2016. 9.

20

The National Health Insurance

Big Data in Korea
Hwa-yeon Lee
Dept. of Big Data Steering / Deputy Director
National Health Insurance Service,
South Korea

Contents

. Background of KNHI Big Data

. Current Status of Big Data

. Future Plans

. Background of
KNHI Big Data

NHI Working Process

Single Insurer
National Health Insurance Service
(NHIS)

Managing
beneficiaries
Eligibility

Notifying
R & A Results

Collecting
Premiums

Review &
Assess
Claim

Insured

Healthcare Services
Copayment

Quality Management

Claim & Payment

Providers

Medical care, Health screening

&
Long-term care

Increase of The aged & Medical Expense

60
45.6
37.8

40
24.4
20
9.1

The aged
population(%)
15.6

12.3

0
2005

2015

Medical
expense(%)

2020

Expected time(year) of Reach

Duration(year)

Division

An ageing
society(7%)

Old age society

(14%)

Superaged society
(20%)

7% 14%

14% 20%

Japan
France
Britain
USA
Korea

1970
1864
1929
1942
2000

1994
1979
1976
2015
2018

2006
2018
2026
2036
2026

24 years
115 years
47 years
73 years
18 years

12 years
39 years
50 years
21 years
8 years
5

Health Behaviors & Medical Expense

Medical Expense
for Chronic Disease (%)

Health Behaviors

60
60
47.3
40
38.1

43.7
39.5

42.1
38

43.1
41.7

40
29.5

35
32

20

20
14.1

13.9

12.5

13.5

0
11

12

13

14

0
2005

2010

2014
6

Limitation of Treatment-based medical

service
Average times of Ambulatory care : 14.6(2015) OECD mean: 6.5
Although, Treatment / Control rate of disease is low

[Hypertension]

%
100
80
60

80.3

57.7

Korea
USA

70.9

51.4

49.3

36.8

40

[DM]

80

61.464

34.6
24.1

40
20

72.6
72.7

60

20

Korea
USA

100

Building NHID (2012.6)

Working DB

NHID*

Beneficiary &
Contribution DB
Medical
Institution DB
Health
Screening DB

Extraction of
main DB & variables
Rebuilding DB by

Medical Aid DB
Long-term Care
DB

date
De-identification

* NHID :
National Health
Information Data
8

NHID DB

Beneficiary &
Contribution DB
Health Screening DB

Medical Institution DB

NHID
(2001~2015)

Long-term Care DB

Patient Registry DB
Mortality & Birth DB

Service Benefits DB
Whole Population
(50 millions)

Managing Eligibilities &

Contributions

Medical Service /
Health Screening Service

Long term Care Service

NHID Variables
Demogra
phic &
Social
Variables
Service
Benefits DB

Sex, Age, Birth, Death, Disability, Residential Area, Biciary

Type, Premiums, Workplace Type
Disease, Utilization, Cost, Details, Manpower, Facility,
Device

Medical

Health
Screening
DB

Smoking , Alcohol, Physical Activity, Disease History, Mental Health,

Body Measure, Lab Test, Cancer

Long-term
Care DB

Long-term care applicant info, Grading info, User info, Long-term care
institution info, Benefit info

10

. Current Status of
NHI Big Data
Supporting Health Research
Providing Health Information

Providing Data for Health Research

1. Sample Research DB (3 types, 2014.7~)
- Sample Cohort DB, Health Screening DB, The Ageing DB
Sample Cohort DB ?

Subject : 1 million (2% of Whole Population)

Duration : 02~15 (14 years)
Data : The Insured, Medical Treatment
Health Screening, Institute DB
Feature : Deidentification,
Only for Research
Methods : Portable Device(USB)

Sample DB

NHID
2%

The Insured
Health
Screening
Medical
Treatment
Institute
DB

12

Providing Data for Health Research

2. Customized DB for Study
- Providing full data by disease, subject
- Operating in regional big data center
* 8 centers(HQ, Busan etc.), 80 seats
- DB Features
* Un-individual, Only for research
* let result tables out, not raw data

