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Trend Analysis of Medical Care Utilization among People with Autistic Spectrum Disorder Using National Health Insurance Data (자폐성장애인의 의료이용 경향분석 및 시사점 : 국민건강보험자료를 이용한 융복합적 접근)

  • Yun, Jieun;Kim, Hyun Joo
    • Journal of Digital Convergence
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    • v.16 no.11
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    • pp.411-418
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    • 2018
  • The purpose of this study was to estimate the current status and trends of healthcare utilization among people with ASD. Using National Health Insurance open database, from 2010 to 2017. We analyzed the treatment prevalence for people with ASD, the pattern of healthcare utilization, the difference in medical care utilization according to age, and the type and location of main medical institutions. The main results of the study are as follows: First, the medical utilization has been continuously increasing from 2010 to 2017. The total amount of medical utilization is increased by 50% in 2017 compared to 2010, and the treatment prevalence was estimated to be 79.1% in 2017 and medical uses for the next three years is also increasing. Second, the pattern of medical care utilization varied widely according to age, especially after 20 years of age. Third, the types of medical institutions that were mainly used were 45.6% in the medical clinic and 35.9% in Seoul. The results of this study can be used as a minimum reference point of evaluating the effectiveness of government policy on future autistic disorders. However, further studies are required to increase the prevalence of treatment for autistic patients and to find out the difference in medical use according to age.

Impact of COVID-19 on Dental Trauma in Korea (국내에서 발생한 치과적 외상에 대한 코로나 바이러스 감염증-19의 영향)

  • Son, Donghyun;Lee, Yoon;Kim, Jihun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.1
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    • pp.76-84
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    • 2022
  • The study was conducted to analyze the impacts of COVID-19 on the number of dental trauma patients. Based on the data provided by the Health Insurance Review and Assessment Service's Healthcare Bigdata Hub, dental trauma which occurred from 2010 to 2020 was analyzed. Since the outbreak of COVID-19, the incidence of dental trauma per 100,000 decreased compared to the average Incidence between 2017 to 2019. By age, it decreased by 5.4% (p = 0.017) for 0 - 4 years old, 30.3% (p < 0.001) for 5 - 9 years old, 39.5% (p < 0.001) for 10 - 14 years old, 14.5% (p = 0.002) for 15 - 19 years old, 1.3% for 20 - 29 years old, 0.2% for 40 - 49 years old, 2.7% for 50 - 59 years old, 1.2% for 60 years old or older, but it increased by 2.5% for 30 - 39 years old. Compared monthly, before and after the outbreak of COVID-19 confirmed patients, the number of dental trauma patients dropped sharply. After the outbreak of COVID-19, the incidence of dental trauma decreased significantly for under 20 years old, but the decrease was not significant for 20 years old or older.

Trends in Ankyloglossia and Surgical Treatment among Pediatric Patients in South Korea (국내 소아청소년 환자에서의 혀유착증 진단과 설소대 수술 시행의 최근 경향)

  • Taehyun Kim;Daewoo Lee;Jae-Gon Kim;Yeonmi Yang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.2
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    • pp.229-238
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    • 2023
  • The objective of this study was to investigate trends in ankyloglossia and its surgical treatment among pediatric patients in South Korea from 2011 to 2020. Data from Health Insurance Review and Assessment Service (HIRA)'s Healthcare Bigdata Hub were used for analysis of the ankyloglossia diagnosis rate and frenum surgery rate. Considering annual population change, crude rates per 100,000 were calculated and analyzed. To investigate other factors of frenum surgery incidence besides gender and age, pediatric patient sample data from HIRA were used. The diagnosis rate of ankyloglossia increased from 204.4 in 2011 to 356.6 per 100,000 people in 2020, while the frenum surgery rate increased from 26.8 to 34.3 per 100,000 people. Males were more likely to receive frenum surgery than females. Surgeries were more likely to be done at a hospital instead of a clinic or a general hospital. In the age group of 0 - 4 years, the largest number of frenum surgeries were performed in pediatrics, and in the age group of 5 - 9 years, the largest number of surgeries were conducted in pediatric dentistry. In the older age groups, the largest proportion of frenum surgeries were performed in the departments of conservative dentistry and oral and maxillofacial surgery. The diagnosis of ankyloglossia and the operation of frenum surgery among South Korean children increased during the last decade. Since the function of the tongue can affect maxillofacial development in many aspects, pediatric dentists should pay more attention to the functional management of intraoral soft tissue in growing children.

