Background and Data Configuration Process of a Nationwide Population-Based Study Using the Korean National Health Insurance System

TLDR

The Korean National Health Insurance Service is a mandatory, fee‑for‑service single‑payer system covering the entire population and provides comprehensive, serial data that, through open‑access agreements, supports population‑based epidemiology and disease research. The study aims to describe the history, structure, contents, and data‑procurement procedures of the Korean NHI system to aid researchers. Researchers access the NHI data through four databases—claims, health check‑ups, and LTCI—providing comprehensive information on health insurance and chronic disease trends.

Abstract

The National Health Insurance Service (NHIS) recently signed an agreement to provide limited open access to the databases within the Korean Diabetes Association for the benefit of Korean subjects with diabetes. Here, we present the history, structure, contents, and way to use data procurement in the Korean National Health Insurance (NHI) system for the benefit of Korean researchers.The NHIS in Korea is a single-payer program and is mandatory for all residents in Korea. The three main healthcare programs of the NHI, Medical Aid, and long-term care insurance (LTCI) provide 100% coverage for the Korean population. The NHIS in Korea has adopted a fee-for-service system to pay health providers. Researchers can obtain health information from the four databases of the insured that contain data on health insurance claims, health check-ups and LTCI.Metabolic disease as chronic disease is increasing with aging society. NHIS data is based on mandatory, serial population data, so, this might show the time course of disease and predict some disease progress, and also be used in primary and secondary prevention of disease after data mining.The NHIS database represents the entire Korean population and can be used as a population-based database. The integrated information technology of the NHIS database makes it a world-leading population-based epidemiology and disease research platform.