13

Data Providing Website

Homepage : http://nhiss.nhis.or.kr/

14

Collaborative Research
3. Networking for joint-research
MOU : 24 organization
(Society, Public Organization, Hospital etc.)
Subject : Specific subject in medical society
Social health, Safety concerns
- Health concerns : Dring, Smoking, Damage of
Humidifier germicide, etc.
- Safety concerns : Child/ The aging abuse, Low-birth rate
15

Collaborative Research

16

Study Example ; based on NHID

Smoking Effect on Health Outcomes (2012)
- Population : 1,329,525 persons 30 aged more in health
screening DB of the employees and
dependents during 1992~1995
- Follow up : 19 years(1993~2011) for disease death

92

93

94

1,055,008

437,014

1,112,820

95

1996

2009

2010

2011

275,095

1,329,525 persons
(Male: 846,909, Female: 482,618)

Follow up
(19 years)
17

Study Example ; based on NHID

Research Results
- Disease of Relative Risk( RR) of smokers over Non-smokers in Korea
- Health Insurance Expenses by smoking

1.6914 trillion KRW (2011), Account for 3.7% out of total expense
Use of Results
- Providing evidence for the smoking lawsuit in Korea ('14. 4.14)

- Providing evidence for plan and assessment of health policy

7
6

Female

Male

6.5
5.5
4.6

3.6

RR

2.5

1.7

2
1
0

Laryngeal
cancer

Lung
cancer

pancreatic
cancer

18

Study Example ; based on NHID

High smoking rate during1980-1990 in Korea Lasting smoking impact

on

health -> Need long period study

UK research show that Smoking impact is the highest in 40 years after
smoking exposure in GP cohort study

Lung
cancer
RR

16
14
12
10
8
6
4
2
0

20

40

50

FU(year)
19

Supporting Health Service

Personal Health Record (My Health Bank), 2012~)

Health Screenings
Checking latest 5
years

Questionnaires
Checking 5 years
health questionnaire

Health
Screenings
Questionnaires

Medical Treatments
Checking latest
1 year of medical
treatments/
prescriptions

Patient-generated data
(PGD)
Self-input Measurements
of BP, DM. etc.

Medical
Treatments
Patientgenetated
Data(PGD)

20

Infectious Disease Alram Service(2014.

5~)

Target : 5 disease (Flu, Eye disease, Dermatitis, Asthma, Food poisoning)

Alram : Concern Caution Alert Danger
Contents : Disease & Social Media & Climate Information

21

 Public Data : (NHIS) Medical Record, (The Meteorological

Administration Agency) Climate Data, (Ministry of Food and
Drug Safety) Food Poisoning DB, (Ministry of Environment)
Pollution DB
Private Data : SNS(Social Network Service) : Twit, Blog, News
Data
Pubic
structured
data

Collection
Healthcare Data

Data Mining
Data Mining
Analyzing
healthcare

daily
data

Analyzing healthcare
data by region/ age/sex

NHI Big
data

Private
unstructur
ed data

Disease trend analyzing

SNS data

Modeling keyword
Analyzing disease
keywords

The dogs
walked home.
Home on the
range The dogs
walked home.
Home on the
range

SNS data

Text mining

Filtering
unstructured data

Analyzing daily
keywords by date,
region

Risk Prediction
The prediction by
structured data
The prediction by
unstructured data
Correlation
between health data
and keyword

Prediction modeling

Visual Service
Disease
Disease trend
trend

SNS
SNS trend
trend

Forecast
Forecast
Safety (State 1)
Cautious[Stage 2)
Risky
(Stage 3)

Monitoring
Forecasting

22

Providing Regional Health Disease Index

Supporting Regional Customized Health Service

23

. Future Plan

Extended PHR(Personal Health Record)

AS IS

TO BE

MY HEALTH BANK
Health
Information

Disease
Prediction

Life Log Data

Walking
Diet

Medical Check-up
results
Questionnaire about
health habits
Medical history
Medication
Self-recording

Provide health
information via
Homepage

Bloodpressure

Share with the

medical
practitioners

Glucose

Support Self Health

Management

Treatment and
Consulting

Approve

Health risk appraisal

Prediction of strokes
Metabolic syndrome
Check
Obesity program

Medical Images
CT

MRI
Update Information

X-ray

Sonography

Transfer Health
Information

25

KNHI Big Data Platform

26

Thank you