Administrative Claims Datasets in South Korea and Japan: A Comparative Assessment Based on Extensive Practical Experience

Haine Lee; Younghyun Kang; Ji-Hyun Lee; Jae-Eun Myung; Liesl Strachan; Yoko Ishiguro; Sang-Soo Lee

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자료유형: 학술저널

저자정보: Haine Lee (Medtronic Korea Ltd.) Younghyun Kang (Medtronic Korea Ltd.) Ji-Hyun Lee (Medtronic Korea Ltd.) Jae-Eun Myung (Medtronic Korea Ltd.) Liesl Strachan (Medtronic Australia Pty Ltd.) Yoko Ishiguro (Medtronic Japan Ltd.) Sang-Soo Lee (Sungkyunkwan University)

저널정보: 한국보건의료기술평가학회 보건의료기술평가 보건의료기술평가 제8권 제1호

발행연도: 2020.1

수록면: 33 - 42 (10page)

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

초록· 키워드

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The administrative claims datasets refer to the data that occurs when healthcare providers claim ser- vices and items of care rendered to patients from payers. The purpose of this study is to review and compare the characteristics and differences of the administrative claims data in South Korea and Ja- pan. We compared the differences of claims data and examined the utilization of the data based on the hands-on experience of analyzing the data in both countries. The structure of claims data of both countries are comparable since they originated from similar health insurance systems in general. However, there also exist some differences: 1) institution in charge of managing claims data, 2) data access, and 3) data component. First, while the claims data in South Korea are only constructed and operated by National Health Insurance Service and Health Insurance Review and Assessment Ser- vice, those in Japan are constructed not only Ministry of Health, Labor and Welfare but also local governments, academic societies or private entities. Second, in Japan, only government officials or academic societies members can have access to the claims data while other stakeholders can access data that are constructed by private entities but not nationally representative. However, private sector is allowed to access the claims data with public Institutional Review Boards in South Korea. Lastly, unlike Korea, the Diagnosis Procedure Combination database in Japan has a unique characteristic that contains important clinical outcomes and can be analyzed together with claims data. Generating robust research using real-world datasets such as claims, clinical and Electronic Medical Records data is emerging. Based on the review of this study, to enable researchers to perform extensive re- search projects, policies on the use and management of medical big data need to be developed and strengthened.

#Administrative claims datasets · Health insurance claims · Utilizing · DPC · National Health Insurance Service · Health Insurance Review and Assessment Service · Ministry of Health #Labor and Welfare · Medical Data Vision · South Korea · Japan.

참고문헌 (30)

참고문헌 신청

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