• Korean Journal of Community Nutrition
• /
• v.26 no.3
• /
• pp.211-227
• /
• 2021

Objectives: We aimed to examine the association between the relative preference for vegetables and meat and cancer incidence, in a population-based retrospective cohort in Korea. Methods: We included 10,148,131 participants (5,794,124 men; 4,354,007 women) who underwent national health screening between 2004 and 2005 from the National Health Information Database of the National Health Insurance Service (NHIS-NHID). Participants were asked whether they preferred consuming 1) vegetables more often, 2) both vegetables and meat or 3) meat more often. Participants were followed up to Dec. 31, 2017. All cancer and eighteen common cancer cases were identified through the code from the International Classification of Diseases, 10th revision. We estimated sex-specific relative risks and 95% confidence intervals, adjusting for age, body mass index, alcohol consumption, smoking, physical activity, and income level. Results: During an average follow-up of 12.4 years, 714,170 cancer cases were documented. In men, consuming meat more often was associated with lower risk of esophageal, liver, and stomach cancers, but higher risk of lung and kidney cancers. Consuming both vegetables and meat was associated with higher risk of prostate cancer, but with lower risk of esophageal, liver, and stomach cancers in men. In women, consuming meat more often was associated with a higher risk of colorectal cancer and breast, endometrial, and cervical cancers diagnosed before the age of 50. Consuming both vegetables and meat was associated with lower risk of liver cancer in women. Conclusions: Our study suggests a potential link between vegetable and meat intake and cancer incidence in the Korean population. Further investigation on the association between the intake of specific types of vegetables and meat and cancer risk in Korean prospective cohort studies is needed.

• Health Policy and Management
• /
• v.29 no.3
• /
• pp.262-276
• /
• 2019

Background: The most important thing to strengthen primary care is to prove that the continuity of primary care is an essential area for good health outcomes. The purpose of this study is to analyze the effect of outpatient continuity of primary care on the hospitalization experience of diabetes mellitus in new diabetic patients. Methods: Using the Korean National Health Insurance Service national sample cohort (NHIS-NSC 2011-2015) data, 3,391 new diabetic patients in 2012 were selected for the study. Multiple logistic regression was performed to investigate the effect of outpatient continuity of primary care on hospitalization in new diabetic patients. Results: The outpatient continuity of primary care in new diabetic patients was measured by the continuity of care index, which showed that 69.4% (n=2,352) were high level and 30.6% (n=1,039) were low level. Patients who had high continuity of primary care at the early stage of diabetes diagnosis showed 3.49 times more likely to maintain high continuity of primary care in the second year (95% confidence interval [CI], 2.72-4.49). Patients with low continuity of primary care for 2 years from the initial diagnosis of diabetes were 2.56 times more likely to be hospitalized due to diabetes than those who did not (95% CI, 1.55-4.25). Conclusion: This study identified the need for policies to increase the continuity of primary care for new diabetic patients and could contribute to lowering the admission rate of diabetic patients if the policy for this would work effectively.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
• /
• 2017.10a
• /
• pp.115-117
• /
• 2017

R has become a popular analytics platform as it provides powerful analytic functions as well as visualizations. However, it has a weakness in which scalability is limited. As an alternative, the RHadoop package facilitates distributed processing of R programs under the Hadoop platform. This paper investigates usefulness of the RHadoop package when analyzing healthcare big data that is widely open in the internet space. To do this, this paper has compared analytic performances of R and RHadoop using the medical treatment records of year 2015 provided by National Health Insurance Service. The result shows that RHadoop effectively enhances processing performance of healthcare big data compared with R.

• Journal of Preventive Medicine and Public Health
• /
• v.52 no.6
• /
• pp.393-404
• /
• 2019

Objectives: The purpose of this study was to determine the associations between blood hemoglobin (Hgb) levels and the risk of death by specific causes. Methods: Using the National Health Insurance Services-National Health Screening Cohort (n=487 643), we classified serum Hgb levels into 6 sex-specific groups. Cox regression analysis was used to analyze the associations between Hgb levels and the risk of cause-specific death. Results: Hgb levels in male population showed a U-shaped, J-shaped, or inverse J-shaped association with the risk of death from ischemic heart disease, acute myocardial infarction, liver cancer, cirrhosis and chronic obstructive pulmonary disease (COPD) (all non-linear p<0.05; hazard ratio [HR]; 95% confidence interval [CI]) for the lowest and the highest Hgb levels for the risk of each cause of death in male population: HR, 1.14; 95% CI, 0.98 to 1.34; HR, 2.87; 95% CI, 1.48 to 5.57; HR, 1.16; 95% CI, 0.96 to 1.40; HR, 3.05; 95% CI, 1.44 to 6.48; HR, 1.36; 95% CI, 1.18 to 1.56; HR, 2.11; 95% CI, 1.05 to 4.26; HR, 3.64; 95% CI, 2.49 to 5.33; HR, 5.97; 95% CI, 1.44 to 24.82; HR, 1.62; 95% CI, 1.14 to 2.30; HR, 3.84; 95% CI, 1.22 to 12.13, respectively), while in female population, high Hgb levels were associated with a lower risk of death from hypertension and a higher risk of death from COPD (overall p<0.05; HR, 1.86; 95% CI, 1.29 to 2.67 for the lowest Hgb levels for hypertension; overall p<0.01, HR, 6.60; 95% CI, 2.37 to 18.14 for the highest Hgb levels for COPD). For the risk of lung cancer death by Hgb levels, a linear negative association was found in male population (overall p<0.01; the lowest Hgb levels, HR, 1.17; 95% CI, 1.05 to 1.33) but an inverse J-shaped association was found in female population (non-linear p=0.01; HR, 1.25; 95% CI, 0.96 to 1.63; HR, 2.58; 95% CI, 1.21 to 5.50). Conclusions: Both low and high Hgb levels were associated with an increased risk of death from various causes, and some diseases showed different patterns according to sex.

