scholarly journals Cohort profile: the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) in Korea

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016640 ◽  
Author(s):  
Sang Cheol Seong ◽  
Yeon-Yong Kim ◽  
Sue K Park ◽  
Young Ho Khang ◽  
Hyeon Chang Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Dental Health ◽  
Malignant Neoplasm ◽  
Communicable Diseases ◽  
Health Screening ◽  
Non Communicable Diseases ◽  
The Republic

PurposeThe National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) is a cohort of participants who participated in health screening programmes provided by the NHIS in the Republic of Korea. The NHIS constructed the NHIS-HEALS cohort database in 2015. The purpose of this cohort is to offer relevant and useful data for health researchers, especially in the field of non-communicable diseases and health risk factors, and policy-maker.ParticipantsTo construct the NHIS-HEALS database, a sample cohort was first selected from the 2002 and 2003 health screening participants, who were aged between 40 and 79 in 2002 and followed up through 2013. This cohort included 514 866 health screening participants who comprised a random selection of 10% of all health screening participants in 2002 and 2003.Findings to dateThe age-standardised prevalence of anaemia, diabetes mellitus, hypertension, obesity, hypercholesterolaemia and abnormal urine protein were 9.8%, 8.2%, 35.6%, 2.7%, 14.2% and 2.0%, respectively. The age-standardised mortality rate for the first 2 years (through 2004) was 442.0 per 100 000 person-years, while the rate for 10 years (through 2012) was 865.9 per 100 000 person-years. The most common cause of death was malignant neoplasm in both sexes (364.1 per 100 000 person-years for men, 128.3 per 100 000 person-years for women).Future plansThis database can be used to study the risk factors of non-communicable diseases and dental health problems, which are important health issues that have not yet been fully investigated. The cohort will be maintained and continuously updated by the NHIS.

scholarly journals The Role of Public Health Centers (Puskesmas) as the Gatekeeper of National Health Insurance

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Betri Anita ◽  
Henni Febriawati ◽  
Yandrizal Yandrizal
Keyword(s):  
Health Insurance ◽  
Health Center ◽  
National Health Insurance ◽  
National Health ◽  
Communicable Diseases ◽  
Care Quality ◽  
Morbidity Rate ◽  
Non Communicable Diseases ◽  
Study Approach

The percentages of referrals for the first level health facilities visits are coming from the health center (Puskesmas) with 16.85% at the highest and from the practicing doctors with 12.45% at the lowest. The aim of the research is to examine the efficiency the promotion, preventive and curative care quality improvement. This study used qualitative exploratory design by case study approach. The collection of data was conducted through field observations, document observation and in-depth interviews. TThe informants consisted of 4 Head of Health Center/Puskesmas, 9 cadres of integrated guiding posts (Pos Pembinaan terpadu /Posbindu) for Non-Communicable Diseases (NCDs), 9 cadres of Integrated Service Post (Pos Pelayanan Terpadu/Posyandu), 33 participants of the National Health Insurance and 23 people from community who have not joined the national health insurance scheme. The results show that mini workshops are held every month in preparing activities with a focus on the causes of most diseases in the previous month. Posyandu may reduce morbidity rate on infants and pregnant women, Posbindu for Non-communicable Diseases can prevent and control non-communicable diseases. Quality of service can improve the perception of the quality of the service and can reduce referrals to hospital.

scholarly journals Management of chronic non-communicable diseases in Ghana: a qualitative study using the chronic care model

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hubert Amu ◽  
Eugene Kofuor Maafo Darteh ◽  
Elvis Enowbeyang Tarkang ◽  
Akwasi Kumi-Kyereme
Keyword(s):  
Health Insurance ◽  
Qualitative Study ◽  
National Health Insurance ◽  
National Health ◽  
Health Professionals ◽  
Chronic Care ◽  
Management Practices ◽  
Communicable Diseases ◽  
Effective Management ◽  
Non Communicable Diseases

Abstract Background While the burden and mortality from chronic non-communicable diseases (CNCDs) have reached epidemic proportions in sub-Saharan Africa (SSA), decision-makers and individuals still consider CNCDs to be infrequent and, therefore, do not pay the needed attention to their management. We, therefore, explored the practices and challenges associated with the management of CNCDs by patients and health professionals. Methods This was a qualitative study among 82 CNCD patients and 30 health professionals. Face-to-face in-depth interviews were used in collecting data from the participants. Data collected were analysed using thematic analysis. Results Experiences of health professionals regarding CNCD management practices involved general assessments such as education of patients, and specific practices based on type and stage of CNCDs presented. Patients’ experiences mainly centred on self-management practices which comprised self-restrictions, exercise, and the use of anthropometric equipment to monitor health status at home. Inadequate logistics, work-related stress due to heavy workload, poor utility supply, and financial incapability of patients to afford the cost of managing their conditions were challenges that militated against the effective management of CNCDs. Conclusions A myriad of challenges inhibits the effective management of CNCDs. To accelerate progress towards meeting the Sustainable Development Goal 3 on reducing premature mortality from CNCDs, the Ghana Health Service and management of the respective hospitals should ensure improved utility supply, adequate staff motivation, and regular in-service training. A chronic care management policy should also be implemented in addition to the review of the country’s National Health Insurance Scheme (NHIS) by the Ministry of Health and the National Health Insurance Authority to cover the management of all CNCDs.

