Data Resource Profile: The National Health Information Database of the National Health Insurance Service in South Korea

Seong, Sang Cheol; Kim, Yeon Yong; Khang, Young-Ho; Park, Jong Heon; Kang, Hee Jin; Lee, Hee Young; Ho, Cheol; Song, Jong Sun; Bang, Ji Hyon; Ha, Seongjun; Lee, Eun Joo; Shin, Soon Ae

doi:10.1093/ije/dyw253

Cited by 725 publications

(730 citation statements)

References 10 publications

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“…The study population was derived from the National Health Insurance Service‐Health Screening Cohort (NHIS‐HEALS). In South Korea, the NHIS provides mandatory health insurance covering nearly all forms of healthcare for all Korean citizens . Records from inpatient and outpatient department visits including diagnosis, drug prescriptions, treatment, and surgical procedures are collected.…”

Section: Methodsmentioning

confidence: 99%

Association of Chronic Periodontitis on Alzheimer's Disease or Vascular Dementia

Choi

Kim

Chang

et al. 2019

J American Geriatrics Society

123

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OBJECTIVES Although chronic periodontitis has been associated with Alzheimer's disease, the effect of chronic periodontitis on vascular dementia as well as the role of lifestyle behaviors such as smoking, alcohol consumption, and physical activity in this association are still unclear. DESIGN Retrospective cohort study. SETTING Population based. PARTICIPANTS The study population was derived from the Korean National Health Insurance Service‐Health Screening Cohort. Among 262 349 participants, diagnosis of chronic periodontitis was determined during 2003‐2004. MEASUREMENTS Starting from 2005, participants were followed up for overall dementia, Alzheimer's disease, and vascular dementia until 2015. Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of dementia according to chronic periodontitis. RESULTS Compared with nonchronic periodontitis participants, chronic periodontitis patients had elevated risk for overall dementia (aHR = 1.06; 95% CI = 1.01‐1.11) and Alzheimer's disease (aHR = 1.05; 95% CI = 1.00‐1.11). There was a tendency toward increased vascular dementia risk among chronic periodontitis patients (aHR = 1.10; 95% CI = 0.98‐1.22). The risk‐increasing effect of chronic periodontitis on dementia tended to be stronger among participants with healthy lifestyle behaviors including never‐smokers and those who exercised and did not consume alcohol. CONCLUSION Chronic periodontitis may be associated with a higher risk of developing dementia. Future studies that investigate whether preventing chronic periodontitis may lead to reduced risk of dementia are needed.

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Section: Methodsmentioning

confidence: 99%

Association of Chronic Periodontitis on Alzheimer's Disease or Vascular Dementia

Choi

Kim

Chang

et al. 2019

J American Geriatrics Society

123

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“…The NHSP includes a self‐questionnaire on health behavior, anthropometric measurements, and a laboratory test (eg, fasting glucose and lipid levels). Based on available NHI data of demographic factors including insurance contribution (a proxy income), information on the utilization of medical facilities, and the results of NHSP, a national database has been established and linked to the death registry database . This national database is widely used in epidemiologic studies, including those for neurodegenerative disease .…”

Section: Methodsmentioning

confidence: 99%

Association of statin use with Parkinson's disease: Dose–response relationship

2019

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Background There have been conflicting results on the association between statin use and Parkinson's disease (PD) incidence. Objectives This study investigated the association between time‐varying status of statin use and incidence of PD while considering the dose–response relationship and total cholesterol level. Methods Using the database of the Korean National Health Insurance Service from 2002 to 2015, we examined 76,043 subjects (≥60 years old) free of PD, dementia, and stroke at baseline. The dose of statin use was classified into the following four 6‐month categories (<180, 180‐365, 365‐540, and ≥540 days) for each 2‐year interval. The incidence of PD was identified by the prescription records for any anti‐PD medication with a diagnosis of PD. Results During 10 years of follow‐up, 1,427 PD cases occurred. Statin “ever use” was significantly associated with a high risk of PD incidence (adjusted hazard ratio = 1.28; 95% confidence interval = 1.12‐1.46) when compared with statin nonuse. In terms of a dose–response relationship, although a duration of statin use <365 days was associated with a higher risk of PD, the duration of statin use ≥365 days was not significantly associated with an increased risk of PD. Conclusions Statin use was associated with an elevated PD risk of PD, but long‐term and adherent statin use was not significantly associated with elevated PD risk. However, there was no evidence of benefit with any statin treatment related to PD risk. Our study suggests that there is a complex relationship among cholesterol level, statin use, and PD risk that warrants further studies. © 2019 International Parkinson and Movement Disorder Society

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“…The National Health Insurance Service (NHIS) of Korea provides mandatory health insurance for Korean citizens since the National Health Insurance Act in 1989 20, 21. With an enrollment rate of 97%, the NHIS provides biannual health examinations for all enrollees who turn 40 years old.…”

Section: Methodsmentioning

confidence: 99%

Effect of smoking cessation on the risk of dementia: a longitudinal study

Choi

Park

2018

Ann Clin Transl Neurol

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ObjectiveTo determine the risk of developing dementia in relation to duration of smoking cessation by using a nationwide health claims database.MethodsThis cohort study included 46,140 men aged 60 years or older from Korean National Health Insurance System – National Health Screening Cohort, a population‐based national health screening program from 2002 to 2013. The changes in smoking habit from a questionnaire during the first (2002 and 2003) and second (2004 and 2005) health examination periods, participants were divided into continual smokers, short‐term (less than 4 years) quitters, long‐term (4 years or more) quitters, and never smokers. Participants were followed‐up for 8 years from January 1, 2006 for the development of overall dementia, Alzheimer's disease, and vascular dementia.ResultsCompared to continual smokers, long‐term quitters and never smokers had decreased risk of overall dementia (hazard ratio, HR 0.86 95% CI, confidence interval 0.75–0.99 and HR: 0.81; 95% CI: 0.71–0.91, respectively). Never smokers had decreased risk of Alzheimer's disease (HR: 0.82; 95% CI: 0.70–0.96) compared to continual smokers. Finally, both long‐term quitters (HR: 0.68; 95% CI: 0.48–0.96) and never smokers (HR: 0.71; 95% CI: 0.54–0.95) had decreased risk of vascular dementia compared to continual smokers.InterpretationSmoking was associated with increased risk of dementia. Smokers who quit for a prolonged period of time may benefit from reduced risk of dementia. Therefore, smokers should be encouraged to quit in order to reduce the risk of developing dementia, especially in the elderly population who are already at risk.

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Data Resource Profile: The National Health Information Database of the National Health Insurance Service in South Korea

Cited by 725 publications

References 10 publications

Association of Chronic Periodontitis on Alzheimer's Disease or Vascular Dementia

Association of Chronic Periodontitis on Alzheimer's Disease or Vascular Dementia

Association of statin use with Parkinson's disease: Dose–response relationship

Effect of smoking cessation on the risk of dementia: a longitudinal study

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