clin Pharmacol Ther 2014; 52: 948-56. https://doi.org/10.5414/CP202132
  20. Han E, Suh DC, Lee SM, Jang S. The impact of medication adherence on health outcomes for chronic metabolic diseases: a retrospective cohort study. Res Social Adm Pharm 2014; 10: e87-98. https://doi.org/10.1016/j.sapharm.2014.02.001
  21. Ahn SH, Choi NK, Kim YJ, Seong JM, Shin JY, Jung SY, Park BJ. Drug persistency of cholinesterase inhibitors for patients with dementia of Alzheimer type in Korea. Arch Pharm Res 2015; 38: 1255-62. https://doi.org/10.1007/s12272-014-0500-8
  22. Cho SK, Sung YK, Choi CB, Bae SC. Impact of comorbidities on TNF inhibitor persistence in rheumatoid arthritis patients: an analysis of Korean National Health Insurance claims data. Rheumatol Int 2012; 32: 3851-6. https://doi.org/10.1007/s00296-011-2312-1
  23. Shin DW, Park JH, Park JH, Park EC, Kim SY, Kim SG, Choi JY. Antihypertensive medication adherence in cancer survivors and its affecting factors: results of a Korean population-based study. Support Care Cancer 2011; 19: 211-20. https://doi.org/10.1007/s00520-009-0802-4
  24. Park JH, Shin Y, Lee SY, Lee SI. Antihypertensive drug medication adherence and its affecting factors in South Korea. Int J Cardiol 2008; 128: 392-8. https://doi.org/10.1016/j.ijcard.2007.04.114
  25. Rhee CK, Yoon HK, Yoo KH, Kim YS, Lee SW, Park YB, Lee JH, Kim Y, Kim K, Kim J, et al. Medical utilization and cost in patients with overlap syndrome of chronic obstructive pulmonary disease and asthma. COPD 2014; 11: 163-70. https://doi.org/10.3109/15412555.2013.831061
  26. Kim JH, Park JS, Kim KH, Jeong HC, Kim EK, Lee JH. Inhaled corticosteroid is associated with an increased risk of TB in patients with COPD. Chest 2013; 143: 1018-24. https://doi.org/10.1378/chest.12-1225
  27. Kim J, Rhee CK, Yoo KH, Kim YS, Lee SW, Park YB, Lee JH, Oh Y, Lee SD, Kim Y, et al. The health care burden of high grade chronic obstructive pulmonary disease in Korea: analysis of the Korean Health Insurance Review and Assessment Service data. Int J Chron Obstruct Pulmon Dis 2013; 8: 561-8.
  28. Kim J, Lee JH, Kim Y, Kim K, Oh YM, Yoo KH, Rhee CK, Yoon HK, Kim YS, Park YB, et al. Association between chronic obstructive pulmonary disease and gastroesophageal reflux disease: a national cross-sectional cohort study. BMC Pulm Med 2013; 13: 51. https://doi.org/10.1186/1471-2466-13-51
  29. Martens EP, Pestman WR, de Boer A, Belitser SV, Klungel OH. Instrumental variables: application and limitations. Epidemiology 2006; 17: 260-7. https://doi.org/10.1097/01.ede.0000215160.88317.cb
  30. Kim HA, Kim S, Seo YI, Choi HJ, Seong SC, Song YW, Hunter D, Zhang Y. The epidemiology of total knee replacement in South Korea: national registry data. Rheumatology (Oxford) 2008; 47: 88-91. https://doi.org/10.1093/rheumatology/kem308
  31. Kim SA, Kilgore PE, Lee SY, Nyambat B, Ki M. Trends in pneumonia and influenza-associated hospitalizations in South Korea, 2002-2005. J Health Popul Nutr 2011; 29: 574-82.
  32. Kwon GY, Lee H, Gwack J, Lee SW, Ki M, Youn SK. Regional distribution of hepatitis C virus infection in the Republic of Korea, 2007-2011. Gut Liver 2014; 8: 428-32. https://doi.org/10.5009/gnl.2014.8.4.428
  33. Lee EJ, Park HM. Trends in laparoscopic surgery for hysterectomy in Korea between 2007 and 2009. J Obstet Gynaecol Res 2014; 40: 1695-9. https://doi.org/10.1111/jog.12376
  34. Lee JH, Park YS, Choi JS. The epidemiology of appendicitis and appendectomy in South Korea: national registry data. J Epidemiol 2010; 20: 97-105. https://doi.org/10.2188/jea.JE20090011
  35. Lee WJ, Ko Y, Cha ES. Acute pesticide poisoning among children in South Korea: findings from National Health Insurance claims data, 2006-2009. J Trop Pediatr 2014; 60: 4-9. https://doi.org/10.1093/tropej/fmt067
  36. Lee YK, Ha YC, Yoon BH, Koo KH. National trends of hip arthroscopy in Korea. J Korean Med Sci 2014; 29: 277-80. https://doi.org/10.3346/jkms.2014.29.2.277
  37. Lee YK, Yoon BH, Nho JH, Kim KC, Ha YC, Koo KH. National trends of surgical treatment for intertrochanteric fractures in Korea. J Korean Med Sci 2013; 28: 1407-8. https://doi.org/10.3346/jkms.2013.28.9.1407
  38. Research Data Assistance Center (ResDAC) (US) [Internet]. Available at http://www.resdac.org/ [accessed on 6 November 2016].
