- Health Insurance Claim Review Using Information Technologies
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Park YT, Yoon JS, Speedie SM, Yoon H, Lee J
- KMID: 2229473
- Healthc Inform Res.
- 2012 Sep;18(3):215-224.
- doi: 10.4258/hir.2012.18.3.215
OBJECTIVES: The objective of this paper is to describe the Health Insurance Review and Assessment Service (HIRA)'s payment request (PARE) system that plays the role of the gateway for all... -
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- Charges in Hospital Service Pattern Before and After the Deligated Review System
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Oh DK
- KMID: 2282171
- Korean J Prev Med.
- 1983 Oct;16(1):121-127.
To identify the changes in professional services pattern after introducing the deligated system of claims review started in 1982, a university hospital under this system was examined. For comparison, claims... -
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- A methodological study on simplifying claims review system in medical insurance
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Kim SI, Kang HG, Kim HJ, Chae YM, Sohn M, Lee MK
- KMID: 2282766
- Korean J Prev Med.
- 1995 Sep;28(3):640-650.
After the introduction of National Medical Insurance in 1989, the medical demand has rapidly increased. The impact of increased medical demand was followed by an increase in the number of... -
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- Refinement and Evaluation of Korean Outpatient Groups for Visits with Multiple Procedures and Chemotherapy, and Medical Visit Indicators
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Park H, Kang GW, Yoon S, Park EJ, Choi S, Yu S, Yang EJ
- KMID: 2165250
- Health Policy Manag.
- 2015 Sep;25(3):185-196.
- doi: 10.4332/KJHPA.2015.25.3.185
BACKGROUND: Issues concerning with the classification accuracy of Korean Outpatient Groups (KOPGs) have been raised by providers and researchers. The KOPG is an outpatient classification system used to measure casemix... -
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- An Evaluation of Sampling Design for Estimating an Epidemiologic Volume of Diabetes and for Assessing Present Status of Its Control in Korea
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Lee JS, Kim J, Baik SH, Park IB, Lee J
- KMID: 797668
- J Prev Med Public Health.
- 2009 Mar;42(2):135-142.
- doi: 10.3961/jpmph.2009.42.2.135
OBJECTIVES: An appropriate sampling strategy for estimating an epidemiologic volume of diabetes has been evaluated through a simulation. METHODS: We analyzed about 250 million medical insurance claims data submitted to... -
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- The Effect of the Cost Exemption Policy for Hospitalized Children under 6 Years Old on the Medical Utilization in Korea
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Jeon KS, Yoon SJ, Ahn HS, Shin HW, Yoon YH, Hwang SM, Kyung MH
- KMID: 792571
- J Prev Med Public Health.
- 2008 Sep;41(5):295-299.
- doi: 10.3961/jpmph.2008.41.5.295
OBJECTIVES: The Korean government in January 2006 instigated an exemption policy for hospitalized children under the age of six years old. This study examines how this policy affected the utilization... -
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- A Comparative Study on Comorbidity Measurements with Lookback Period using Health Insurance Database: Focused on Patients Who Underwent Percutaneous Coronary Intervention
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Kim KH, Ahn LS
- KMID: 1008663
- J Prev Med Public Health.
- 2009 Jul;42(4):267-273.
- doi: 10.3961/jpmph.2009.42.4.267
OBJECTIVES: To compare the performance of three comorbidity measurements (Charlson comorbidity index, Elixhauser's comorbidity and comorbidity selection) with the effect of different comorbidity lookback periods when predicting in-hospital mortality for... -
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- The Effect of Outpatient Cost Sharing on Health Care Utilization of the Elderly
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Kim M, Kwon S
- KMID: 1098207
- J Prev Med Public Health.
- 2010 Nov;43(6):496-504.
- doi: 10.3961/jpmph.2010.43.6.496
OBJECTIVES: The purpose of this study was to analyze the effect of outpatient cost-sharing on health care utilization by the elderly. METHODS: The data in this analysis was the health... -
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- Towards universal coverage: an evaluation of the benefit enhancement plan for four major conditions in Korean National Health Insurance
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Kim Y
- KMID: 2064874
- J Korean Med Assoc.
- 2014 Mar;57(3):198-203.
- doi: 10.5124/jkma.2014.57.3.198
Owing to low contributions and a limited benefits design, the Korean National Health Insurance (NHI) took only 12 years from its establishment to achieve universal population coverage. However, the NHI... -
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- Impact of Risk Adjustment with Insurance Claims Data on Cesarean Delivery Rates of Healthcare Organizations in Korea
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Lee KS, Lee SI, Seo K, Do YM
- KMID: 792335
- J Prev Med Public Health.
- 2005 May;38(2):132-140.
OBJECTIVES: To propose a risk-adjustment model from insurance claims data, and analyze the changes in cesarean section rates of healthcare organizations after adjusting for risk distribution. METHODS: The study sample... -
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- Olmesartan is not associated with the risk of enteropathy: a Korean nationwide observational cohort study
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You SC, Park H, Yoon D, Park S, Joung B, Park RW
- KMID: 2452492
- Korean J Intern Med.
