The Risk Measure of Hypertension and Diabetes by National Health Insurance Data

Introduction: Korea’s health insurance is a social insurance that the government is the insurer and the whole nation. All of the national medical benefits are claimed,reviewed and paid for. PURPOSE The study purpose is to investigate the relative risk(RR) of stroke, myocardial infarction and chronic renal failure due to hypertension and diabetes, and the population attributable risk(PAR) by using health claim data for all Koreans in Korea. Method: The research data are the claims for medical insurance fees from 1999 to 2006.We calculated the RR of stroke, myocardial infarction,and chronic renal failure in 2004 and 20respectively,among those who had been diagnosed with hypertension or diabetes even once in eight years from 1999 to 2006, compared with those in other populations.If a person who did not claim a medical fee for the disease for five years from 1999 to 2003 had a medical fee claim for that year,the person was defined as the treatment incidence.PAR of hypertension or diabetes for these complications was calculated using RR and treatment prevalence. Result: In 2005, the treatment prevalence rate of hypertension over 30 years old was 23.1% and the diabetes was 10.5%.The National Health and Nutrition Survey, which is a nationwide survey,has 27.9% hypertension and 8.1% diabetes.The RR of stroke was 11.0,the RR of myocardial infarction was 13.6, and the RR of chronic renal failure was 30.3.The PAR of hypertension or diabetes to stroke was 73.0% over 30 years old. Myocardial infarction was 77.3% and chronic renal failure was 88.8%. In other words, 73% of patients with stroke, 77.3% of patients with myocardial infarction,and 88.8% of patients with chronic renal failure could not have developed if hypertension and diabetes is completely managed. Discussion: Although it is different from the official cohort data because it is measurement using the health insurance fee claim data,it is meaningful to be able to generally see the disease prevalence and the occurrence status for the whole nation.