  39. Chronic Condition Data Warehouse (CCW) (US) [Internet]. Available at Available at http://www.ccwdata.org/ [accessed on 6 November 2016].
  40. Ahn YH, Kim ES, Ham OK, Kim SH, Hwang SS, Chun SH, Gwon NY, Choi JY. Factors associated with the overuse or underuse of health care services among medical aid beneficiaries in Korea. J Community Health Nurs 2011; 28: 190-203. https://doi.org/10.1080/07370016.2011.614837
  41. Cho GJ, Kim LY, Hong HR, Lee CE, Hong SC, Oh MJ, Kim HJ. Trends in the rates of peripartum hysterectomy and uterine artery embolization. PLoS One 2013; 8: e60512. https://doi.org/10.1371/journal.pone.0060512
  42. Choi HG, Hah JH, Jung YH, Kim DW, Sung MW. Influences of demographic changes and medical insurance status on tonsillectomy and adenoidectomy rates in Korea. Eur Arch Otorhinolaryngol 2014; 271: 2293-8. https://doi.org/10.1007/s00405-013-2759-7
  43. Chung W. Psychiatric inpatient expenditures and public health insurance programmes: analysis of a national database covering the entire South Korean population. BMC Health Serv Res 2010; 10: 263. https://doi.org/10.1186/1472-6963-10-263
  44. Chung W, Chang HS, Oh SM, Yoon CW. Factors associated with long-stay status in patients with schizophrenia: an analysis of national databases covering the entire Korean population. Int J Soc Psychiatry 2013; 59: 207-16. https://doi.org/10.1177/0020764011431794
  45. Han K, Cho M, Chun K. Determinants of health care expenditures and the contribution of associated factors: 16 cities and provinces in Korea, 2003-2010. J Prev Med Public Health 2013; 46: 300-8. https://doi.org/10.3961/jpmph.2013.46.6.300
  46. Hong JS, Kang HC. Relationship between the use of new or used computed tomography scanners and image retake rates in South Korea. Acta Radiol 2013; 54: 428-34. https://doi.org/10.1258/ar.2012.120290
  47. Kim V, Kim H, Lee K, Chang S, Hur M, Kang J, Kim S, Lee SW, Kim YE. Variation in the numbers of red blood cell units transfused at different medical institution types from 2006 to 2010 in Korea. Ann Lab Med 2013; 33: 331-42. https://doi.org/10.3343/alm.2013.33.5.331
  48. Koh IJ, Kim TK, Chang CB, Cho HJ, In Y. Trends in use of total knee arthroplasty in Korea from 2001 to 2010. Clin Orthop Relat Res 2013; 471: 1441-50. https://doi.org/10.1007/s11999-012-2622-y
  49. Lee HS. The impact of emergency room utilization by depression patients on medical treatment expense in Korea. Osong Public Health Res Perspect 2013; 4: 240-5. https://doi.org/10.1016/j.phrp.2013.09.007
  50. Lee K, Kim H, Heo JH, Bae HJ, Koh IS, Chang S. Application of magnetic resonance imaging and magnetic resonance angiography as diagnostic measures for the first attack of suspected cerebrovascular diseases in Korea. Yonsei Med J 2011; 52: 727-33. https://doi.org/10.3349/ymj.2011.52.5.727
  51. Park HS, Choi BY, Kwon YD. Rapid increase in the national treatment costs for hepatitis A infections in Korea. Tohoku J Exp Med 2012; 226: 85-93. https://doi.org/10.1620/tjem.226.85
  52. Kim C, Yoo KH, Rhee CK, Yoon HK, Kim YS, Lee SW, Oh YM, Lee SD, Lee JH, Kim KJ, et al. Health care use and economic burden of patients with diagnosed chronic obstructive pulmonary disease in Korea. Int J Tuberc Lung Dis 2014; 18: 737-43. https://doi.org/10.5588/ijtld.13.0634
  53. Kim HA, Koh SH, Lee B, Kim IJ, Seo YI, Song YW, Hunter DJ, Zhang Y. Low rate of total hip replacement as reflected by a low prevalence of hip osteoarthritis in South Korea. Osteoarthritis Cartilage 2008; 16: 1572-5. https://doi.org/10.1016/j.joca.2008.04.024
  54. Kim YJ, Choi NK, Kim MS, Lee J, Chang Y, Seong JM, Jung SY, Shin JY, Park JE, Park BJ. Evaluation of low-dose aspirin for primary prevention of ischemic stroke among patients with diabetes: a retrospective cohort study. Diabetol Metab Syndr 2015; 7: 8. https://doi.org/10.1186/s13098-015-0002-y
  55. Lee K, Lee S. Effects of the DRG-based prospective payment system operated by the voluntarily participating providers on the cesarean section rates in Korea. Health Policy 2007; 81: 300-8. https://doi.org/10.1016/j.healthpol.2006.05.019
  56. Bae G, Park C, Lee H, Han E, Kim DS, Jang S. Effective policy initiatives to constrain lipid-lowering drug expenditure growth in South Korea. BMC Health Serv Res 2014; 14: 100. https://doi.org/10.1186/1472-6963-14-100
  57. Heo JH, Suh DC, Kim S, Lee EK. Evaluation of the pilot program on the real-time drug utilization review system in South Korea. Int J Med Inform 2013; 82: 987-95. https://doi.org/10.1016/j.ijmedinf.2013.07.001
