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Pharmacoepidemiology and Risk Management 2024; 16(1): 1-10

Published online March 31, 2024 https://doi.org/10.56142/perm.24.0003

Copyright © Korean Society for Pharmacoepidemiology and Risk Management.

Current Issues and Improvement Strategies for Promoting the Utilization of National Health Insurance Claims Data

국내 건강보험 청구자료의 활용 촉진을 위한 현안 및 개선방안

Hee-Jin Kim1, Dong Wook Kim2, Myeong Gyu Kim3,4, Mi-Sook Kim5, Ye-Jee Kim6, Jeong Ah Kim1, Suvin Park1, SeungJin Bae3,4, Aesun Shin7, Ju-Young Shin8, Song Vogue Ahn1, Jeonghoon Ahn1, Bo Ram Yang9, Heehyun Won1, Seung-Mi Lee10, Joongyub Lee7, Hui-Eon Lee4, Sun-Young Jung11, Haerin Cho1, Nam-Kyong Choi1,4

김희진1, 김동욱2, 김명규3,4, 김미숙5, 김예지6, 김정아1, 박수빈1, 배승진3,4, 신애선7, 신주영8, 안성복1, 안정훈1, 양보람9, 원희현1, 이승미10, 이중엽7, 이희언4, 정선영11, 조해린1, 최남경1,4

1Department of Health Convergence, College of Science and Industry Convergence, Ewha Womans University, Seoul, Korea
2Department of Information and Statistics, Research Institute of Natural Science, Gyeongsang National University, Jinju, Korea
3College of Pharmacy, Ewha Womans University, Seoul, Korea
4Graduate School of Industrial Pharmaceutical Science, College of Pharmacy, Ewha Womans University, Seoul, Korea
5Medical Research Collaborating Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
6Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
7Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
8School of Pharmacy, Sungkyunkwan University, Suwon, Korea
9College of Pharmacy, Chungnam National University, Daejeon, Korea
10College of Pharmacy, Daegu Catholic University, Gyeongsan, Korea
11College of Pharmacy, Chung-Ang University, Seoul, Korea

1이화여자대학교 신산업대학교 융합보건학과, 2경상국립대학교 자연과학대학 정보통계학과, 3이화여자대학교 약학대학, 4이화여자대학교 약학대학 제약산업학과, 5서울대학교병원 의생명연구원 의학연구협력센터, 6서울아산병원/울산대학교 의과대학 의학통계학과, 7서울대학교 의과대학 예방의학교실, 8성균관대학교 약학대학, 9충남대학교 약학대학, 10대구가톨릭대학교 약학대학, 11중앙대학교 약학대학

Correspondence to:Nam-Kyong Choi
Department of Health Convergence, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
Tel: +82-2-3277-6585
Fax: +82-2-3277-2867
E-mail: nchoi@ewha.ac.kr

Received: February 26, 2024; Revised: March 12, 2024; Accepted: March 13, 2024

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

While health insurance claims data in Korea have the potential as evidence for drug regulatory decision-making, its effective utilization remains limited. This study aims to identify the challenges encountered by researchers in utilizing claims data and discuss improvement strategies. We summarized practical difficulties encountered by researchers who have experience using claims data from the National Health Insurance Service and the Health Insurance Review and Assessment Service. Challenges encountered by researchers included difficulties in acquiring drug data, delays in data provision, limited provision of information on specific conditions, drugs, and treatments, small data capacity, short data usage periods, and spatiotemporal considerations when accessing data. To maximize the utility of claims data in drug regulatory decision-making, continuous communication between researchers and data providers is necessary for addressing these challenges.

KeywordsHealthcare administrative claims, Real-world data, Real-world evidence, Pharmaceutical research, Regulatory science

Korean Society for Pharmacoepidemiology and Risk Management

Vol.16 No.2
September, 2024

eISSN 2982-5954

Frequency: Bimonthly

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