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- Cohort profile: the KDCA-Tuberculosis-NHIS cohort linking tuberculosis surveillance and health insurance data in Korea
- Dawoon Jeong, Jinsun Kim, Seung Won Lee, Hongjo Choi, Hojoon Sohn, Jieun Kim, Hyewon Lee, Hyeran Jeong, Seung Eun Lee, Young-joon Park, Jaiyong Kim, Eun Mi Kim, Minji Koo, Hoyeon Jang, Young Ae Kang
- Epidemiol Health. 2025;47:e2025071. Published online December 13, 2025
- DOI: https://doi.org/10.4178/epih.e2025071
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- 5 Web of Science
- 3 Crossref
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Abstract
Summary
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Supplementary Material -
AbstractDespite a steady decline in incidence, tuberculosis (TB) remains a substantial public health burden in Korea, particularly among older adults. Existing national TB surveillance systems lack sufficiently comprehensive data to assess long-term outcomes and health disparities. The K-TB-N cohort integrates data from 3 national sources: the Korean Tuberculosis Surveillance System (2011-2022), the National Health Insurance Database (2010-2022), and mortality data from Statistics Korea (2010-2022). After data cleaning and linkage, the final cohort included 373,812 patients (375,440 episodes) with either drug-susceptible TB or drug- resistant TB. TB notifications declined by approximately 60% over the study period, while the median patient age continued to rise. Treatment success improved over time, accompanied by reductions in lost to follow-up. However, mortality during treatment increased, with more than half of deaths attributed to non-TB causes such as pneumonia, cancer, and cardiovascular disease. Post-treatment mortality also remained high, particularly among patients with drug-resistant TB. The K-TB-N cohort provides a comprehensive, linked dataset for advancing research on TB epidemiology, treatment outcomes, comorbidities, and health disparities. It enables evaluations of public health interventions, long-term prognosis, and strategies for post-TB care. This cohort will remain a valuable resource for shaping data-driven TB control policies in aging and high-burden settings.
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SummaryKorean summary
- K-TB-N 코호트는 결핵 신고자료, 건강보험청구자료, 통계청 사망자료를 연계한 국내 최초의 전국단위 결핵 통합자료 코호트이다. - 이 코호트를 결핵 치료 성과와 치료 종료 이후 사망을 포함한 장기예후 분석이 가능하다. - 코호트에 포함된 2011-2022년 사이, 결핵 발생은 60% 감소하였고, 결핵 환자의 평균 연령은 증가하였다. 결핵 치료 중 사망율은 증가하였는데, 사망원인의 50% 이상은 비결핵성 사망이었다.Key Message
- The K-TB-N cohort is the first national-level integrated TB cohort in South Korea that combines three distinct datasets, overcoming the limitations of single-source TB registries. - The linkage of clinical data (KTB-Surv), health insurance claims (NHID), and mortality records (Statistics Korea) allows long-term tracking of treatment outcomes and post-treatment mortality. - TB notifications declined by ~60% during the study period, while the median patient age increased. - The mortality during TB treatment rose, with over half of deaths attributed to non-TB causes. -
Citations
Citations to this article as recorded by
- Suicide risk in people with tuberculosis in Republic of Korea: a nationwide cohort, 2012–2021
Chiwook Chung, Seung Won Lee, Dawoon Jeong, Hongjo Choi, Hojoon Sohn, Young Ae Kang
Infectious Diseases of Poverty.2026;[Epub] CrossRef - Clinical outcomes and recurrence after treatment of asymptomatic pulmonary tuberculosis: A nationwide cohort study
Se Hyun Kwak, Hongjo Choi, Seung Won Lee, Dawoon Jeong, Hojoon Sohn, Young Ae Kang
International Journal of Infectious Diseases.2026; 169: 108805. CrossRef - Context-dependent risk stratification using a tuberculin skin test induration threshold of ≥ 15 mm in school tuberculosis screening in Hangzhou, China: a historical cohort study
Xiangjie Meng, Yin Tang, Jun Shou, Nan Jiang, Yu Zhang
Tropical Medicine and Health.2026;[Epub] CrossRef
- Suicide risk in people with tuberculosis in Republic of Korea: a nationwide cohort, 2012–2021
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