  58. Kim YJ, Oh Y, Park S, Cho S, Park H. Stratified sampling design based on data mining. Healthc Inform Res 2013; 19: 186-95. https://doi.org/10.4258/hir.2013.19.3.186
  59. Seo HJ, Yoon SJ, Lee SI, Lee KS, Yun YH, Kim EJ, Oh IH. A comparison of the Charlson comorbidity index derived from medical records and claims data from patients undergoing lung cancer surgery in Korea: a population-based investigation. BMC Health Serv Res 2010; 10: 236. https://doi.org/10.1186/1472-6963-10-236
  60. Park HK, Yoon SJ, Ahn HS, Ahn LS, Seo HJ, Lee SI, Lee KS. Comparison of risk-adjustment models using administrative or clinical data for outcome prediction in patients after myocardial infarction or coronary bypass surgery in Korea. Int J Clin Pract 2007; 61: 1086-90. https://doi.org/10.1111/j.1742-1241.2007.01345.x

Cited by

  1. Psychiatric comorbidities among patients undergoing liver transplantation in South Korea: a nationwide population-based study vol.12, pp.2, 2018, https://doi.org/10.1007/s12072-018-9849-y
  2. Epidemiology of allergic diseases in Korean children vol.6, pp.suppl1, 2017, https://doi.org/10.4168/aard.2018.6.s1.s9
  3. Epidemiology of allergic diseases in Korean children vol.6, pp.suppl1, 2017, https://doi.org/10.4168/aard.2018.6.s1.s9
  4. Exposure to air pollution during preconceptional and prenatal periods and risk of hypertensive disorders of pregnancy: a retrospective cohort study in Seoul, Korea vol.18, pp.None, 2017, https://doi.org/10.1186/s12884-018-1982-z
  5. Association of oral ciprofloxacin, levofloxacin, ofloxacin and moxifloxacin with the risk of serious ventricular arrhythmia: a nationwide cohort study in Korea vol.8, pp.9, 2017, https://doi.org/10.1136/bmjopen-2017-020974
  6. Risk of Fracture Prevalence and Glycemic Control in Korean Older and Middle-aged Patients with Diabetes: A Retrospective Analysis of a Cohort Derived from the Korean National Health Insurance Sharing vol.28, pp.3, 2017, https://doi.org/10.24304/kjcp.2018.28.3.194
  7. Venous thromboembolism in relapsed or refractory multiple myeloma patients treated with lenalidomide plus dexamethasone vol.109, pp.1, 2019, https://doi.org/10.1007/s12185-018-2540-1
  8. Cost-effectiveness of influenza vaccine strategies for the elderly in South Korea vol.14, pp.1, 2017, https://doi.org/10.1371/journal.pone.0209643
  9. High-Risk Human Papillomavirus Infection and the Risk of Cardiovascular Disease in Korean Women : A Cohort Study vol.124, pp.5, 2017, https://doi.org/10.1161/circresaha.118.313779
  10. Validation of algorithms to identify knee osteoarthritis patients in the claims database vol.22, pp.5, 2017, https://doi.org/10.1111/1756-185x.13470
  11. Is androgen deprivation therapy associated with cerebral infarction in patients with prostate cancer? A Korean nationwide population‐based propensity score matching study vol.8, pp.9, 2017, https://doi.org/10.1002/cam4.2325
  12. Increased Risk of Herpes Zoster in Young and Metabolically Healthy Patients with Inflammatory Bowel Disease: A Nationwide Population-Based Study vol.13, pp.3, 2017, https://doi.org/10.5009/gnl18304
  13. Emerging trends of inflammatory bowel disease in South Korea: A nationwide population‐based study vol.34, pp.6, 2019, https://doi.org/10.1111/jgh.14542
  14. Incidence and clinical impact of perianal disease in patients with ulcerative colitis: A nationwide population‐based study vol.34, pp.6, 2019, https://doi.org/10.1111/jgh.14555
  15. Which growth parameters can affect mortality in cerebral palsy? vol.14, pp.6, 2017, https://doi.org/10.1371/journal.pone.0218320
  16. National practice patterns and direct medical costs for prostate cancer in Korea across a 10 year period: a nationwide population-based study using a national health insurance database vol.19, pp.None, 2017, https://doi.org/10.1186/s12913-019-4218-7
  17. Effectiveness and Safety of Clopidogrel Co‐administered With Statins and Proton Pump Inhibitors: A Korean National Health Insurance Database Study vol.106, pp.1, 2017, https://doi.org/10.1002/cpt.1361
  18. Metabolic Obesity Phenotypes and Risk of Cellulitis: A Cohort Study vol.8, pp.7, 2017, https://doi.org/10.3390/jcm8070953
  19. Epidemiology of pharmaceutically treated depression and treatment resistant depression in South Korea vol.14, pp.8, 2017, https://doi.org/10.1371/journal.pone.0221552
  20. Effect of Having a Usual Source of Care on Medical Expenses - Using the Korea Health Panel Data vol.34, pp.35, 2019, https://doi.org/10.3346/jkms.2019.34.e229
