• Title/Summary/Keyword: National Health Insurance Research Database

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Association of Congestive Heart Failure and Death with Ankylosing Spondylitis : A Nationwide Longitudinal Cohort Study in Korea

  • Bae, Ki Hwan;Hong, Je Beom;Choi, Yoon Jin;Jung, Jin Hyung;Han, In-Bo;Choi, Jung Min;Sohn, Seil
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.217-224
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    • 2019
  • Objective : We attempted to discover that Ankylosing spondylitis (AS) has a comprehensive relationship with congestive heart failure and death. Methods : We used a nationwide database managed by the Korean National Health Insurance Service from 2010 to 2014. Twelve thousand nine hundred eighty-eight patients with a diagnosis of AS and 64940 age- and sex- stratified matching subjects without AS were enrolled in the AS and control groups. Incidence probabilities of 6 years congestive heart failure and death in each group were calculated. The Cox proportional hazard regression analysis was used to estimate the hazard ratio. We divided the AS and control groups into subgroups according to sex, age, income, and comorbidities. Results : During the follow-up period, 102 patients (0.79%) in the AS group and 201 patients (0.32%) in the control group developed congestive heart failure (p<0.0001). In addition, 211 (1.62%) subjects in the AS group died during the follow-up period compared to 639 (0.98%) subjects in the control group (p<0.0001). The adjusted hazard ratio of congestive heart failure and death in the AS group was 2.28 (95% confidence interval [CI], 1.80-2.89) and 1.66 (95% CI, 1.42-1.95), respectively. The hazard ratios of congestive heart failure and death were significantly increased in all of the subgroups. Conclusion : The incidence rates of congestive heart failure and death were increased in AS patients.

The Epidemiology of Antidepressant Prescriptions in South Korea from the Viewpoint of Medical Providers : A Nationwide Register-Based Study (정신과 의사와 비정신과 의사의 항우울제 처방에 대한 연구 : 건강보험심사평가원 청구 데이터 중심으로)

  • Kim, Min Ji;Kim, Namwoo;Shin, Daun;Rhee, Sang Jin;Park, C. Hyung Keun;Kim, Hyeyoung;Yang, Boram;Ahn, Yong Min
    • Korean Journal of Biological Psychiatry
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    • v.26 no.2
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    • pp.39-46
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    • 2019
  • Antidepressants are widely used to treat depression in Korea, however, only a few studies have focused on the provider of the treatment. The aim of the study is to compare the differences between patients who were prescribed antidepressants by psychiatrists and those who were prescribed antidepressants by non-psychiatrists in South Korea. Patients with a diagnosis of depressive disorder who had been newly prescribed antidepressants in 2012 were selected from the Health Insurance Review and Assessment Service database. They were classified into two groups depending on whether they received the antidepressant prescription from a psychiatrist or non-psychiatrist. Sociodemographic, clinical, and depression related cost has been investigated. Treatment resistant depression, which is defined as a failure of two antidepressant regimens to alleviate symptoms, was also investigated. Prescription adequacy was assessed based on whether a regimen was maintained for at least 4 weeks. Among the 834694 patients with pharmaceutically treated depression (PTD) examined in this study, 326122 (39.1%) were treated by psychiatrists. Patients who were treated by psychiatrists were younger and had more psychiatric comorbidities than those treated by non-psychiatrists. They had longer PTD duration (229.3 days vs. 103.0 days, p < 0.05) and a larger proportion of treatment resistant depression (9.3% of PTD) when compared to those patients treated by non-psychiatrists. The patients treated by psychiatrists had a smaller proportion of inadequate antidepressant use compared to those patients in the non-psychiatrist group (44.5% vs. 65.1%, p < 0.05). The costs related to depression corrected with PTD duration were higher in the non-psychiatrist group (32214 won vs. 56001 won, p < 0.05). Patients who receive antidepressants from psychiatrists are patients with more severe, treatment-resistant depression. Psychiatrists prescribe antidepressants more adequately and cost- effectively than non-psychiatrists.

