Exploring the Korean National Health Examination Baseline (KNHEB) Cohort: Your Key to Understanding Longitudinal Health Trends in South Korea – BMC Public Health

In South Korea, nearly all residents are enrolled in a single-payer health insurance system. This ensures that everyone has access to general health screenings. The National Health Insurance Service (NHIS) takes charge, covering over 97% of the population. The goal of these screenings is to catch health issues early and connect patients to necessary care. The program originally targeted those aged 40 and over but expanded to include dependents aged 20 and above, as well as beneficiaries of the Medical Aid program. Participation in these screenings has grown significantly, jumping from 43.2% in 2002 to 74.1% in 2019, indicating a strong public engagement in health maintenance.

The NHIS maintains a comprehensive database of medical records, which supports extensive health research. This database helps researchers run studies like the Korean National Health Examination Database (KNHEB) without needing individual consent, as the data is de-identified. In total, 8,916,544 participants were included in the KNHEB, derived from the health screenings held between 2002 and 2003.

To ensure the KNHEB is representative, its demographic data was compared to the 2001 Korea National Health and Nutrition Examination Survey (KNHANES). This survey uses a complex sampling design to reflect the general population accurately. The KNHEB closely mirrors this population regarding factors like age, gender, and health behaviors. For example, 59.5% of the KNHEB cohort was male, aligning closely with national statistics. The smoking and alcohol consumption rates were also comparable, suggesting that the cohort reflects broader societal health trends.

One factor that influenced participation rates was employment status. Individuals with employer-provided health insurance were more likely to participate due to better access to the screening programs. Data shows that 76% of KNHEB participants were employed, compared to a more balanced division in the general population’s insurance coverage. This discrepancy relates to workplace health policies and their impact on access to screenings.

Following participants over time is crucial for health research. The KNHEB’s database captures various details, like hospital visits and health check-up results, allowing researchers to track health outcomes. The average follow-up period for participants extended to over 16 years, providing a rich resource for understanding health trends and mortality rates. By 2019, nearly 841,000 participants had passed away, with follow-up data continuing until 2019 for those still living.

Comprehensive health data includes details on insurance eligibility, death records, hospital visits, and health checks. For instance, death notifications are collected through Statistics Korea, which has a high accuracy rate of 91.9% for recording causes of death. This meticulous data collection informs public health policies and helps researchers identify trends and areas for improvement in healthcare delivery.

Adaptations to health screenings have happened over the years. Since 2008, the Ministry of Health and Welfare has implemented changes to enhance testing methods and data collection. These updates allow for more detailed assessments of lifestyle factors, such as smoking and alcohol consumption, turning them into continuous measures for more nuanced analysis.

In summary, the KNHEB cohort reflects South Korea’s commitment to public health through its robust screenings and data collection efforts. This extensive database not only informs current health policies but also helps predict future trends, paving the way for improved healthcare for all citizens.

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