  21. Injury epidemiology of workers by age, sex and industrial classification using the medical claim data of National Health Insurance in South Korea, 2012–2015: a population-based retrospective st vol.9, pp.9, 2017, https://doi.org/10.1136/bmjopen-2019-029413
  22. Healthcare resource use and costs of diabetic macular oedema for patients with antivascular endothelial growth factor versus a dexamethasone intravitreal implant in Korea: a population-based study vol.9, pp.9, 2019, https://doi.org/10.1136/bmjopen-2019-030930
  23. Effects of Pregnancy and Delivery Methods on Change in Ankylosing Spondylitis Treatment Using the Korean Health Insurance Review and Assessment Service Claims Database vol.34, pp.37, 2017, https://doi.org/10.3346/jkms.2019.34.e238
  24. Malignancy risk in Korean male patients with ankylosing spondylitis vol.39, pp.10, 2017, https://doi.org/10.1007/s00296-019-04408-3
  25. Epidemiology and medical service use for spontaneous pneumothorax: a 12-year study using nationwide cohort data in Korea vol.9, pp.10, 2017, https://doi.org/10.1136/bmjopen-2018-028624
  26. Nationwide Trends in Pancreatitis and Pancreatic Cancer Risk Among Patients With Newly Diagnosed Type 2 Diabetes Receiving Dipeptidyl Peptidase 4 Inhibitors vol.42, pp.11, 2017, https://doi.org/10.2337/dc18-2195
  27. Risk of Cancers in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: Results from the Korea National Health Insurance Claims Database 2010–2018 vol.8, pp.11, 2017, https://doi.org/10.3390/jcm8111871
  28. Validation of claims data to identify death among aged persons utilizing enrollment data from health insurance unions vol.24, pp.1, 2017, https://doi.org/10.1186/s12199-019-0819-3
  29. Prevalence and incidence of atherosclerotic cardiovascular disease and its risk factors in Korea: a nationwide population-based study vol.19, pp.1, 2017, https://doi.org/10.1186/s12889-019-7439-0
  30. Prevalence and incidence of Parkinson’s disease and drug-induced parkinsonism in Korea vol.19, pp.1, 2019, https://doi.org/10.1186/s12889-019-7664-6
  31. Factors related to the use of opioids as early treatment in patients with knee osteoarthritis vol.21, pp.1, 2017, https://doi.org/10.1186/s13075-019-2004-x
  32. Interest and limits of assessing acute kidney injury in administrative dataset vol.9, pp.1, 2017, https://doi.org/10.1186/s13613-019-0535-6
  33. Prognostic Impact of Pregnancy in Korean Patients with Breast Cancer vol.24, pp.12, 2017, https://doi.org/10.1634/theoncologist.2019-0167
  34. National Health Insurance Databases in Indonesia, Vietnam and the Philippines vol.3, pp.4, 2019, https://doi.org/10.1007/s41669-019-0127-2
  35. 최근 5개년 (2013~2017)간 기관지확장증(J47) 환자에게 처방한 급여한약제제 현황 분석 - 건강보험청구자료 중심으로 vol.23, pp.3, 2019, https://doi.org/10.25153/spkom.2019.23.3.001
  36. The Incidence and Management Trends of Metastatic Spinal Tumors in South Korea : A Nationwide Population-based Study vol.45, pp.14, 2017, https://doi.org/10.1097/brs.0000000000003445
  37. Using clinical registries, administrative data and electronic medical records to improve medication safety and effectiveness in dementia : vol.33, pp.2, 2020, https://doi.org/10.1097/yco.0000000000000579
  38. Effects of a Safety Letter on Metoclopramide Use in Korea: An Interrupted Time-Series Analysis vol.13, pp.None, 2020, https://doi.org/10.2147/rmhp.s263579
  39. Validity of Diagnostic Codes for Identification of Psoriasis Patients in Korea vol.32, pp.2, 2017, https://doi.org/10.5021/ad.2020.32.2.115
  40. Increasing burden of biliary tract infection caused by extended‐spectrum beta‐lactamase‐producing organisms in Korea: A nationwide population‐based study vol.35, pp.1, 2020, https://doi.org/10.1111/jgh.14809
  41. Comprehensive Trends and Patterns of Antihypertensive Prescriptions Using a Nationwide Claims Database in Korea vol.12, pp.None, 2020, https://doi.org/10.2147/clep.s265966
  42. Incidence of Tuberculosis in Systemic Necrotizing Vasculitides: A Population-Based Study From an Intermediate-Burden Country vol.7, pp.None, 2017, https://doi.org/10.3389/fmed.2020.550004
  43. Incidence of acute spinal cord injury and associated complications of methylprednisolone therapy: a national population-based study in South Korea vol.58, pp.2, 2020, https://doi.org/10.1038/s41393-019-0357-2
  44. Incidence and Outcomes of Perianal Disease in an Asian Population with Crohn’s Disease: A Nationwide Population-Based Study vol.65, pp.4, 2017, https://doi.org/10.1007/s10620-019-05819-9