• Journal of Korean Neurosurgical Society
• /
• v.63 no.6
• /
• pp.784-793
• /
• 2020

Objective : We attempted to compare the incidence of pyogenic spondylitis (PS) and tuberculous spondylitis (TS) between 2007 and 2016. Furthermore, we investigated the patients who underwent surgery in 2016 compared to that in 2007. Methods : We used a nationwide database managed by the Korean National Health Insurance Service (NHIS) in 2007 and 2016. Total 9655 patients with a newly diagnosis of PS or TS were enrolled in PS or TS group. Among them, 1721 patients underwent either fusion or decompression surgery. We analyzed demographic distribution of patients according to gender and age and year of diagnosis. Results : Comparing between 2007 and 2016, the incidence of PS has increased in 2016 than in 2007 (4874 vs. 2431, p<0.0001). Conversely, declination of incidence of TS was discovered in 2016 compared to 2007 (594 vs. 1756, p<0.0001). Females showed predominance over males regarding both PS and TS (5228 vs. 4427, p<0.0001). Among them, the number of PS patients who underwent surgery increased significantly in 2016 relative to that in 2007 (979 vs. 592, p<0.0001). Conclusion : This nationwide study suggests that PS may increase and TS may decrease in Korea. In addition, demand for surgery regarding PS may increase.

• Journal of Korean Clinical Health Science
• /
• v.9 no.2
• /
• pp.1493-1501
• /
• 2021

Purpose: The purpose of this study is to classify the characteristics of each item of CIST evaluation and to find out the degree of recognition of the characteristics of the cognitive tool. Methods: This study was conducted for occupational therapy majors at M University located in Gyeongsangnam-do. The data collection from May to June 2021. Total of 25 copies of the data were finally analyzed, SPSS Statistics 26 was used for data analysis. Results: As a result of the study, the significance level was visual reasoning 1 test strip and the visual reasoning 1 tool. In the relationship between the correspondence 1 figure simulation sheet and the figure simulation tool for each item and statistically significant, and the correspondence 2 visual reasoning 2 sheet. Visual reasoning 2 sheet and visual reasoning tool also showed that was found to be statistically significant. The correlation for visual reasoning 1 sheet and the visual reasoning 1 tool, reasoning 2 tool and visual reasoning 1 sheet, and the visual reasoning 2 tool and the verbal reasoning sheet. Conclusion: In this study, in the CIST items that may be difficult, it is better to attach the actual tool rather than the verbal explanation of the test paper to increase the efficiency of the test and the understanding of subjects with mild cognitive impairment. It was implemented by applying the tool, and it was found that the use of the tool in the visual reasoning item showed a high correlation by item. Furthermore, based on this study, it will be possible to suggest a method to control the difficulty of each subject of the cognitive evaluation tool, and to prepare a standard for future research.

• International Neurourology Journal
• /
• v.22 no.4
• /
• pp.305-312
• /
• 2018

Purpose: The aim of this study was to analyze the efficacy and to estimate the complication rate of incontinence surgery according to the surgeon's specialty and whether a preoperative urodynamic study (UDS) was performed, using a nationally representative dataset. Methods: We enrolled 356,155 women over 20 years old who had undergone surgery for stress urinary incontinence between 2006 and 2015. Patients were followed for up to 3 years to analyze the reoperation and complication rates. Data were obtained from the National Health Claims Database of the National Health Insurance Service (NHIS) of Korea. Multiple Cox regression analysis was conducted to examine the efficacy and safety of incontinence surgery according to the surgeon's specialty and whether a preoperative UDS was performed. Results: The hazard ratio (HR) for reoperation was significantly higher for procedures performed by nonurologists than for procedures performed by urologists (HR, 1.174; 95% confidence interval [CI], 1.103-1.249). Acute urinary retention, postoperative infections, procedure-associated pain, and other complications were also more common in procedures performed by nonurologists than in those performed by urologists. When stratified by whether a preoperative UDS was performed, the HR for reoperation according to the surgeon's specialty varied by performance of a preoperative UDS. While the reoperation rate was significantly higher in procedures performed by non-urologists when a preoperative UDS was performed (HR, 1.208; 95% CI, 1.122-1.3), there was no significant difference in the HRs for reoperation according to specialty when a preoperative UDS was not performed. Conclusions: This population-based study showed that the postoperative outcomes of incontinence surgery were dependent upon the surgeon's specialty and that the reoperation rate according to the surgeon's specialty varied based on whether a preoperative UDS was performed.

