Taiwan

l National Health Insurance Research Database (NHIRD)

The National Health Insurance Research Database (NHIRD) in Taiwan is a population-level data source, covering approximately 23 million individuals, accounting for 99.9% of the Taiwanese population. The NHIRD contains demographic information and medical claims data for a wide range of healthcare services, including records from outpatient visits, emergency department visits, hospitalizations, procedures, and prescriptions. It helps construct longitudinal histories, making it feasible for cohort study designs. It can be linked to various other national health-related databases, including Cause of Death data, the Taiwan Cancer Registry Database, the Taiwan Biobank, Birth Certificates Application (BCA) database, and Registry of Catastrophic Illness Patients, etc. To ensure patient privacy, personal identification numbers are encrypted and replaced with unique, anonymous identifiers. These anonymous identifiers are then used as linkage keys to connect data across multiple databases. The integration of multiple databases enhances the NHIRD’s utility as a comprehensive real-world resource for diverse longitudinal studies and provides extensive insights into public health trends across Taiwan.

Reference:

1. Li BM, Yang AS, Cheng MC, et al. Risk of suicide in patients with atrial fibrillation receiving different oral anticoagulants: a nationwide analysis using target trial emulation framework. BMC Med. 2024;22(1):451. Published 2024 Oct 11. doi:10.1186/s12916-024-03645-z

2. Huang WC, Yang AS, Tsai DH, et al. Association between recently raised anticholinergic burden and risk of acute cardiovascular events: nationwide case-case-time-control study. BMJ. 2023;382:e076045. Published 2023 Sep 27. doi:10.1136/bmj-2023-076045

3. Huang HK, Liu PP, Lin SM, et al. Diabetes-Related Complications and Mortality in Patients With Atrial Fibrillation Receiving Different Oral Anticoagulants : A Nationwide Analysis. Ann Intern Med. 2022;175(4):490-498. doi:10.7326/M21-3498

4. Lee WA, Shao SC, Liao TC, et al. Comparative Risk of Arterial Thromboembolic Events Between Aflibercept and Ranibizumab in Patients with Maculopathy: A Population-Based Retrospective Cohort Study. BioDrugs. 2021;35(5):579-588. doi:10.1007/s40259-021-00497-4

5. Hsieh CY, Shao SC, Sung SF, Hsieh MHC, Tsai DHT, Lin SJ, Lai ECC. Taiwan’s National Health Insurance Research Database (NHIRD): in the Era of Artificial Intelligence, Causal Inference, and Data Security. Clin Epidemiol. 2025;17:967-981
https://doi.org/10.2147/CLEP.S553894

l Chang Gung Research Database (CGRD)

The Chang Gung Research Database (CGRD), the largest multi‐institutional electronic medical records (EMR) collection in Taiwan, provides access to researchers with standardized patient‐level data. It is the first and largest EMR database encompassing multiple medical institutions, covering 6.1% of outpatients and 10.2% of hospitalized patients in Taiwan. The CGRD contains more detailed clinical information that is not available from claims databases, such as Taiwan's National Health Insurance Research Database (NHIRD). In addition to prescriptions, diagnoses, and procedure records, the CGRD includes information from pathological reports and laboratory results such as HbA1c, eGFR.

Reference:

1. Tsai DH, Chuang AT, Liu KH, et al. Sodium-glucose cotransporter 2 (SGLT2) inhibitors and risk of chronic kidney disease-mineral and bone disorders in patients with type 2 diabetes mellitus and stage 1-3 chronic kidney disease. CMAJ. 2025;197(7):E178-E189. Published 2025 Feb 23. doi:10.1503/cmaj.240922

2. Hu JC, Shao SC, Tsai DH, et al. Use of SGLT2 Inhibitors vs GLP-1 RAs and Anemia in Patients With Diabetes and CKD. JAMA Netw Open. 2024;7(3):e240946. Published 2024 Mar 4. doi:10.1001/jamanetworkopen.2024.0946

l Taiwan Biobank (TWB)

Taiwan Biobank (TWB) is a large-scale national biomedical database integrating genetic, clinical, and lifestyle data from a community-based and hospital-based cohort. It includes demographic information, medical history, biospecimens (blood, urine, saliva), biochemical markers (lipids, HbA1c, liver/kidney function), and whole-genome data. TWB’s strengths lie in its longitudinal follow-up, standardized data collection, and the ability to link with other insurance databases and longitudinal registries, enabling real-world clinical applications. It supports genome-wide association studies (GWAS), precision medicine, cancer research, and public health policymaking. With its large, representative sample, comprehensive multi-omics data, and disease-specific research capabilities, TWB plays a crucial role in advancing genomic research and healthcare innovation in Taiwan.