  45. Reasons for the High Cesarean Delivery Rate among Women with Ankylosing Spondylitis: Using the Korean National Health Insurance Database vol.47, pp.5, 2017, https://doi.org/10.3899/jrheum.190754
  46. Diabetes mellitus increases mortality in acute pyelonephritis patients: a population study based on the National Health Insurance Claim Data of South Korea for 2010-2014 vol.48, pp.3, 2020, https://doi.org/10.1007/s15010-020-01419-2
  47. Modeling Healthcare Costs Attributable to Secondhand Smoke Exposure at Home among South Korean Children vol.17, pp.12, 2017, https://doi.org/10.3390/ijerph17124496
  48. Comparison of urologic complications between laparoscopic radical hysterectomy and abdominal radical hysterectomy: A nationwide study from the National Health Insurance vol.158, pp.1, 2017, https://doi.org/10.1016/j.ygyno.2020.04.686
  49. Infection, antibiotic exposure and development of atopic dermatitis: A nationwide case-control study vol.47, pp.7, 2017, https://doi.org/10.1111/1346-8138.15387
  50. Patterns of percutaneous transthoracic needle biopsy (PTNB) of the lung and risk of PTNB-related severe pneumothorax: A nationwide population-based study vol.15, pp.7, 2020, https://doi.org/10.1371/journal.pone.0235599
  51. Acromioplasty rates in patients with shoulder disorders with and without acupuncture treatment: a retrospective propensity score-matched cohort study vol.38, pp.4, 2017, https://doi.org/10.1177/0964528419895529
  52. Factors influencing the use of health services by trauma patients according to insurance type and injury severity score in South Korea: Based on Andersen’s behavioral model vol.15, pp.8, 2017, https://doi.org/10.1371/journal.pone.0238258
  53. Factors influencing the use of health services by trauma patients according to insurance type and injury severity score in South Korea: Based on Andersen’s behavioral model vol.15, pp.8, 2017, https://doi.org/10.1371/journal.pone.0238258
  54. Patterns of the Diagnosis Prevalence of Psychiatric Disorders in the Population Aged 0-18 Years Based on the Nationwide Insurance Sample Data vol.31, pp.4, 2017, https://doi.org/10.5765/jkacap.200017
  55. The economic impact of disease progression and death in hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) advanced breast cancer patients: using Korean nationw vol.36, pp.11, 2017, https://doi.org/10.1080/03007995.2020.1826917
  56. Medication utilization among adult patients with attention-deficit/hyperactivity disorder after reimbursement criteria change vol.35, pp.6, 2017, https://doi.org/10.1097/yic.0000000000000332
  57. The risk of stroke/systemic embolism and major bleeding in Asian patients with non-valvular atrial fibrillation treated with non-vitamin K oral anticoagulants compared to warfarin: Results from a real vol.15, pp.11, 2017, https://doi.org/10.1371/journal.pone.0242922
  58. Epidemiology of community-acquired pneumonia in the era of extended serotype-covering multivalent pneumococcal conjugate vaccines vol.38, pp.49, 2017, https://doi.org/10.1016/j.vaccine.2020.10.046
  59. Frequent Outpatient Visits Prevent Exacerbation of Chronic Obstructive Pulmonary Disease vol.10, pp.None, 2017, https://doi.org/10.1038/s41598-020-63064-x
  60. Increased incidence of bladder cancer with metabolically unhealthy status: analysis from the National Health Checkup database in Korea vol.10, pp.None, 2017, https://doi.org/10.1038/s41598-020-63595-3
  61. Gender differences in adverse event reports associated with antidiabetic drugs vol.10, pp.1, 2017, https://doi.org/10.1038/s41598-020-74000-4
  62. Outcomes after aortic aneurysm repair in patients with history of cancer: a nationwide dataset analysis vol.20, pp.1, 2017, https://doi.org/10.1186/s12893-020-00754-3
  63. Cost analysis of depression using the national insurance system in South Korea: a comparison of depression and treatment-resistant depression vol.20, pp.None, 2017, https://doi.org/10.1186/s12913-020-05153-1
  64. Exposure-weighted scoring for metabolic syndrome and the risk of myocardial infarction and stroke: a nationwide population-based study vol.19, pp.1, 2020, https://doi.org/10.1186/s12933-020-01129-x
  65. The triglyceride-glucose index predicts ischemic heart disease risk in Koreans: a prospective study using National Health Insurance Service data vol.19, pp.1, 2020, https://doi.org/10.1186/s12933-020-01186-2
