Parasitic infections and medical expenses according to Health Insurance Review Assessment claims data in South Korea, 2011–2018

IntroductionIn South Korea, Health Insurance Review and Assessment claims data contain comprehensive information on healthcare services for almost the entire population. The present study used claims data on parasitic diseases from 2011 to 2018, and associated medical expenses to investigate infection trends associated with endemic parasitic diseases in South Korea, including those not monitored by Korea Centers for Disease Control and Prevention.MethodsBasic data regarding each parasitic disease were curated from the Healthcare Bigdata Hub (http://opendata.hira.or.kr). Ten endemic parasitic diseases, three pandemic protozoan diseases, and three ectoparasitic diseases were evaluated between 2011 and 2018. Data on each parasitic disease included the number of patients of each sex, age range within 5 years, province, and total medical expenses. Heatmap and principal component analysis were performed to visualize the incidence pattern of parasitic diseases by provinces.ResultsClonorchiasis and pinworm infections decreased remarkably from 6,097 and 4,018 infections in 2011 to 3,008 and 1,988 infections in 2018, respectively. Other endemic parasitic diseases mostly declined or remained steady over the 8-year period, except for anisakiasis, which doubled from 409 in 2011 to 818 in 2018. Provinces close to North Korea had a higher frequency of claims for Plasmodium vivax infection. The highest rate of clonorchiasis was in Gyeongsangnam-do, while that of anisakiasis was in southern Korea. Jeju province had the highest number of claims for cysticercosis, anisakiasis, pinworm infection, and soil-transmitted helminth infections. The total medical expense for anisakiasis was 65 million Korean won (57,000 US$) in 2011, rising to 237 million Korean won (206,000 US$) in 2018. The medical expense for trichomoniasis was 6,063 million won and for scabies was 1,669 million won in 2018. Since the claims data include only data reported by healthcare providers, some discrepancies might have occurred.ConclusionOur findings provide the basis for a health policy to reduce further infections and medical expense.

**引言**：在韩国，健康保险审查与评估（Health Insurance Review and Assessment, HIRA）理赔数据涵盖了几乎全体国民的医疗服务完整信息。本研究调取2011至2018年的寄生虫病相关理赔数据及关联医疗费用，旨在探究韩国本土流行寄生虫病（含未纳入韩国疾病控制与预防中心（Korea Centers for Disease Control and Prevention, KCDC）监测范围的病种）的感染流行趋势。

**方法**：本研究从医疗大数据中心（Healthcare Bigdata Hub，网址：http://opendata.hira.or.kr）提取各类寄生虫病的基础数据。2011至2018年间，本研究共纳入10种本土流行寄生虫病、3种流行性原虫病及3种体外寄生虫病进行分析。单病种数据包含患者性别分布、5年一档的年龄分层、就诊省份及总医疗费用信息。本研究通过热图（Heatmap）与主成分分析（Principal Component Analysis, PCA）可视化不同省份的寄生虫病发病分布模式。

**结果**：华支睾吸虫病（Clonorchiasis）与蛲虫病感染例数分别从2011年的6097例、4018例显著下降至2018年的3008例、1988例。其余本土流行寄生虫病在8年研究周期内多呈下降或平稳态势，仅异尖线虫病（Anisakiasis）感染例数翻倍，从2011年的409例增至2018年的818例。毗邻朝鲜的省份间日疟原虫（Plasmodium vivax）感染理赔频次更高。华支睾吸虫病发病率最高的省份为庆尚南道，而异尖线虫病高发区域则为韩国南部地区。济州特别自治道的囊尾蚴病、异尖线虫病、蛲虫病及土源性蠕虫感染理赔例数均为全国最高。异尖线虫病的总医疗费用从2011年的6500万韩元（约合57000美元）升至2018年的23700万韩元（约合206000美元）。2018年，滴虫病的医疗费用达60.63亿韩元，疥疮的医疗费用则为16.69亿韩元。由于本研究使用的理赔数据仅涵盖医疗服务机构上报的信息，可能存在一定的数据偏差。

**结论**：本研究结果可为制定进一步降低寄生虫感染发生率与医疗负担的卫生政策提供科学依据。