- 2019 Jan;34(1):90-98.
- doi: 10.3904/kjim.2017.002
BACKGROUND/AIMS: Olmesartan, a widely used angiotensin II receptor blocker (ARB), has been linked to sprue-like enteropathy. No cases of olmesartan-associated enteropathy have been reported in Northeast Asia. We investigated the... -
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- Cost-of-illness Study of Asthma in Korea: Estimated from the Korea National Health Insurance Claims Database
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Park CS, Kang HY, Kwon I, Kang DR, Jung HY
- KMID: 1085083
- J Prev Med Public Health.
- 2006 Sep;39(5):397-403.
OBJECTIVES: We estimated the asthma-related health care utilization and costs in Korea from the insurer's and societal perspective. METHODS: We extracted the insurance claims records from the Korea National... -
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- Continuity of Care of Patient with Diabetes and Its Affecting Factors in Korea
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Yoon CH, Lee SJ, Choo S, Moon OR, Park JH
- KMID: 792458
- J Prev Med Public Health.
- 2007 Jan;40(1):51-58.
- doi: 10.3961/jpmph.2007.40.1.51
OBJECTIVES: The objectives of this study were to estimate the continuity of care for all Koreans with diabetes and to identify factors affecting the continuity of care. METHODS: We... -
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- Impact of DRG Payment on the Length of Stay and the Number of Outpatient Visits After Discharge for Caesarean Section During 2004-2007
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Shon C, Chung S, Yi S, Kwon S
- KMID: 1003039
- J Prev Med Public Health.
- 2011 Jan;44(1):48-55.
- doi: 10.3961/jpmph.2011.44.1.48
OBJECTIVES: The purpose of this study was to examine the impact of Diagnosis-Related Group (DRG)-based payment on the length of stay and the number of outpatient visits after discharge in... -
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- Socioeconomic Costs of Stroke in Korea: Estimated from the Korea National Health Insurance Claims Database
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Lim SJ, Kim HJ, Nam CM, Chang HS, Jang YH, Kim S, Kang HY
- KMID: 1008661
- J Prev Med Public Health.
- 2009 Jul;42(4):251-260.
- doi: 10.3961/jpmph.2009.42.4.251
OBJECTIVES: To estimate the annual socioeconomic costs of stroke in Korea in 2005 from a societal perspective. METHODS: We identified those 20 years or older who had at least one... -
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- Prognostic Impact of Charlson Comorbidity Index Obtained from Medical Records and Claims Data on 1-year Mortality and Length of Stay in Gastric Cancer Patients
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Kyung MH, Yoon SJ, Ahn HS, Hwang SM, Seo HJ, Kim KH, Park HK
- KMID: 797665
- J Prev Med Public Health.
- 2009 Mar;42(2):117-122.
- doi: 10.3961/jpmph.2009.42.2.117
OBJECTIVES: We tried to evaluate the agreement of the Charlson comorbidity index values (CCI) obtained from different sources (medical records and National Health Insurance claims data) for gastric cancer patients.... -
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- Differences in Utilization Patterns among Medications in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: a 36-Month Retrospective Study Using the Korean Health Insurance Review and Assessment Claims Database
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Bhang SY, Hwang JW, Kwak YS, Joung YS, Lee S, Kim B, Sohn SH, Chung US, Yang J, Hong M, Bahn GH, Choi HY, Oh IH, Lee YJ
- KMID: 2373758
- J Korean Med Sci.
- 2016 Aug;31(8):1284-1291.
- doi: 10.3346/jkms.2016.31.8.1284
We evaluated the differences in utilization patterns including persistence and adherence among medications in children and adolescents with attention deficit hyperactivity disorder (ADHD). The current study was performed using data... -
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- Economic Burden of Cancer in South Korea for the Year 2005
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Kim J, Hahm MI, Park EC, Park JH, Park JH, Kim SE, Kim SG
- KMID: 797676
- J Prev Med Public Health.
- 2009 May;42(3):190-198.
- doi: 10.3961/jpmph.2009.42.3.190
OBJECTIVES: The objective of this study is to estimate the economic costs of cancer on society. METHODS: We estimated the economic burden of people with cancer in South Korea. To... -
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- Trends and Patterns of Hepatocellular Carcinoma Treatment in Korea
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Hong YM, Yoon KT, Cho M, Kang DH, Kim HW, Choi CW, Park SB, Heo J, Woo HY, Lim W
- KMID: 2363501
- J Korean Med Sci.
- 2016 Mar;31(3):403-409.
- doi: 10.3346/jkms.2016.31.3.403
Multiple therapeutic modalities are available for hepatocellular carcinoma (HCC) treatment. We aimed to evaluate the trends for HCC treatment in Korea. Recent trends and patterns in treatment modalities were assessed... -
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- Antihypertensive Drug Medication Adherence of People with Disabilities and its Affecting Factors in Korea
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Park JH, Shin Y, Lee SY, Park JH
- KMID: 792484
- J Prev Med Public Health.
- 2007 May;40(3):249-258.
- doi: 10.3961/jpmph.2007.40.3.249
OBJECTIVES: The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors... -
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