  66. The effect of bed-to-nurse ratio on hospital mortality of critically ill children on mechanical ventilation: a nationwide population-based study vol.10, pp.1, 2017, https://doi.org/10.1186/s13613-020-00780-7
  67. Comparative effectiveness of budesonide inhalation suspension and montelukast in children with mild asthma in Korea vol.57, pp.12, 2020, https://doi.org/10.1080/02770903.2019.1648504
  68. Seasonal variation of peptic ulcer disease, peptic ulcer bleeding, and acute pancreatitis : A nationwide population-based study using a common data model vol.100, pp.21, 2021, https://doi.org/10.1097/md.0000000000025820
  69. Relationship between hospital specialization and health outcomes in patients with nonsurgical spinal joint disease in South Korea : A nationwide evidence-based study using national health insurance da vol.100, pp.32, 2021, https://doi.org/10.1097/md.0000000000026832
  70. Trends and Characteristics of Endoscopic Retrograde Cholangiopancreatography: A Nationwide Database Study in Korea vol.26, pp.3, 2017, https://doi.org/10.15279/kpba.2021.26.3.186
  71. Impact of COVID-19 on Heart Failure Patients in South Korea : A Nationwide Population-Based Study vol.62, pp.5, 2017, https://doi.org/10.1536/ihj.21-198
  72. Pediatric Sedation in the Emergency Department: Trends from a Nationwide Population-based Study in Korea, 2007-2018 vol.36, pp.33, 2021, https://doi.org/10.3346/jkms.2021.36.e213
  73. An Increasing Trend in the Number of Anterior Cruciate Ligament Reconstruction in Korea: A Nationwide Epidemiologic Study vol.13, pp.None, 2017, https://doi.org/10.4055/cios20276
  74. Incidence rates of severe cutaneous adverse reactions due to antiseizure medication: A nationwide study using health claims data in Korea vol.62, pp.1, 2021, https://doi.org/10.1111/epi.16751
  75. Gastro-oesophageal reflux disease increases healthcare use and medical costs in patients with bronchiectasis: a Korean nationwide population-based study vol.14, pp.None, 2017, https://doi.org/10.1177/17562848211062801
  76. Real-world data analysis of the clinical and economic burden and risk factors in patients with major depressive disorder with an inadequate response to initial antidepressants vol.24, pp.1, 2021, https://doi.org/10.1080/13696998.2021.1918922
  77. Comparison of healthcare resource utilization and medical costs between patients with seropositive and seronegative rheumatoid arthritis vol.13, pp.None, 2017, https://doi.org/10.1177/1759720x211024830
  78. Joint Effect of Hepatic Steatosis and Alanine Aminotransferase Within the Normal Range on Incident Ischemic Heart Disease: A Prospective Study in Koreans vol.16, pp.None, 2017, https://doi.org/10.2147/cia.s301741
  79. Risk of Stroke in Systemic Necrotizing Vasculitis: A Nationwide Study Using the National Claims Database vol.12, pp.None, 2021, https://doi.org/10.3389/fimmu.2021.629902
  80. New Obligations of Health Insurance Review and Assessment Service: Taking Full-fledged Action Against the COVID-19 Pandemic vol.54, pp.1, 2017, https://doi.org/10.3961/jpmph.20.594
  81. Association of COVID‐19 with skin diseases and relevant biologics: a cross‐sectional study using nationwide claim data in South Korea* vol.184, pp.2, 2017, https://doi.org/10.1111/bjd.19507
  82. Survival in untreated hepatocellular carcinoma: A national cohort study vol.16, pp.2, 2017, https://doi.org/10.1371/journal.pone.0246143
  83. Incidence of Cancer and Asbestos-Related Diseases among Residents Living near Abandoned Asbestos Mines in South Korea: A Retrospective Cohort Study Using National Health Insurance Database vol.18, pp.3, 2017, https://doi.org/10.3390/ijerph18030875
  84. Incidence and Prevalence of Juvenile Systemic Lupus Erythematosus in Korea: Data From the 2017 National Health Claims Database vol.48, pp.2, 2021, https://doi.org/10.3899/jrheum.191186
  85. Tooth loss and risk of end‐stage renal disease: A nationwide cohort study vol.92, pp.3, 2017, https://doi.org/10.1002/jper.19-0679
  86. Effect of angiotensin converting enzyme inhibitor and angiotensin II receptor blocker on the patients with sepsis vol.36, pp.2, 2017, https://doi.org/10.3904/kjim.2019.262
  87. Effects of a DPP-4 Inhibitor and RAS Blockade on Clinical Outcomes of Patients with Diabetes and COVID-19 vol.45, pp.2, 2017, https://doi.org/10.4093/dmj.2020.0206
  88. An increasing trend of posterior cruciate ligament reconstruction in South Korea: epidemiologic analysis using Korean National Health Insurance System Database vol.33, pp.1, 2021, https://doi.org/10.1186/s43019-021-00126-y
