ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Policy
This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health WelfareView all 104 articles
Impact of COVID-19 on National Health Screening Participation and Chronic Disease Detection: Evidence from South Korea's NHIS Database
Provisionally accepted
- 1Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- 2Kyung Hee University Medical Center, Dongdaemun-gu, Republic of Korea
- 3Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
- 4Seoul National University Seoul Metropolitan Government Boramae Medical Center, Dongjak-gu, Republic of Korea
- 5Hallym University Medical Center, Yeongdeungpo-gu, Republic of Korea
- 6Woori Hospital, Pocheon-si, Republic of Korea
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Background: The COVID-19 pandemic disrupted preventive healthcare services worldwide, raising concerns about missed diagnoses of chronic diseases. South Korea's national health screening program experienced a substantial decline in participation during 2020. This study investigated how changes in screening rates influenced chronic disease detection and what these shifts reveal about the resilience of the national health system. Methods: Using the Korea Disease Control and Prevention Agency–National Health Insurance Service (K-COV-N) database, we analyzed trends in national health screening participation (2010–2020) and new diagnoses of hypertension, diabetes mellitus, and dyslipidemia before (2019) and during (2020) the COVID-19 pandemic. Relative risks (RRs) for newly diagnosed chronic diseases were calculated for individuals who underwent health checkups and those who did not. Results: Health screening participation dropped from 75.4% in 2019 to 68.7% in 2020. Despite this decrease, new diagnoses of chronic diseases increased by approximately 550,000 cases in 2020 compared with 2019. Hypertension, diabetes, and dyslipidemia all showed higher relative risks among individuals who underwent screenings than among those who did not. Cardiovascular and cerebrovascular diseases declined, while heart failure increased slightly. Conclusion: The decline in preventive health screening did not correspond to a decline in chronic disease detection, suggesting a behavioral and systemic shift toward alternative diagnostic pathways. These findings underscore the importance of resilient health systems that maintain continuity of essential services during public health crises.
Keywords: COVID-19, Chronic Disease Detection, Health system resilience, National health screening program, South Korea, Preventive healthcare policy
Received: 08 Oct 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Oh, Kim, Lee, Park, Han, KOO, Cho and Song. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bumjo Oh, bo39@snu.ac.kr
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