Using the National Health Information Database of the National Health Insurance Service in Korea for Monitoring Mortality and Life Expectancy at National and Local Levels

Abstract

This study explores whether the National Health Information Database (NHID) can be used to monitor health status of entire population in Korea. We calculated the crude mortality rate and life expectancy (LE) at birth across the national, provincial, and municipal levels using the NHID eligibility database from 2004 to 2015, and compared the results with the corresponding values obtained from the Korean Statistical Information Service (KOSIS) of Statistics Korea. The study results showed that the ratio of crude mortality rate between the two data was 0.99. The absolute difference between the LE of the two data was not more than 0.5 years, and did not exceed 0.3 years in gender specific results. The concordance correlation coefficients (CCC) between the crude mortality rates from NHID and the rates from KOSIS ranged 0.997–0.999 among the municipalities. For LE, the CCC between the NHID and KOSIS across the municipalities were 0.990 in 2004–2009 and 0.985 in 2010–2015 among men, and 0.952 in 2004–2009 and 0.914 in 2010–2015 among women, respectively. Overall, the NHID was a good source for monitoring mortality and LE across national, provincial, and municipal levels with the population representativeness of entire Korean population. The results of this study indicate that NHID may well contribute to the national health promotion policy as a part of the health and health equity monitoring system.

Life Expectancy and Inequalities Therein by Income From 2016 to 2018 Across the 253 Electoral Constituencies of the National Assembly of the Korea

“…The NHID data cover the entire population of Korea, including National Health Insurance beneficiaries and Medical Aid recipients, except for foreigners. The NHID data have been reported to be comparable to data from Statistics Korea for calculating mortality at the national, provincial, and district levels [5]. Using the NHID data, inequalities in life expectancy by income have been explored in prior Korean studies [2,3,6].…”

Income-related inequality in quality-adjusted life expectancy in Korea at the national and district levels

“…The information on mortality and HRQoL required for QALE calculations was obtained from the NHID and KCHS, respectively, according to gender, income, and district. Both the NHID and KCHS are considered to be good sources for monitoring income-based health outcomes at the district level, as they have district-level population representation and contain information on household income [8,9]. A total of 342,439,895 subjects and 1,753,476 deaths from the NHID were analyzed to investigate mortality and 1,577,541 participants from the KCHS were examined to evaluate HRQoL (see Supplementary Tables 1, 2 and 3).…”

“…In South Korea (hereafter 'Korea'), the National Health Information Database (NHID) of the National Health Insurance Service [7] and the Korean Community Health Survey (KCHS) [8] provide information on mortality rates [9] and health-related quality of life (HRQoL) [10], respectively, according to income at both the national and district levels. This data infrastructure in Korea provides a unique opportunity to investigate not only socioeconomic inequalities in HE, but also variations in inequality across subnational districts.…”

Comparison of three small-area mortality metrics according to urbanity in Korea: the standardized mortality ratio, comparative mortality figure, and life expectancy

“…Death information is also collected individually in conjunction with death certificate data from Statistics Korea [25]. In a previous study, the numbers of population and deaths at the district level (the administrative level in Korea above the dong/eup/myeon level) in the national statistics database and the NHID were highly correlated [26]. Prior research compared the NHID with the NAD of the Ministry of Interior and Safety (MOIS) for calculating small-area level mortality [27].…”