  89. Association between CVDs and initiation and adherence to statin treatment in patients with newly diagnosed hypercholesterolaemia: a retrospective cohort study vol.11, pp.4, 2017, https://doi.org/10.1136/bmjopen-2020-045375
  90. Incidence and prevalence of systemic lupus erythematosus among Korean women in childbearing years: A nationwide population-based study vol.30, pp.4, 2021, https://doi.org/10.1177/0961203320984845
  91. Incidence and prevalence of immune thrombocytopenia under the copayment waiver policy for pediatric patients in Korea: Data from the National Health Claims Database vol.30, pp.4, 2017, https://doi.org/10.1177/0961203321995247
  92. Medication Adherence and Persistence of Open-Angle Glaucoma Patients in Korea: A Retrospective Study Using National Health Insurance Claims Data vol.18, pp.8, 2017, https://doi.org/10.3390/ijerph18084106
  93. Pregnancy outcomes in Korean women with ankylosing spondylitis vol.36, pp.3, 2017, https://doi.org/10.3904/kjim.2019.144
  94. Use of Renin-Angiotensin-Aldosterone System Inhibitors and Severe COVID-19 Outcomes in Patients with Hypertension: A Nationwide Cohort Study vol.45, pp.3, 2021, https://doi.org/10.4093/dmj.2020.0279
  95. The seasonal pattern of restless legs syndrome in a sample from the Korean Health Insurance Review and Assessment Service national database vol.17, pp.5, 2017, https://doi.org/10.5664/jcsm.9136
  96. Independent Risk Factors for Hepatocellular Carcinoma Recurrence after Direct-Acting Antiviral Therapy in Patients with Chronic Hepatitis C vol.15, pp.3, 2017, https://doi.org/10.5009/gnl20151
  97. Cardiovascular safety of evogliptin in patients with type 2 diabetes: A nationwide cohort study vol.23, pp.6, 2017, https://doi.org/10.1111/dom.14330
  98. Association between Influenza Vaccination and the Risk of Bell’s Palsy in the Korean Elderly vol.9, pp.7, 2017, https://doi.org/10.3390/vaccines9070746
  99. Clinical Study Using Healthcare Claims Database vol.28, pp.3, 2017, https://doi.org/10.4078/jrd.2021.28.3.119
  100. Gastrointestinal and Nongastrointestinal Complications of Esophagogastroduodenoscopy and Colonoscopy in the Real World: A Nationwide Standard Cohort Using the Common Data Model Database vol.15, pp.4, 2017, https://doi.org/10.5009/gnl20222
  101. Risk of tuberculosis in patients with cancer treated with immune checkpoint inhibitors: a nationwide observational study vol.9, pp.9, 2021, https://doi.org/10.1136/jitc-2021-002960
  102. Use of olanzapine compared with clozapine for treatment-resistant schizophrenia in a real-world setting: nationwide register-based study vol.7, pp.5, 2017, https://doi.org/10.1192/bjo.2021.964
  103. Treatment Pattern of Antithrombotic Therapy over Time after Percutaneous Coronary Intervention in Patients with Atrial Fibrillation in Real-World Practice in Korea vol.9, pp.9, 2017, https://doi.org/10.3390/healthcare9091185
  104. Impact of Reduced-Dose Nonvitamin K Antagonist Oral Anticoagulants on Outcomes Compared to Warfarin in Korean Patients with Atrial Fibrillation: A Nationwide Population-Based Study vol.10, pp.17, 2017, https://doi.org/10.3390/jcm10173918
  105. Estimating the burden of nosocomial exposure to tuberculosis in South Korea, a nationwide population based cross-sectional study vol.36, pp.5, 2017, https://doi.org/10.3904/kjim.2020.144
  106. Effectiveness and safety of non‐vitamin K antagonist oral anticoagulants in patients with non‐valvular atrial fibrillation: A nationwide, population‐based study in Korea vol.37, pp.5, 2021, https://doi.org/10.1002/joa3.12607
  107. Statin use for primary prevention in patients with type 2 diabetes: Can it benefit all ages? – A nationwide propensity-matched cohort study vol.180, pp.None, 2021, https://doi.org/10.1016/j.diabres.2021.109044
  108. Coexisting and Second Primary Cancers in Patients with Uveal Melanoma: A 10-Year Nationwide Database Analysis vol.10, pp.20, 2021, https://doi.org/10.3390/jcm10204744
  109. Changes in respiratory diseases in South Korea during the COVID-19 pandemic: an interrupted time series study vol.6, pp.12, 2017, https://doi.org/10.1136/bmjgh-2021-006912
  110. Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study vol.10, pp.21, 2017, https://doi.org/10.3390/jcm10215110
  111. The risk factors and incidence of major infectious diseases in patients with ankylosing spondylitis receiving tumor necrosis factor inhibitors vol.31, pp.6, 2021, https://doi.org/10.1080/14397595.2021.1878985
