{"title":"National Health Insurance Data as a Research Tool in Korean Medicine: a guide to database utilization and methodological approaches.","authors":"Chan-Young Kwon, Il-Su Park","doi":"10.3831/KPI.2025.28.1.1","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to provide a practical framework for Korean medicine (KM) researchers on effectively utilizing Korean National Health Insurance (NHI) data, focusing on database characteristics, access methods, and methodological considerations for generating high-quality evidence in KM research.</p><p><strong>Methods: </strong>This study analyzed the NHI data system structure, analyzing its two major databases the National Health Insurance Service (NHIS) and Health Insurance Review and Assessment Service (HIRA). We examined available data types, access protocols, and methodological approaches, with particular emphasis on their application in KM research. The study synthesized current challenges and opportunities specific to KM research using these databases.</p><p><strong>Results: </strong>Our analysis revealed three key findings 1) The distinct characteristics and complementary nature of NHIS and HIRA databases, with NHIS providing comprehensive longitudinal data suitable for cohort studies and HIRA offering detailed cross-sectional data optimal for utilization pattern analysis; 2) Multiple data access options including Sample Research DB and Customized Research DB from NHIS, and Patient Sample Data and Customized Research Data from HIRA, each with specific advantages for different research designs; 3) Critical methodological considerations for KM research, particularly addressing the limited coverage of KM services (0.8% of total covered items) and the high proportion of non-covered services in KM practices (24.2-49.2% across different institution types).</p><p><strong>Conclusion: </strong>For effective utilization of NHI data in KM research, we recommend 1) Implementing hybrid research designs that combine health insurance data with institutional data to overcome limited KM coverage; 2) Establishing clear operational definitions and applying appropriate statistical methods for bias adjustment; 3) Working toward developing a specialized Korean Medicine Utilization Cohort Database. These approaches can enhance the quality and generalizability of KM research using health insurance data, ultimately contributing to evidence-based practice in Korean medicine.</p>","PeriodicalId":16769,"journal":{"name":"Journal of Pharmacopuncture","volume":"28 1","pages":"1-10"},"PeriodicalIF":1.2000,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933915/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pharmacopuncture","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3831/KPI.2025.28.1.1","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INTEGRATIVE & COMPLEMENTARY MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: This study aims to provide a practical framework for Korean medicine (KM) researchers on effectively utilizing Korean National Health Insurance (NHI) data, focusing on database characteristics, access methods, and methodological considerations for generating high-quality evidence in KM research.
Methods: This study analyzed the NHI data system structure, analyzing its two major databases the National Health Insurance Service (NHIS) and Health Insurance Review and Assessment Service (HIRA). We examined available data types, access protocols, and methodological approaches, with particular emphasis on their application in KM research. The study synthesized current challenges and opportunities specific to KM research using these databases.
Results: Our analysis revealed three key findings 1) The distinct characteristics and complementary nature of NHIS and HIRA databases, with NHIS providing comprehensive longitudinal data suitable for cohort studies and HIRA offering detailed cross-sectional data optimal for utilization pattern analysis; 2) Multiple data access options including Sample Research DB and Customized Research DB from NHIS, and Patient Sample Data and Customized Research Data from HIRA, each with specific advantages for different research designs; 3) Critical methodological considerations for KM research, particularly addressing the limited coverage of KM services (0.8% of total covered items) and the high proportion of non-covered services in KM practices (24.2-49.2% across different institution types).
Conclusion: For effective utilization of NHI data in KM research, we recommend 1) Implementing hybrid research designs that combine health insurance data with institutional data to overcome limited KM coverage; 2) Establishing clear operational definitions and applying appropriate statistical methods for bias adjustment; 3) Working toward developing a specialized Korean Medicine Utilization Cohort Database. These approaches can enhance the quality and generalizability of KM research using health insurance data, ultimately contributing to evidence-based practice in Korean medicine.
期刊介绍：
The Journal of Pharmacopuncture covers a wide range of basic and clinical science research relevant to all aspects of the biotechnology of integrated approaches using both pharmacology and acupuncture therapeutics, including research involving pharmacology, acupuncture studies and pharmacopuncture studies. The subjects are mainly divided into three categories: pharmacology (applied phytomedicine, plant sciences, pharmacology, toxicology, medicinal plants, traditional medicines, herbal medicine, Sasang constitutional medicine, herbal formulae, foods, agricultural technologies, naturopathy, etc.), acupuncture (acupressure, electroacupuncture, laser acupuncture, moxibustion, cupping, etc.), and pharmacopuncture (aqua-acupuncture, meridian pharmacopuncture, eight-principles pharmacopuncture, animal-based pharmacopuncture, mountain ginseng pharmacopuncture, bee venom therapy, needle embedding therapy, implant therapy, etc.). Other categories include chuna treatment, veterinary acupuncture and related animal studies, alternative medicines for treating cancer and cancer-related symptoms, etc. Broader topical coverage on the effects of acupuncture, the medical plants used in traditional and alternative medicine, pharmacological action and other related modalities, such as anthroposophy, homeopathy, ayurveda, bioelectromagnetic therapy, chiropractic, neural therapy and meditation, can be considered to be within the journal’s scope if based on acupoints and meridians. Submissions of original articles, review articles, systematic reviews, case reports, brief reports, opinions, commentaries, medical lectures, letters to the editor, photo-essays, technical notes, and book reviews are encouraged. Providing free access to the full text of all current and archived articles on its website (www.journal.ac), also searchable through a Google Scholar search.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