Effect of Lifestyle Risk Factors on Daily Life and Cognitive Function of the Older Adults in the Community (지역사회 노인의 라이프스타일 위험요인이 일상생활 활동과 인지기능에 미치는 영향)

  • Lim, Young-Myoung;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.12 no.4
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    • pp.111-122
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    • 2023
  • Objective : To identify the effect of lifestyle risk factors on the daily activities and cognition of the older adults in the community using the National Health Insurance Corporation 2015 geriatric cohort database. Methods : Lifestyle risk factors were defined as body mass index (BMI), smoking, drinking, vigorous exercise, moderate exercise, and walking, and basic and instrumental activities of daily living (ADL) and cognitive function variables were included in the analysis. ADL and cognitive function according to sex and age were analyzed using a t-test and one-way ANOVA. The correlation between lifestyle risk factors, ADL, and cognitive function was analyzed using Pearson's correlation analysis, and multiple regression analysis was performed to analyze their influence. Results : The factors affecting basic ADL (BADL) were sex and walking exercises, with an explanatory power of 1.7%. Instrumental ADL (IADL) included age, drinking, and walking exercises, with an explanatory power of 2.6%. Cognitive function included sex, age, BMI, vigorous exercise, and walking, with an explanatory power of 5.3%. Conclusion : Lifestyle risk factors partially affected BADLs/IADLs and cognitive function in community-dwelling older adults. This suggests the need to systematically manage lifestyle risk factors to improve and maintain the healthy lives of older adults facing biological aging.

Factors Affecting the Morbidity Related to Respiratory Dieseases in Urban Korea (한국 도시의 만성호흡기 질환 이환율에 영향을 주는 요인)

  • Han, Sung-Hyun;Park, Jae-Sung;Seo, Seung-Hee;Yoon, Jee-Eun;Jee, Sun-Ha
    • Korea journal of population studies
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    • v.28 no.2
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    • pp.205-217
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    • 2005
  • Purpose: To evaluate the factors affecting hospital utilization for respiratory diseases by ecological study design and GIS tool. To raise the social concern for respiratory disease by the result. Methods: Hospital admission data supported by national health insurance cooperation were transformed to spread sheet data format and combined with air monitoring dataset. Air pollution data were collected from the annual report of air monitoring published by Korea Ministry of Environment. Socioeconomic statistics including population density, age distribution, forest ratio etc.. were filed using Korea National Statistical Office database. Multiple linear regression analysis was performed to evaluate the factors affecting hospital utilization for respiratory diseases. Analytical unit was 52 cities. Results: The factors affecting hospital utilization for respiratory diseases were the proportion of population 60 years and over, seaside city, $O_3$ level, smoking rate. Conclusions: However, outdoor pollutants monitoring data and smoking rate have weakness in reflecting individual exposure. Further research is required to propose more illustrative means to evaluate causal relationship between air pollution and respiratory health effect factors.

The Effects of PM10 on the Hospital Admission of Patients with Respiratory Disease in Seoul, Korea (서울지역 미세먼지가 호흡기계 질환으로 입원한 환자에 미치는 영향)

  • Pak, Hae-Yong;Pak, Yun-Suk
    • Journal of Convergence for Information Technology
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    • v.9 no.6
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    • pp.194-201
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    • 2019
  • This cohort study aimed to identify the effects of daily PM10 exposure on the hospital admission of patients with respiratory diseases, during the nine-year period (2002-2010), in Seoul, Korea. The research subjects were 13,974 patients who had been hospitalized with respiratory diseases, including chronic obstructive pulmonary disease (COPD), asthma, and pneumonia. During the follow-up period, an increase of 10 ug/m3 in PM10 under the threshold of 50 ug/m3 of PM10 led to hospital admission in 1.38% of the age group younger than 15 years, 1.62% in those 65 years or older, 2.87% in patients 75 years or older and in 1.50% of pneumonia patients, 1.51% of COPD patients, and 1.55% of pneumonia and asthma patients. Under the threshold of 80 ug/m3 of PM10, there was a 3.71% increase in new patients admitted in the age group 65 years or older and 4.25% in those at least 75 years old. Our study found that high PM10 was associated with increased risk of admission of respiratory patients, especially in the elderly. People who already have a respiratory disease should refrain from exposure to particulate matter when there is a high concentration of PM10, especially older patients.