Analysis on the Relationship between the Number of Clinics and the Use of Preventable Hospital Service: focusing on asthma patients (지역 내 의원 수와 예방 가능한 병원 서비스 이용 간의 관계분석: 천식 환자를 중심으로)

  • Lee, Hyun-Ji;Park, You-Hyun;Cho, Hyung-Kyung;Seol, Jin-Ju;Kwak, Jin-Mi;So, Ye-Kyeong;Park, Su-Jin;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.25 no.4
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    • pp.94-102
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    • 2020
  • Purposes: The purpose of this study was to analyze the trends of hospitalization and emergency room visits of asthma patients over the three years in 25 districts of Seoul. And analyzed the relationship between preventable hospital service uses and number of clinics for asthma patients. Methods: Data was collected from a customized database of the NHI(National Health Insurance) for 2016 to 2018. The number of clinics means Internal Medicine, Pediatrics, Ear-Nose-Throat, and Family Medicine clinics. The hospital service means the number of adults admission for asthma and the number of total asthma emergency visits. This study used kappa analysis to assess the agreements of indicators between years, and structural equation modeling analysis was applied to analyze the relationship. Findings: The kappa value of the number of adults admission for asthma was compared between 2016 and 2017(kappa score=0.68), and was lowered when compared between 2016 and 2018(kappa score=0.26). And the value of kappa in the number of total asthma emergency visits due to asthma between 2016 and 2017(kappa score=0.51) was lower than that of between 2016 and 2018(kappa score=0.60). And the results showed that the number of clinics significantly negatively related to the uses of hospital services in asthmatic patients(β=-0.5, p=0.005). Practical Implication: This research could provide policy implications for strengthening primary care services that can contribute to the reduction of preventable hospital services.

Current Status of Combination Western and Korean medicine in Public Health Center in a Rural Area (일개 보건소의 양약-한약 병용투여 현황 보고 : 2019년 의무기록에 대한 후향적 분석)

  • Park, Seongjun;Choi, Seong-hun;Park, Chanjong;Lee, Keun-hee;Kong, Kyu-dong;Hong, Jieun;Chu, Hongmin;Kang, Kyung-ho
    • Journal of Society of Preventive Korean Medicine
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    • v.24 no.2
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    • pp.57-62
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    • 2020
  • Objectives : This study is retrospective chart review research on the combined-prescription of Western and Korean medicine in Public Health Center in rural area. Methods : Researchers reviewed medical records of patients who was prescribed Korean medicine and Western medicine from 1st, Jan, 2019 to 31st, Dec, 2019 in Public Health Center. 50 patients' medical records were included. Results : Total number of treatment is 3,808 cases and 1.3% of them is prescribed Korean medicine and Western medicine simultaneously. Prescription of Korean medicine is 153 cases and Western medicine is 160. Jowiseunggi-tang and Diroba tablet were the most frequently prescribed Korean medicine and Western medicine. Furthermore, Korean Medicine Doctors of Public Health Center use muscular skeletal disease system code(M code among KCD code) for prescription and Western Medicine Doctors use diseases of the circulatory system(I code among KCD code) frequently. Conclusions : We analyze 50 patients who were prescribed both Korean medicine and Western medicine. Mostly, patients were prescribed medicine for different diseases in each clinic. In western medicine clinic, drugs about circulatory or endocrine disease were prescribed frequently and in Korean Medicine clinic, drugs about muscular skeletal disease were most frequently prescribed. This result imply the real world's combination of prescription status that was different from result of National health insurance corporation database. Senior patients in rural area take medicine long period and have various underlying disease. We call for some attention about senior and rural area patients' prescription status in interaction studies of Korean medicine and Western medicine.

