Taiwan’s national health insurance research database: Past and future

Cheng Yang Hsieh, Chien Chou Su, Shih Chieh Shao, Sheng Feng Sung, Swu Jane Lin, Yea Huei Kao Yang, Edward Chia Cheng Lai

Research output: Contribution to journalReview articlepeer-review

94 Citations (Scopus)

Abstract

Taiwan’s National Health Insurance Research Database (NHIRD) exemplifies a population-level data source for generating real-world evidence to support clinical decisions and health care policy-making. Like with all claims databases, there have been some validity concerns of studies using the NHIRD, such as the accuracy of diagnosis codes and issues around unmeasured confounders. Endeavors to validate diagnosed codes or to develop methodologic approaches to address unmeasured confounders have largely increased the reliability of NHIRD studies. Recently, Taiwan’s Ministry of Health and Welfare (MOHW) established a Health and Welfare Data Center (HWDC), a data repository site that centralizes the NHIRD and about 70 other health-related databases for data management and analyses. To strengthen the protection of data privacy, investigators are required to conduct on-site analysis at an HWDC through remote connection to MOHW servers. Although the tight regulation of this on-site analysis has led to inconvenience for analysts and has increased time and costs required for research, the HWDC has created opportunities for enriched dimensions of study by linking across the NHIRD and other databases. In the near future, researchers will have greater opportunity to distill knowledge from the NHIRD linked to hospital-based electronic medical records databases containing unstructured patient-level information by using artificial intelligence techniques, including machine learning and natural language processes. We believe that NHIRD with multiple data sources could represent a powerful research engine with enriched dimensions and could serve as a guiding light for real-world evidence-based medicine in Taiwan.

Original languageEnglish
Pages (from-to)349-358
Number of pages10
JournalClinical Epidemiology
Volume11
DOIs
Publication statusPublished - 2019

All Science Journal Classification (ASJC) codes

  • Epidemiology

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