Journal of Preventive Medicine and Public Health

Scoping Review

Reporting Quality for Comorbidity Adjustment in Studies Using Korean Health Insurance Claim Data: A Scoping Review: Kyoung-Hoon Kim; J Prev Med Public Health. 2026;59(2):123-131. Published online January 6, 2026; DOI: https://doi.org/10.3961/jpmph.25.839

931 View
136 Download

Abstract Summary PDF: Objectives
Adjustment for comorbidity is essential in observational studies using administrative data to ensure the reproducibility and transparency of research findings. However, the reporting quality of comorbidity adjustment in studies using the National Health Insurance Claim Data (NHICD) has not yet been evaluated. This study aimed to assess the reporting quality of comorbidity adjustment in health outcome studies that used the NHICD.
Methods
We conducted a PubMed search in April 2025 using the terms “(Korea OR Korean) AND (‘health insurance claim*’ OR claims data OR NHIS OR HIRA) AND (2024).” Of the 239 retrieved studies, 82 outcome studies that exclusively used the NHICD and adjusted for comorbidities as confounding variables were included. Reporting quality was evaluated across 3 domains: (1) scope of data, (2) range of diagnostic codes, and (3) length of the look-back period.
Results
Among the 82 studies, 33 (40.2%) used ad hoc selection, 33 (40.2%) used the Charlson comorbidity index, and 13 (15.9%) applied both methods. The Elixhauser comorbidity measure was rarely used, appearing in only 3 studies. Only 3 studies explicitly described the scope of data used, and 6 reported the diagnostic code range. The look-back period was specified in 26 studies (31.7%), with 1 year being the most commonly reported duration.
Conclusions
The reporting quality of comorbidity adjustment in studies using the NHICD remains suboptimal. Transparent and standardized reporting of data scope, diagnostic code range, and look-back period is essential to improve the reproducibility and comparability of research findings.; Summary

Korean summary
건강보험 청구자료를 활용한 관찰연구에서 동반질환 보정은 연구 결과의 타당성을 확보하는 데 중요한 요소이나, 그 보고 수준은 충분히 평가되지 않았다. 본 연구는 2024년에 발표된 건강보험 청구자료 기반 연구를 대상으로 문헌검색을 수행하고, 데이터 범위, 진단코드 범위, 관찰기간 측면에서 동반질환 보정의 보고 수준을 평가하였다. 그 결과, 대부분의 연구에서 이러한 핵심 방법론적 정보가 충분히 보고되지 않았으며, 보고 방식에도 상당한 변이가 존재하였다. 이러한 결과는 연구의 재현성과 비교 가능성을 제한할 수 있음을 의미하며, 향후 행정자료 기반 연구의 신뢰성과 방법론적 정확성을 높이기 위해 표준화되고 투명한 보고가 필요함을 시사한다.

Key Message
The reporting quality of comorbidity adjustment in studies using Korean health insurance claims data remains suboptimal. Key methodological elements, including the scope of data, diagnostic code range, and look-back period, are frequently omitted or insufficiently described, limiting the reproducibility and comparability of findings. Transparent and standardized reporting of these components is essential to improve methodological rigor and support more reliable evidence generation in administrative data research.

Original Article

Trends in Regional Disparities in Cardiovascular Surgery and Mortality in Korea: A National Cross-sectional Study: Dal-Lae Jin, Kyoung-Hoon Kim, Euy Suk Chung, Seok-Jun Yoon; J Prev Med Public Health. 2024;57(3):260-268. Published online May 30, 2024; DOI: https://doi.org/10.3961/jpmph.24.057

7,935 View
302 Download
4 Web of Science
5 Crossref

Abstract Summary PDF Supplementary Material

Objectives
Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival.
Methods
A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed.
Results
The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91).
Conclusions
Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.

Summary

Korean summary
심혈관 관련 수술을 대상으로 지역적 불균형을 분석한 결과, 관상동맥우회술, 경피적 관상동맥중재술, 스텐트 삽입술은 전국적으로 광범위하게 분포되었다. 반면에 대동맥류 절제술은 지역적 불균형이 발생하였고, 사망률 또한 유의한 차이가 있었다. 따라서 의료 격차 해소를 위해 병원 간 협력체계 구축, 지역 균형적 의료자원 확충 등 정책적 노력이 필요하다

Key Message
An analysis of regional disparities in cardiovascular surgeries revealed that coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), and stent insertion procedures were widely distributed nationwide. However, there was a regional imbalance in aortic aneurysm resection (AAR) surgeries, which also showed significant differences in mortality rates. Therefore, policy efforts are needed to bridge the healthcare gap, such as establishing collaborative systems among hospitals and ensuring a balanced distribution of medical resources across regions.

Citations

Citations to this article as recorded by

Nationwide Trends in Coronary Artery Bypass Grafting in the Republic of Korea, 2005–2022: A Comparison with International Data
Min Ho Ju, Jun Ho Lee, Yun Jin Kim, Ho Jin Kim, Ho Young Hwang, Sang Yoon Yeom, Hee Jung Kim, Young-Nam Youn, Wook Sung Kim, Man-Jong Baek, Hyun Keun Chee
Journal of Chest Surgery.2026; 59(1): 7. CrossRef
Association between socioeconomic status and cardiovascular disease by sex: Mediating roles of psychological and behavioral factors
Jiwon Choi, Sung-il Cho, Belal Hossain
PLOS One.2026; 21(4): e0345573. CrossRef
Global trends and practices in coronary artery bypass surgery
Shahzad G. Raja
Academia Medicine.2025;[Epub] CrossRef
Metagenome-assembled genomes reveal microbial signatures and metabolic pathways linked to coronary artery disease
Soomin Lee, Shahbaz Raza, Eun-Ju Lee, Yoosoo Chang, Seungho Ryu, Hyung-Lae Kim, Si-Hyuck Kang, Han-Na Kim, Ying Zhang
mSystems.2025;[Epub] CrossRef
Regional disparities in the distribution of public and private healthcare facilities in South Korea
Jiyu Park, Byeongyun Jeon, Eun Lee, Abel C. H. Chen
PLOS One.2025; 20(9): e0330090. CrossRef

First
Prev
Page of 1
Next
Last

Search