Past and Current Status of Adult Type 2 Diabetes Mellitus Management in Korea: A National Health Insurance Service Database Analysis

Abstract

Korea's National Healthcare Program, the National Health Insurance Service (NHIS), a government-affiliated agency under the Korean Ministry of Health and Welfare, covers the entire Korean population. The NHIS supervises all medical services in Korea and establishes a systematic National Health Information database (DB). A health information DB system including all of the claims, medications, death information, and health check-ups, both in the general population and in patients with various diseases, is not common worldwide. On June 9, 2014, the NHIS signed a memorandum of understanding with the Korean Diabetes Association (KDA) to provide limited open access to its DB. By October 31, 2017, seven papers had been published through this collaborative research project. These studies were conducted to investigate the past and current status of type 2 diabetes mellitus and its complications and management in Korea. This review is a brief summary of the collaborative projects between the KDA and the NHIS over the last 3 years. According to the analysis, the national health check-up DB or claim DB were used, and the age category or study period were differentially applied.

The association between nonalcoholic fatty liver disease and esophageal, stomach, or colorectal cancer: National population-based cohort study

“…All Korean subscribers are encouraged to receive regular biennial or pre-employment healthcare checkups provided by the NHIS. This regular healthcare checkup includes anthropometric measurements, blood pressure, alcohol and smoking status, physical activity, and laboratory tests after overnight fasting, including serum glucose, total cholesterol, creatinine, liver function, and urinalysis [26][27][28][29][30]. Quality control procedures for laboratory tests were performed in accordance with the Korean Association of Laboratory Quality Control [27,30].…”

“…Past history, including stroke or coronary artery disease and lifestyle habits were collected by standardized self-report questionnaires. Additionally, the NHIS contains information on the patients' demographics, medical use, transaction information, healthcare checkups, and claims [26][27][28][29][30].…”

Heritability estimation of dichotomous phenotypes using a liability threshold model on ascertained family‐based samples

“…For our analyses, the effect of age was adjusted through use as a covariate, and the standardized age was incorporated into the final analyses. The prevalence of T2D was set at 10.9% (Ko et al, ), and its heritability was estimated using our experimental method adjusted for the ascertainment bias.…”

Changes in metabolic syndrome and its components and the risk of type 2 diabetes: a nationwide cohort study

“…Among the total datasets of the NHIS DB, we used qualifications, claims, the health check-up DB, and death information. Due to the inevitable limitations of the claim DB, T2D was defined operationally 13 . T2D from the claim DB was categorized based on the ICD-10 code of T2D (E11-E14) as principal diagnosis or up to a fourth additional diagnosis and at least one antidiabetic drug prescribed in a given year.…”