• Journal of Preventive Medicine and Public Health
• /
• v.31 no.4 s.63
• /
• pp.814-827
• /
• 1998

In this study we analyzed the insurance claims data to investigate the medical care utilization pattern of tuberculosis patients in private sector. We selected the claims of principal or secondary diagnosis with tuberculosis from claims database of National federation of Medical Insurance, from December 1995 to November 1996. Both spell-based analysis and person-based analysis were carried out. In spell-based analysis, type and location of treatment facilities, distribution of diagnoses, number of outpatient/inpatient treatments were analyzed. Additionally in person-based analysis, number of tuberculosis patients, demographic characteristics, number of treatments per person, frequency and pattern of change in source of care were analyzed. The results were as follows 1. The number of treatments with tuberculosis was 863,641 from 1 December 1995 to 30 November 1996. The number of patients was 313.964. 2. Most of tuberculosis patients in private sector were treated in general hospital (45.8%) and clinics(42.2%) 3. About 77.7% of tuberculosis patients who were treated more than two times did not change the source of care. 18,9% of tuberculosis patients changed source of care only once. Even when we limited tuberculosis patient to those who were treated more than five times and whose treatment period were longer than six months, 94.7% of patients did not change source of care at all, or changed treatment facility only once. 4. The probability of change in source of rare was higher in pulmonary tuberculosis, in twenties, and in rural area respectively than other tuberculosis. In conclusion, healer shopping of tuberculosis patients was not serious as expected. However special attention is needed to pulmonary tuberculosis in twenties and rural area.

• Journal of the Korean Society of Radiology
• /
• v.15 no.7
• /
• pp.1021-1030
• /
• 2021

This study analyzed the status of tuberculosis patients in Korea by collecting data from the Statistics Korea and the KDCA's GLOBAL Tuberculosis Report from 2010 to 2018 to find ways to manage tuberculosis patients in Korea and provide basic data on tuberculosis policies. The results are as follows. First, the results of tuberculosis patients in Korea decreased by about 21.3% to 33,796 (65.9%) in 2018 and 26,433 (51.5%) in 2018. Second, the status of tuberculosis patient treatment in Korea was found to be 655 in 2018, an increase of about 160% compared to 2014. Third, the incidence of tuberculosis among adolescents was 1.8% in 2018 for those aged 10 to 14 and 15.0% for those aged 15 to 19, the highest rate of tuberculosis among high school students, Fourth, looking at the incidence of tuberculosis patients by age, subjects in their 60s or older showed a prevalence of tuberculosis by 60% or more, especially elderly tuberculosis patients over 80 years of age. Fifth, the status of the incidence of tuberculosis patients by gender was found to be 1.4 times higher in men than in women in 2018 compared to 2010. Sixth, 1,419 people (75.6%) in Jeollanam-do had the highest prevalence of tuberculosis nationwide, and 99 people (33.4%) in Sejong had the lowest prevalence. Seventh, the number of foreign patients in Korea continued to increase to 1,510 in 2012, increasing to 2,569 in 2016. The results this study indicate the need for rapid and accurate early tuberculosis screening policies and management for tuberculosis relapse patients, high school student, age groups over 60, a group of men such as the military, the elderly over 80, and foreigners.

• The Korean Journal of Applied Statistics
• /
• v.31 no.4
• /
• pp.529-538
• /
• 2018

Tuberculosis causes high morbidity and mortality. However, Korea still has the highest tuberculosis (TB) incidence and mortality among OECD countries despite decreasing incidence and mortality due to the development of modern medicine. Korea has now implemented various policy projects to prevent and control tuberculosis. This study analyzes the effects of public-private mix (PPM) tuberculosis control program on treatment outcomes and identifies the factors that affecting the success of TB treatment. We analyzed 130,000 new tuberculosis patient cohort from 2012 to 2015 using data of tuberculosis patient reports managed by the Disease Control Headquarters. A cumulative incidence function (CIF) compared the cumulative treatment success rates for each factor. We compared the results of the analysis using two popular types of competition risk models (cause-specific Cox's proportional hazards model and subdistribution hazard model) that account for the main event of interest (treatment success) and competing events (death).

• Journal of Digital Convergence
• /
• v.13 no.5
• /
• pp.259-267
• /
• 2015

This study is aimed at understanding the factors affecting rehospitalization of a tuberculosis patient. In a public hospital with a tuberculosis ward in Seoul, the data of 360 patients who discharged the hospital from July 1, 2012 to December 31, 2012. Data was selected from 'nursing information survey' or 'discharge analysis DB' of the department of medical records. The possibility of rehospitalization was higher in the group with those who has no job, those with medical care assistant than with health insurance, drinks about 10 times a month, personally came to the hospital, main guardian is the patient's spouse, have discharged from hospital against the doctor's advise, and principle diagnosis is not a pulmonary tuberculosis but the other respiratory disease. Therefore, it is expected that the possibility of rehospitalization would be effectively reduced if an intensive intervention is taken on the first hospitalized patients who have the features described above.

