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.

Analysis of oversight systems is often conducted from a single disciplinary perspective and by using a limited set of criteria for evaluation. In this article, we develop an approach that blends risk analysis, social science, public administration, legal, public policy, and ethical perspectives to develop a broad set of criteria for assessing oversight systems. Multiple methods, including historical analysis, expert elicitation, and behavioral consensus, were employed to develop multidisciplinary criteria for evaluating oversight of emerging technologies. Sixty-six initial criteria were identified from extensive literature reviews and input from our Working Group. Criteria were placed in four categories reflecting the development, attributes, evolution, and outcomes of oversight systems. Expert elicitation, consensus methods, and multidisciplinary review of the literature were used to refine a condensed, operative set of criteria. Twenty-eight criteria resulted spanning four categories: seven development criteria, 15 attribute criteria, five outcome criteria, and one evolution criterion. These criteria illuminate how oversight systems develop, operate, change, and affect society. We term our approach "integrated oversight assessment" and propose its use as a tool for analyzing relationships among features, outcomes, and tradeoffs of oversight systems. Comparisons among historical case studies of oversight using a consistent set of criteria should result in defensible and evidence-supported lessons to guide the development of oversight systems for emerging technologies, such as nanotechnology.

ObjectiveThe aim of this study was to evaluate the secular trends of incidence of gestational diabetes mellitus (GDM) and insulin treatment for GDM in a Korean population and to determine the factors that contribute to the trends in the incidence of GDM.Study DesignWe used data collected by the Health Insurance Review & Assessment Service of Korea and analyzed data from women who had given birth from 2006 to 2010. We evaluated the trends in the incidence of GDM and GDM requiring insulin treatment and the changes in risk factors.ResultsThere were 1,824,913 births during the study period, which included 129,666 cases of GDM, an incidence of 7.11% over this period. The incidence of GDM increased from 3.86% in 2007 to 11.83% in 2010, with a continuous increase after adjustment for age. However, the number of GDM cases that required insulin treatment decreased significantly from 13.87% in 2007 to 5.94% in 2010. The proportion of patients who were at an older age and multiparity, 2 GDM risk factors, increased during the study period.ConclusionsIn Korea, the incidence of GDM, especially mild GDM, increased dramatically during the period from 2006 to 2010. Further efforts are needed to monitor this trend and to identify associated factors.

• Medicare Part D services are delivered through 2 different types of private plans: Medicare Advantage prescription drug (MA-PD) plans or stand-alone prescription drug plans (PDPs). MA-PD plans cover both drug therapy and other medical services, whereas PDPs provide prescription drug coverage only. • An economic model suggests that an optimal level of medication use, which maximizes consumers' utility or benefit, will be achieved when one insurer is responsible for covering all types of substitutable services. Observational studies have suggested that pharmacy therapy and nondrug medical services may be substitutable. Goldman et al. (2006) found that medication possession ratio (MPR) of less than 80% for statin therapy was associated with increases in hospitalizations and emergency room visits. Gibson et al. (2006) reported that MPR greater than 80% for statin therapy was related to fewer coronary heart disease-related hospitalizations, all-cause hospitalizations, and emergency room visits.• These findings suggest that health plans that cover both drug and medical services may have an incentive to improve medication adherence in an attempt to reduce medical costs. MA-PD plans offer more generous drug benefits than do PDPs. However, little is known about whether Medicare beneficiaries in MA-PD plans, which cover different types of substitutable services, have better medication adherence than those in PDPs. What is already known about this subjectComparison of Statin Adherence Among Beneficiaries in MA-PD Plans Versus PDPs Kyoungrae Jung, PhD; A. Marshall McBean, MD, MSc; and Jee-Ae Kim, MPP ABSTRACT BACKGROUND: Medicare Part D, which provides prescription drug coverage to Medicare beneficiaries, is delivered through either Medicare Advantage prescription drug (MA-PD) plans or stand-alone prescription drug plans (PDPs). MA-PD plans cover both drug therapy and other medical services, whereas PDPs provide prescription drug coverage only. Because of the potential substitutability between prescription drugs and other medical services, MA-PD plans may make greater efforts to improve enrollees' adherence to recommended medications than PDPs. Prescription drug benefits are more generous in MA-PD plans than in PDPs.