Development of an Algorithm for Stroke Prediction: A National Health Insurance Database Study in Korea

2018 ◽  
Vol 79 (3-4) ◽  
pp. 214-220 ◽  
Author(s):  
Seung Nam Min ◽  
Se Jin Park ◽  
Dong Joon Kim ◽  
Murali Subramaniyam ◽  
Kyung-Sun Lee
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Stroke Prevention ◽  
Normal Subjects ◽  
Control Group ◽  
Modifiable Risk Factors ◽  
Stroke Patients

Background: Stroke is the second leading cause of death worldwide and remains an important health burden both for the individuals and for the national healthcare systems. Potentially modifiable risk factors for stroke include hypertension, cardiac disease, diabetes, and dysregulation of glucose metabolism, atrial fibrillation, and lifestyle factors. Objects: We aimed to derive a model equation for developing a stroke pre-diagnosis algorithm with the potentially modifiable risk factors. Methods: We used logistic regression for model derivation, together with data from the database of the Korea National Health Insurance Service (NHIS). We reviewed the NHIS records of 500,000 enrollees. For the regression analysis, data regarding 367 stroke patients were selected. The control group consisted of 500 patients followed up for 2 consecutive years and with no history of stroke. Results: We developed a logistic regression model based on information regarding several well-known modifiable risk factors. The developed model could correctly discriminate between normal subjects and stroke patients in 65% of cases. Conclusion: The model developed in the present study can be applied in the clinical setting to estimate the probability of stroke in a year and thus improve the stroke prevention strategies in high-risk patients. The approach used to develop the stroke prevention algorithm can be applied for developing similar models for the pre-diagnosis of other diseases.

Prediagnosis Smoking, Obesity, Insulin Resistance, and Second Primary Cancer Risk in Male Cancer Survivors: National Health Insurance Corporation Study

2007 ◽  
Vol 25 (30) ◽  
pp. 4835-4843 ◽  
Author(s):  
Sang Min Park ◽  
Min Kyung Lim ◽  
Kyu Won Jung ◽  
Soon Ae Shin ◽  
Keun-Young Yoo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Health Insurance ◽  
Cancer Survivors ◽  
National Health Insurance ◽  
National Health ◽  
Smoking History ◽  
Second Primary ◽  
Primary Cancer ◽  
Second Primary Cancer

Purpose Smoking, obesity, and insulin resistance are well-known risk factors for cancer, yet few epidemiology studies evaluate their role as risk factors for a second primary cancer (SPC). Patients and Methods We identified 14,181 men with a first cancer from the National Health Insurance Corporation Study cohort. We obtained data on fasting glucose level, body mass index (BMI), and smoking history from an enrollment interview (1996). We obtained SPC incidence data for 1996 through 2002 from the Korean Central Cancer Registry. We used the standard Poisson regression model to estimate the age- and multivariate-adjusted relative risk (RR) for SPCs in relation to smoking history, BMI, and insulin resistance before diagnosis. Results We observed 204 patients with SPC. The overall age-standardized incidence rate of SPC was 603.2 occurrences per 100,000 person-years, which was about 2.3 times higher than that of first cancer in the general male population. Multivariate regression revealed that lung (RR, 3.69; 95% CI, 1.35 to 10.09) and smoking-related (RR, 2.02; 95% CI, 1.02 to 4.03) SPCs were significantly associated with smoking. Obese patients (BMI ≥ 25 kg/m2) had significantly elevated RRs for colorectal (RR, 3.45; 95% CI, 1.50 to 7.93) and genitourinary (RR, 3.61; 95% CI, 1.36 to 9.54) SPCs. Patients with a fasting serum glucose concentration ≥ 126 mg/dL had a higher RR for hepatopancreatobiliary (RR, 3.33; 95% CI, 1.33 to 8.37) and smoking-related (1.93; 95% CI, 1.01 to 3.68) SPCs. Conclusion Prediagnosis smoking history, obesity, and insulin resistance were risk factors for several SPCs. These findings suggest that more thorough surveillance and screening for SPCs is needed for the cancer survivors with these risk factors.

scholarly journals Analysis of characteristics and trends of the In-Hospital Cardiac Arrest incidence in the Republic of Korea: clinical usefulness of national health insurance claim data

2021 ◽  
Keyword(s):  
Cardiac Arrest ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Circulatory System ◽  
Claim Data ◽  
Republic Of Korea ◽  
Classification Of Diseases ◽  
The Republic ◽  
Hospital Cardiac Arrest