  112. Real-World Incidence of Suboptimal Response to Anti-Tumor Necrosis Factor Therapy for Ulcerative Colitis: A Nationwide Population-Based Study vol.15, pp.6, 2021, https://doi.org/10.5009/gnl20353
  113. Androgen deprivation therapy may reduce the risk of primary open-angle glaucoma in patients with prostate cancer: a nationwide population-based cohort study vol.9, pp.4, 2021, https://doi.org/10.1016/j.prnil.2021.05.001
  114. Changes in diagnosis rate and treatment trends of benign prostatic hyperplasia in Korea: A nationwide population-based cohort study vol.9, pp.4, 2017, https://doi.org/10.1016/j.prnil.2021.08.002
  115. The effect of continuity of care on medical costs in patients with chronic shoulder pain vol.11, pp.1, 2021, https://doi.org/10.1038/s41598-021-83596-0
  116. Impact of comorbidity burden on mortality in patients with COVID-19 using the Korean health insurance database vol.11, pp.1, 2017, https://doi.org/10.1038/s41598-021-85813-2
  117. Incidence and management patterns of alcohol-related liver disease in Korea: a nationwide standard cohort study vol.11, pp.1, 2021, https://doi.org/10.1038/s41598-021-86197-z
  118. Radiotherapy for brain metastasis and long-term survival vol.11, pp.1, 2017, https://doi.org/10.1038/s41598-021-87357-x
  119. Androgen-deprivation therapy and the risk of newly developed fractures in patients with prostate cancer: a nationwide cohort study in Korea vol.11, pp.1, 2017, https://doi.org/10.1038/s41598-021-89589-3
  120. Strong association of type 2 diabetes with degenerative lumbar spine disorders vol.11, pp.1, 2017, https://doi.org/10.1038/s41598-021-95626-y
  121. A nationwide nested case‐control study of new‐onset obsessive‐compulsive disorder following antipsychotics use in schizophrenia vol.144, pp.6, 2017, https://doi.org/10.1111/acps.13375
  122. Seasonal variations in the diagnosis of the top 10 cancers in Korea: A nationwide population‐based study using a common data model vol.36, pp.12, 2021, https://doi.org/10.1111/jgh.15634
  123. Incidence rate of active tuberculosis in solid organ transplant recipients: Data from a nationwide population cohort in a high‐endemic country vol.23, pp.6, 2017, https://doi.org/10.1111/tid.13729
  124. Free combination of dutasteride plus tamsulosin for the treatment of benign prostatic hyperplasia in South Korea: analysis of drug utilization and adverse events using the National Health Insurance Re vol.21, pp.1, 2017, https://doi.org/10.1186/s12894-021-00941-1
  125. Trends of Total Knee Arthroplasty According to Age Structural Changes in Korea from 2011 to 2018 vol.18, pp.24, 2017, https://doi.org/10.3390/ijerph182413397
  126. Incidence and prevalence of pressure ulcers in hospitals: 10-year cohort study vol.30, pp.suppl12, 2017, https://doi.org/10.12968/jowc.2021.30.sup12.s38
  127. Association Between Nonsteroidal Antiinflammatory Drug Use and Adverse Clinical Outcomes Among Adults Hospitalized With Coronavirus 2019 in South Korea: A Nationwide Study vol.73, pp.11, 2021, https://doi.org/10.1093/cid/ciaa1056
  128. Association between Irritable Bowel Syndrome and Risk of Osteoporosis in Korean Premenopausal Women vol.30, pp.6, 2017, https://doi.org/10.1159/000517909
  129. Risk factors of chronic opioid use after surgical procedures in noncancer patients : A nationwide case-control study vol.39, pp.2, 2017, https://doi.org/10.1097/eja.0000000000001528
  130. Risk of Periprosthetic Joint Infection in Patients With Total Knee Arthroplasty Undergoing Colonoscopy: A Nationwide Propensity Score Matched Study vol.37, pp.1, 2022, https://doi.org/10.1016/j.arth.2021.09.015
  131. Risk of cardiovascular intervention after androgen deprivation therapy in prostate cancer patients with a prior history of ischemic cardiovascular and cerebrovascular disease: A nationwide population- vol.40, pp.1, 2022, https://doi.org/10.1016/j.urolonc.2021.07.002
  132. Evaluation of persistence and healthcare utilization in patients treated with anti-seizure medications as add-on therapy: A nationwide cohort study in South Korea vol.126, pp.None, 2022, https://doi.org/10.1016/j.yebeh.2021.108459
  133. Does the Use of Asthma-Controller Medication in Accordance with Guidelines Reduce the Incidence of Acute Exacerbations and Healthcare Costs? vol.85, pp.1, 2017, https://doi.org/10.4046/trd.2021.0087
  134. Discontinuation and re-initiation of antidepressants during pregnancy: A nationwide cohort study vol.298, pp.no.pa, 2017, https://doi.org/10.1016/j.jad.2021.10.069