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KMID : 1022920150040010042
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Journal of Korean Academy of Social & Managed Care Pharmacy
2015 Volume.4 No. 1 p.42 ~ p.49
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Public Health- and Social Pharmacy-Related Study using the Korean Health Insurance Review and Assessment Service (HIRA) Claims Data
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Choi Nam-Kyong
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Abstract
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BACKGROUNDS : Health insurance administrative databases are important sources of information in finding health-related evidence. The objective of this study was to introduce the Korean Health Insurance Review and Assessment Service (HIRA) claims database to perform public health and social pharmacy studies.
METHODS : This article introduces the contents and characteristics of the HIRA data, describes the data acquisition procedures, provides examples of studies carried out using the data, and discusses several aspects that requires attention in those studies.
RESULTS : The HIRA claims database contains information on all claims including patients’ diagnoses, treatments, procedures, and prescription drugs for approximately 50 million Koreans. This database can be used for the following analyses: estimation of incidence or prevalence for a variety of specific disease, description of the utilization of health care resources and services, and verification of hypotheses about the health outcomes. This database has advantages including low cost, ease of patient follow-up over long time periods, and absence of reporting bias. There are several limitations of using this database including uncertain or low validity of disease diagnoses, potential discrepancies between physician’s prescriptions and patient’s actual medication intake, and lack of laboratory results and health-related behavioral information.
CONCLUSION : The HIRA data provide tremendous opportunities to perform large-scale quantitative analyses in the fields of public health and social pharmacy. A better understanding of prescribing practice, health policy, and data structures allows the researchers to use the claim database appropriately.
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KEYWORD
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national health insurance, Korean Health Insurance Review and Assessment Service, claims data, database, public health, social pharmacy
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