National Data Analysis of General Radiography Projection Method in Medical Imaging (영상의학검사 일반촬영 분야의 촬영기법에 대한 분석)

  • Kim, Jung-Su;Kim, Jung-Min;Lee, Young-Han;Seo, Deok-Nam;Choi, In-Seok;Nam, So-Ra;Yoon, Yong-Su;Kim, Hyun-Ji;Min, Hye-Lim;Her, Jea;Han, Seong-Gyu
    • Journal of radiological science and technology
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    • v.37 no.3
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    • pp.169-175
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    • 2014
  • According to database of medical institutions of health insurance review & assessment service in 2013, 1118 hospitals and clinics have department of radiology in Korea. And there are CT, fluoroscopic and general radiographic equipment in those hospitals. Above all, general radiographic equipment is the most commonly used in the radiology department. And most of the general radiographic equipment are changing the digital radiography system from the film-screen types of the radiography system nowadays. However, most of the digital radiography department are used the film-screen types of the radiography system. Therefore, in this study, we confirmed present conditions of technical items for general radiography used in hospital and research on general radiographic techniques in domestic medical institutions. We analyzed 26 radiography projection method including chest, skull, spine and pelvis which are generally used in the radiography department.

$H_2$ Receptor Antagonists and Gastric Cancer in the Elderly: A Nested Case-Control Study (노인 인구에서 $H_2$ Receptor Antagonist와 위암과의 관련성: 코호트 내 환자-대조군 연구)

  • Kim, Yoon-I;Heo, Dae-Seog;Lee, Seung-Mi;Youn, Kyoung-Eun;Koo, Hye-Won;Bae, Jong-Myon;Park, Byoung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.3
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    • pp.245-254
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    • 2002
  • Objective : To test if the intake of $H_2$ receptor antagonists ($H_2$-RAs) increases the risk of gastric cancer in the elderly. Methods : The source population for this study was drawn from the responders to a questionnaire survey administered to the Korea Elderly Pharmacoepidemiological Cohort (KEPEC), who were beneficiaries of the Korean Medical Insurance Corporation, were at least 65 years old, and residing in Busan in 1999. The information on $H_2$-RAs exposure was obtained from a drug prescription database compiled between inn. 1993 and Dec. 1994. The cases consisted of 76 gastric cancer patients, as confirmed from the KMIC claims data, the National Cancer Registry and the Busan Cancer Registry. The follow-up period was from Jan. 1993 to Dec. 1998. Cancer free controls were randomly selected by 1:4 individual matching, which took in to consideration the year of birth and gender. Information on confounders was collected by a mail questionnaire survey. The odds ratios, and their 95% confidence intervals, were calculated using a conditional logistic regression model. Results : After adjusting for a history of gastric ulcer symptoms, medication history, and body mass index, the adjusted OR (aOR) was 4.6 (95% CI=1.72-12.49). The odds ratio of long term use (more than 7 days) was 2.3 (95% CI=1.07-4.82). The odds ratio of short term use was 4.6 (95% CI=1.26-16.50). The odds ratio of parenteral use was 4.4 195% CI=1.16-17.05) and combination use between the oral and parenteral routes (aOR, 16.8; 95% CI=1.21-233.24) had the high risk of gastric cancer. The aOR of cimetidine was 1.7 (95% CI=1.04-2.95). The aOR of ranitidine was 2.0 (95% CI=1.21-3.40). The aOR of famotidine was 1.7 (95% CI=0.98-2.80). Conclusion : The intake of $H_2$-RAs might increase the risk of gastric cancer through achlorhydria in the elderly.