Backgrounds: In-Hospital Cardiac Arrest (IHCA) requires the preparation of considerable medical resources in hospitals. Furthermore, compared to Out-of-Hospital Cardiac Arrest, until recently, there have not been many studies on the incidence, characteristics, and prognosis of IHCA. This study is to examine IHCA event rates among hospitalized patients in the Republic of Korea from 2011 to 2015. Methods: The incidence of IHCA in adults was extracted from claim data of the National Health Insurance Service from 2011 to 2015, and analyzed according to age, sex, the classification under the 7th revision of the Korean Standard Classification of Diseases (KCD-7), hospital types, and provinces. Results: From 2011 to 2015, the overall incidence of IHCA in Korea was founded to be 3.00 per 1,000 hospitalizations. The overall 5-year IHCA incidence was higher in male at 3.92 cases per 1,000 hospitalizations and at female 2.19 cases per 1,000 hospitalizations. Incidence due to cardiovascular disease increased year by year, whereas incidences due to respiratory, neurological and infectious disease were decreasing, and in the case of oncologic disease, there was no change. In particular, patients with diseases of the circulatory system had at least a two times higher incidence compared to those with other diseases. The IHCA incidence in general hospitals and tertiary hospitals was at least two-fold higher than the national overall and showed an increasing trend. The provinces that showed a higher IHCA incidence than the five-year national overall were Jeju Special Self-Governing Province, Gangwon Province, and Seoul. Conclusions: The results of this study can be used as important basic data to secure patient safety by reducing the occurrence of IHCA.

scholarly journals Incidence and Risk Factors for Progression to Diabetes Mellitus: A Retrospective Cohort Study

2021 ◽  
Vol 19 (1) ◽  
pp. 123
Author(s):  
Min Kyung Hyun ◽  
Jong Hern Park ◽  
Kyoung Hoon Kim ◽  
Soon-Ki Ahn ◽  
Seon Mi Ji
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cohort Study ◽  
National Health ◽  
Health Screening ◽  
Eligibility Criteria ◽  
The Republic ◽  
High Risk Drinking ◽  
Cox Proportional Hazard Regression

(1) Objective: This study examined the incidence and risk factors contributing to the progression to diabetes mellitus (DM) in a seven-year follow-up study of non-diabetic National Health Examinees. (2) Methods: For this retrospective observational cohort study, we used two national representative databases: the National Health Screening (HEALS) database 2009 and the National Health Insurance Service (NHIS) database 2009–2015. The eligible subjects without DM with blood sugar levels of <126 mg/dL were selected using the HEALS database. The subsequent follow-up and clinical outcomes were evaluated using the NHIS database. Cox proportional hazard regression was applied to examine the effects of the covariates on progression to diabetes. (3) Results: Among those who took part in the national health screening in 2009, 4,205,006 subjects who met the eligibility criteria were selected. Of these, 587,015 were diagnosed with DM during the follow-up by 2015. The incidence of progression from non-diabetes to DM was 14.0%, whereas that from impaired fasting glucose (IFG) to DM was 21.9%. Compared to the normal group, the newly diagnosed DM group was more likely to comprise older, female, currently smoking, and high-risk drinking participants and participants with IFG, hypertension, dyslipidemia, and metabolic syndrome. (4) Conclusions: This epidemiological study in the Republic of Korea found risk factors similar to those of other studies, but the incidence of progression to DM was 22.8 per 1000 person-years, which is higher than that previously reported. Hence, more care is needed to prevent DM.

The Association of Adolescent Fatness and Fitness With Risk Factors for Adult Metabolic Syndrome: A 22-Year Follow-up Study

2014 ◽  
Vol 11 (4) ◽  
pp. 823-830 ◽  
Author(s):  
Yoonsuk Jekal ◽  
YoonMyung Kim ◽  
Ji Eun Yun ◽  
Eun Sung Kim ◽  
Masayo Naruse ◽  
...  
Keyword(s):  
Risk Factors ◽  
High School ◽  
Metabolic Syndrome ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Health Examination ◽  
Follow Up Study ◽  
Fitness Levels

Background:Few studies have been conducted to explore the associations of fatness and fitness during adolescence with risk factors of metabolic syndrome (MetS) during adulthood, particularly in Asians.Methods:Adolescent anthropometric and fitness data were collected during the participants’ high school years (N = 15,896) and their corresponding health examination data from adulthood were taken from the National Health Insurance Corporation (NHIC) in Korea. A total of 1,006 participants (6.3%) were analyzed in the study.Results:The odds ratios (ORs) for being overweight (BMI ≥ 25 kg/m2) during adulthood was 11.87 (95% CI: 4.19–33.59) in men and 8.44 (95% CI: 1.78–40.02) in women, respectively, in the fattest group vs. the leanest group during adolescence. Participants with low fitness levels during adolescence were more likely to be overweight and have abnormal MetS risk factors in adulthood vs. those with high fitness levels. Joint exposure analyses of fatness and fitness showed that male participants who were more fat and unfit during adolescence had 4.11 (95% CI: 1.19–14.14) and 3.04 (95% CI: 1.17–11.12) times higher risk of having abnormal glucose and MetS risks during adulthood, respectively.Conclusions:Fatness and fitness levels during adolescence appear to be significantly associated with the MetS risk factors and prevalence in adulthood in Koreans.

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