Adjusting for Confounders in Outcome Studies Using the Korea National Health Insurance Claim Database: A Review of Methods and Applications
Objectives: Adjusting for potential confounders is crucial for producing valuable evidence in outcome studies. Although numerous studies have been published using the Korea National Health Insurance Claim Database, no study has critically reviewed the methods used to adjust for confounders. This stu...
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| Format: | Article |
| Language: | English |
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Korean Society for Preventive Medicine
2024-01-01
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| Series: | Journal of Preventive Medicine and Public Health |
| Subjects: | |
| Online Access: | http://jpmph.org/upload/pdf/jpmph-23-250.pdf |
| _version_ | 1797316040156250112 |
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| author | Seung Jin Han Kyoung Hoon Kim |
| author_facet | Seung Jin Han Kyoung Hoon Kim |
| author_sort | Seung Jin Han |
| collection | DOAJ |
| description | Objectives: Adjusting for potential confounders is crucial for producing valuable evidence in outcome studies. Although numerous studies have been published using the Korea National Health Insurance Claim Database, no study has critically reviewed the methods used to adjust for confounders. This study aimed to review these studies and suggest methods and applications to adjust for confounders. Methods: We conducted a literature search of electronic databases, including PubMed and Embase, from January 1, 2021 to December 31, 2022. In total, 278 studies were retrieved. Eligibility criteria were published in English and outcome studies. A literature search and article screening were independently performed by 2 authors and finally, 173 of 278 studies were included. Results: Thirty-nine studies used matching at the study design stage, and 171 adjusted for confounders using regression analysis or propensity scores at the analysis stage. Of these, 125 conducted regression analyses based on the study questions. Propensity score matching was the most common method involving propensity scores. A total of 171 studies included age and/or sex as confounders. Comorbidities and healthcare utilization, including medications and procedures, were used as confounders in 146 and 82 studies, respectively. Conclusions: This is the first review to address the methods and applications used to adjust for confounders in recently published studies. Our results indicate that all studies adjusted for confounders with appropriate study designs and statistical methodologies; however, a thorough understanding and careful application of confounding variables are required to avoid erroneous results. |
| first_indexed | 2024-03-08T03:12:30Z |
| format | Article |
| id | doaj.art-26384487a38444e4b51e11f278f39592 |
| institution | Directory Open Access Journal |
| issn | 1975-8375 2233-4521 |
| language | English |
| last_indexed | 2024-03-08T03:12:30Z |
| publishDate | 2024-01-01 |
| publisher | Korean Society for Preventive Medicine |
| record_format | Article |
| series | Journal of Preventive Medicine and Public Health |
| spelling | doaj.art-26384487a38444e4b51e11f278f395922024-02-13T01:12:10ZengKorean Society for Preventive MedicineJournal of Preventive Medicine and Public Health1975-83752233-45212024-01-015711710.3961/jpmph.23.2502331Adjusting for Confounders in Outcome Studies Using the Korea National Health Insurance Claim Database: A Review of Methods and ApplicationsSeung Jin Han0Kyoung Hoon Kim1 Review and Assessment Research Institute, Health Insurance Review & Assessment Service, Wonju, Korea International Policy Research Division, Health Insurance Review & Assessment Service, Wonju, KoreaObjectives: Adjusting for potential confounders is crucial for producing valuable evidence in outcome studies. Although numerous studies have been published using the Korea National Health Insurance Claim Database, no study has critically reviewed the methods used to adjust for confounders. This study aimed to review these studies and suggest methods and applications to adjust for confounders. Methods: We conducted a literature search of electronic databases, including PubMed and Embase, from January 1, 2021 to December 31, 2022. In total, 278 studies were retrieved. Eligibility criteria were published in English and outcome studies. A literature search and article screening were independently performed by 2 authors and finally, 173 of 278 studies were included. Results: Thirty-nine studies used matching at the study design stage, and 171 adjusted for confounders using regression analysis or propensity scores at the analysis stage. Of these, 125 conducted regression analyses based on the study questions. Propensity score matching was the most common method involving propensity scores. A total of 171 studies included age and/or sex as confounders. Comorbidities and healthcare utilization, including medications and procedures, were used as confounders in 146 and 82 studies, respectively. Conclusions: This is the first review to address the methods and applications used to adjust for confounders in recently published studies. Our results indicate that all studies adjusted for confounders with appropriate study designs and statistical methodologies; however, a thorough understanding and careful application of confounding variables are required to avoid erroneous results.http://jpmph.org/upload/pdf/jpmph-23-250.pdfconfounderrisk adjustmentstatistical methodologyhealth insurance claim database |
| spellingShingle | Seung Jin Han Kyoung Hoon Kim Adjusting for Confounders in Outcome Studies Using the Korea National Health Insurance Claim Database: A Review of Methods and Applications Journal of Preventive Medicine and Public Health confounder risk adjustment statistical methodology health insurance claim database |
| title | Adjusting for Confounders in Outcome Studies Using the Korea National Health Insurance Claim Database: A Review of Methods and Applications |
| title_full | Adjusting for Confounders in Outcome Studies Using the Korea National Health Insurance Claim Database: A Review of Methods and Applications |
| title_fullStr | Adjusting for Confounders in Outcome Studies Using the Korea National Health Insurance Claim Database: A Review of Methods and Applications |
| title_full_unstemmed | Adjusting for Confounders in Outcome Studies Using the Korea National Health Insurance Claim Database: A Review of Methods and Applications |
| title_short | Adjusting for Confounders in Outcome Studies Using the Korea National Health Insurance Claim Database: A Review of Methods and Applications |
| title_sort | adjusting for confounders in outcome studies using the korea national health insurance claim database a review of methods and applications |
| topic | confounder risk adjustment statistical methodology health insurance claim database |
| url | http://jpmph.org/upload/pdf/jpmph-23-250.pdf |
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