• The Korean journal of internal medicine
• /
• v.33 no.6
• /
• pp.1241-1251
• /
• 2018

Background/Aims: To estimate the level of agreement and positivity rates of latent tuberculosis infection (LTBI) tests prior to the use of tumor necrosis factor (TNF) inhibitors in relation to underlying rheumatic diseases and endemic tuberculosis levels. Methods: The Ovid-Medline, Embase, and Cochrane Libraries were searched for articles before October 2013 involving LTBI screening in rheumatic patients, including rheumatoid arthritis (RA), ankylosing spondylitis (AS), juvenile idiopathic arthritis (JIA), and psoriatic arthritis. Results: In pooled analyses, 5,224 rheumatic patients had undergone both a tuberculin skin test (TST) and an interferon-gamma release assay (IGRA) before TNF inhibitors use. The positivity of TST, QuantiFERON-TB Gold In Tube (QFT-GIT), and T-SPOT.TB (T-SPOT) tests were estimated to be 29%, 17%, and 18%, respectively. The agreement percentage between the TST and QFT-GIT, and between the TST and T-SPOT were 73% and 75%. Populations from low-to-moderate endemic TB presented with slightly less agreement (71% between TST and QFT-GIT, and 74% between TST and T-SPOT) than patients from high endemic countries (73% between TST and QFT-GIT, and 81% between TST and T-SPOT). By underlying disease stratification, a lower level of agreement between TST and QFT-GIT was found among AS (64%) than among JIA (77%) and RA patients (73%). Conclusions: We reaffirm the current evidence for accuracy of LTBI test done by TST and IGRA among rheumatic patients is inconsistent. Our stratified analysis suggests different screening strategies might be needed in clinical settings considering the endemic status in the patient's country of origin and the precise nature of underlying diseases.

• Tuberculosis and Respiratory Diseases
• /
• v.46 no.4
• /
• pp.473-480
• /
• 1999

Background: Early diagnosis of tuberculosis is critical, especially in Korea, an area where tuberculosis is endemic. Because antibody responses to some membrane proteins of Mycobacterium tuberculosis are not comparable, and the policy of BCG vaccination and the prevalence of tuberculosis are different from country to country, the usefulness of the serological diagnostic tests is questionable in Korea, even though they have been confirmed to be useful in other countries. In the specific context of Korea, we tried to evaluate the validity of the ICT Tuberculosis Test (ICT), a membrane-based antibody kit that purports to detect the 5 M. tuberculosis complex-specific antigens including 38-kDa protein. Method: 68 patients with tuberculosis were tested : 37 had no history of previous tuberculosis, and 31 were reactivated cases. The control group comprised 77 subjects : 25 healthy adults, 35 hospital workers with frequent contact with tuberculosis patients, and 17 in-patients with non-tuberculous respiratory diseases. Results: The diagnostic sensitivities of the ICT were 87% and 73% in patients with versus without previous history of tuberculosis, respectively. The sensitivities of smear-positive and smear-negative patient groups were 81% and 73%, respectively. Both of the two patients with extrapulmonary tuberculosis tested positive through the ICT. The specificities of the ICT were 88%, 94%, and 94% in healthy adults, hospital workers, and non-tuberculous patients, respectively, with an overall specificity of 92%. Conclusion: It is suggested that when combined with traditional techniques, the ICT is an useful tool for the diagnosis of pulmonary tuberculosis. The procedure is simple, easy to perform, rapid, and needs no equipment. It shows 73% sensitivity and 92% specificity for the diagnosis of tuberculosis.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.5
• /
• pp.3363-3368
• /
• 2013