• The Journal of the Korea Contents Association
• /
• v.18 no.1
• /
• pp.76-89
• /
• 2018

The purpose of this study is to analyze factors affecting a grade maintenance of long-term care service users. Using 2008-2014 long-term care raw data of National Health Insurance Service(NHIS), the predictors were examined through the logistic regression by long-term care beneficiaries of grade. The results showed that there are differences by 3 factor groups and grade groups(1-3 grade). In socio-demographic factors, in the 1, 3 grade, Individuals 64 or younger presented a much higher probabilities of the grade maintenance than those 85 and over. In the 3 grade, people of living alone, resident of rural area presented a much higher probabilities of the grade maintenance than others. In disease factors, In the 1 grade, people with dementia presented a much higher probabilities of the grade maintenance than other 2, 3grades. In the 2 grade, people with stroke, fracture presented a much higher probabilities of the grade maintenance than others. In the 3 grade, people with cancer presented a much higher probabilities of the grade maintenance than others. In service factors, In the 2, 3grade, people having more renewal numbers presented a much higher probabilities of the grade maintenance than others. In the 1 grade, people who use facility benefits for more days presented a much higher probabilities of the grade maintenance than others. In the 2 grade, people who use in-home benefits for more days presented a much higher probabilities of the grade maintenance than others. Based on the finding of study, implications and future research directions were discussed for policy considerations.

• Journal of Preventive Medicine and Public Health
• /
• v.55 no.1
• /
• pp.28-36
• /
• 2022

The current multimorbidity correction method in the Global Burden of Disease studies assumes the independent occurrence of diseases. Those studies use Monte-Carlo simulations to adjust for the presence of multiple disease conditions for all diseases. The present study investigated whether the above-mentioned assumption is reasonable based on the prevalence confirmed from actual data. This study compared multimorbidity-adjusted years of lived with disability (YLD) obtained by Monte-Carlo simulations and multimorbidity-adjusted YLD using multimorbidity prevalence derived from National Health Insurance Service data. The 5 most common diseases by sex and age groups were selected as diseases of interest. No significant differences were found between YLD estimations made using actual data and Monte-Carlo simulations, even though assumptions about the independent occurrence of diseases should be carefully applied. The prevalence was not well reflected according to disease characteristics in those under the age of 30, among whom there was a difference in YLD between the 2 methods. Therefore, when calculating the burden of diseases for Koreans over the age of 30, it is possible to calculate the YLD with correction for multimorbidity through Monte-Carlo simulation, but care should be taken with under-30s. It is useful to apply the efficiency and suitability of calibration for multiplicative methods using Monte-Carlo simulations in research on the domestic disease burden, especially in adults in their 30s and older. Further research should be carried out on multimorbidity correction methodology according to the characteristics of multiple diseases by sex and age.

• Journal of Preventive Medicine and Public Health
• /
• v.49 no.1
• /
• pp.23-34
• /
• 2016

South Korea's state health insurer, the National Health Insurance Service (NHIS), is in the process of a compensation suit against tobacco industry. The tobacco companies have habitually endeavored to ensure favorable outcomes in litigation by misusing scientific evidence or recruiting scientists to support its interests. This study analyzed strategies that tobacco companies have used during the NHIS litigation, which has been receiving world-wide attention. To understand the litigation strategies of tobacco companies, the present study reviewed the existing literature and carried out content analysis of petitions, preparatory documents, and supporting evidence submitted to the court by the NHIS and the tobacco companies during the suit. Tobacco companies misrepresented the World Health Organization (WHO) report's argument and misused scientific evidence, and removed the word "deadly" from the title of the citation. Tobacco companies submitted the research results of scientists who had worked as a consultant for the tobacco industry as evidence. Such litigation strategies employed by the tobacco companies internationally were applied similarly in Korean lawsuits. Results of tobacco litigation have a huge influence on tobacco control policies. For desirable outcomes of the suits, healthcare professionals need to pay a great deal of attention to the enormous volume of written opinions and supporting evidence that tobacco companies submit. They also need to face the fact that the companies engage in recruitment of scientists. Healthcare professionals should refuse to partner with tobacco industry, as recommended by Article 5.3 of the WHO Framework Convention on Tobacco Control.