Background: The burden due to cancers is an emerging public health concern especially in resource-limited countries like Nigeria. The WHO estimates that cancer kills more people than tuberculosis, HIV/AIDS and malaria combined. As people in Nigeria and other developing countries are beginning to survive infectious diseases, there is an observed epidemiologic transition to chronic diseases, such as cancers. In 2008, 75 out of 1,000 Nigerians died of cancer. Despite the rising incidence and public health importance, Nigeria lacks an organized and comprehensive strategy to deal with cancers. Materials and Methods: This article reviewed 30 peer-reviewed manuscripts on cancer care in four countries. It highlights the limitations to cancer care in Nigeria; due to lack of awareness, low health literacy, absence of organized screening programs, inadequate manpower (in terms of quality and quantity) as well as limited treatment options. Results: This review led to the formulation of a proposal for Nigerian National Cancer Policy, mainly drawn from effective strategies used in Canada, Brazil and Kenya. This is a vertical cancer program that is patient-centered with an emphasis on tobacco control and cancer disease screening (similar to Canada and Brazil). Additionally, it emphasizes primary cancer prevention (similar to Kenya). Its horizontal integration with other disease programs like HIV/AIDS will improve affordability in a poor resourced country like Nigeria. Capacity building for health professionals, hub-and-spoke implementation of screening services, as well as investment in effective treatment options and increased research in cancer care are essential. International 'twinning collaborations' between institutions in richer countries and Nigeria will enhance effective knowledge translation and improve the quality of patient care. Conclusions: A national cancer policy must be developed and implemented in Nigeria in order to overcome the present limitations which help contribute to the observed increases in cancer morbidity and mortality rates. Cancer control is feasible in Nigeria if the nation was to consider and employ some of the cost-effective strategies proposed here.

• Clinical and Experimental Pediatrics
• /
• v.61 no.11
• /
• pp.366-370
• /
• 2018

Purpose: Tuberculosis (TB) is one of the most important diseases that cause significant mortality and morbidity in young children. Data on TB transmission from an infected child are limited. Herein, we report a case of disseminated TB in a child and conducted a contact investigation among exposed individuals. Methods: A 4-year-old child without Bacille Calmette-$Gu{\acute{e}}rin$ vaccination was diagnosed as having culture-proven disseminated TB. The child initially presented with symptoms of inflammatory bowel disease, and nosocomial and kindergarten exposures were reported. The exposed individuals to the index case were divided into 3 groups, namely household, nosocomial, or kindergarten contacts. Evaluation was performed following the Korean guidelines for TB. Kindergarten contacts were further divided into close or casual contacts. Chest radiography and tuberculin skin test or interferon-gamma-releasing assay were performed for the contacts. Results: We examined 327 individuals (3 household, 10 nosocomial, and 314 kindergarten contacts), of whom 18 (5.5%), the brother of the index patient, and 17 kindergarten children were diagnosed as having latent TB infection (LTBI). LTBI diagnosis was more frequent in the children who had close kindergarten contact with the index case (17.1% vs. 4.4%, P=0.007). None of the cases had active TB. Conclusion: This is the first reported case of TB transmission among young children from a pediatric patient with disseminated TB in Korea. TB should be emphasized as a possible cause of chronic diarrhea and failure to thrive in children. A national TB control policy has been actively applied to identify Korean children with LTBI.

• The Journal of the Korea Contents Association
• /
• v.16 no.10
• /
• pp.196-205
• /
• 2016

The purpose of this study is to identify factors influencing treatment result in patients with Tuberculosis by patient characteristic, admission and disease characteristic, and hospital characteristic from 2006 to 2012. Survey data was using Korean national hospital discharge in-depth survey data produced by KCDC(Korea Center for Disease Control and Prevention). Study subjects were 8,305 inpatients with TB(A15.0~A19.9) and analyzed frequency, chi-square test, and logistic regression by using SPSS 20(Statistical Package for the Science). The results of this study show that influencing factors of treatment result were ages (20-39, 40-64, and over 65 years), type of insurance(medical aid), disease code (A16, A17, A18, A19), LOS (31-90, and 91-180 days), beds of hospital (300-499, 500-999, over 1,000 beds) and hospital district (non-metropolitan). These findings implied that it is necessary to support successful prevention and management for high risk TB groups and to build middle and long-term policies as well as short -term policy.

• Journal of agricultural medicine and community health
• /
• v.31 no.1
• /
• pp.9-20
• /
• 2006

Objectives: This study was aimed at investigating the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors. And we want to compare the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors among the provinces. Methods: In order to compare, the data was referred to National health insurance center for affirming the insurance type of the dead. And age adjusted mortality rate of tuberculosis of each insurance type was analyzed by whole country and the provinces. Related factors of the provinces were gathered from public statistic books. We analysed correlation study between the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors among the provinces. Results: Major findings were as follows 1. The ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis was 5.6. And the ratio was relatively high at 40-60 ages. 2. The ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis by the province was varying. And the factors that were financial independence, crowdedness, percent of people on medical aid, population size served by each public health center, number of hospital by a million peoples have correlated with increment of the ratio. Conclusions: As a consequence of tuberculosis control, the ratio was high. Thus this finding suggests that medical utilization and preventive behavior, environment of tuberculosis patient are under handicapped condition. Especially large cities like metropolitan area who have high financial independence, high population density, high percentage of medical aid peoples have high ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis. There is need for additional and systematic research on the attitude or tendency toward medical services(inc1uding preventive services) utilization of medical aid tuberculosis patients.