The societal cost of rotavirus infection in South Korea (한국에서 로타바이러스 급성 위장관염의 질병 부담)

  • Yang, Bong Min;Jo, Dae Sun;Kim, Youn Hee;Hong, Ji Min;Kim, Jung Soo
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.977-986
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    • 2008
  • Purpose : This study aims to estimate the financial cost of rotavirus infection in Korea in the year of 2005. Methods : The incidence rates used were from the epidemiological profile at Jeoungeub District (5.8 cases/1,000 children <5 years old for inpatients, and 22.65 cases/1,000 children <5 years old for outpatients, per year). The health care cost per capita of rotavirus infection (ICD code: A08.0) was extracted from the Health Insurance Review and Assessment Service database in Korea. The patient survey was conducted to capture information about non-medical costs and associated productivity loss incurred by adult caregivers. Results : The number of annual national cases among children <5 years old with rotavirus infection was estimated to be 69,122 (i.e., 55,030 outpatients and 14,092 inpatients). The total cost of rotavirus infection was estimated at 13.3 billion Korean won, comprising 11 billion Korean won (82.7%) of direct medical costs, 1.6 billion Korean won (12.0%) of direct non-medical costs (e.g., transportation and supplies), and 0.68 billion Korean won (5.1%) of productivity lost by adult caregivers. Conclusion : Rotavirus infection carries not only medical costs but also non-medical and indirect costs; together, these costs incur a significant burden on South Korean society. The impact of rotavirus on quality of life and health among patient caregivers was not considered in this study, but it does merit further research.

Cost-Effectiveness Analysis of a Hyperlipidemia Mass Screening Program in Korea (성인 고지혈증 선별 검사의 비용-효과 분석)

  • Cha, Yeon-Soon;Khang, Young-Ho;Lee, Moo-Song;Kang, Wee-Chang;Jeon, Sung-Hoon;Kim, Kee-Lak;Lee, Sang-Il
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.2
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    • pp.99-106
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    • 2002
  • Objective : Until now, there have been no evidence-based guidelines produced for the mass screening of hyperlipidemia cases in Korea. This study was done to find the most efficient strategy for a hyperlipidemia-screening program among Korean adults, Method : Seven alternative strategies for hyperlipidemia screening were formulated and compared ir terms of cost-effectiveness. Cost and effectiveness were estimated from social perspectives and using a two-stage screening process (initial testing and additional testing for positives from the first test). A computerized database (based on persons who had visited a health promotion center in one teaching hospital for a routine health check-up) was used to determine the cost and the outcome of various strategies. Official data was used in calculating direct and indirect costs. Effectiveness was measured according to the number of persons who needed clinical intervention for hyperlipidemia. A stratified analysis, considering age group and sex, was then done. Sensitivity analyses, focusing on several uncertain parameters, were also done. Results : Of the seven test alternatives available, the most cost-effective strategy was a screening program, which consisted of an initial test of total cholesterol, high-density lipoprotein cholesterol and triglyceride. There was some variation in the rank of the cost-effectiveness ratios for the seven alternatives dependent on age group or gender. Conclusions : Current hyperlipidemia screening practice, for National Health Insurance beneficiaries, tests only the total cholesterol level with a cut-off value of 260mg/dl as an initial screening test. It is not the best strategy for cost-effectiveness, and should be modified. Different screening strategies taking age group and sex into account should be developed and used for the efficient mass screening of hyperlipidemia cases among Korean adults.

Inter-hospital Comparison of Cesarean Section Rates after Risk Adjustment (위험도 보정을 통한 병원간 제왕절개 분만율의 비교)

  • Lee, Sang-Il;Ha, Beom-Man;Lee, Moo-Song;Kang, Wee-Chang;Koo, Hee-Jo;Kim, Chang-Yup;Khang, Young-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.4
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    • pp.337-346
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    • 2001
  • Objective : To determine the clinical risk factors associated with the mode of delivery decision and to compare cesarean section rates after adjusting for risk factors identified among Korean hospitals. Methods Data were collected from 9 general hospitals in two provincial regions by medical record abstraction during February 2000. A total of 3,467 cases were enrolled and analyzed by stepwise logistic regression. Performance of the risk-adjustment model (discrimination and calibration) was evaluated by the C statistic and the Hosmer-Lemeshow test. Crude rates, predicted rates with 95% confidence intervals, and adjusted rates of cesarean section were calculated and compared among the hospitals. Results : The average crude cesarean section rate was 53.2%, ranging from 39.4% to 65.7%. Several risk factors such as maternal age, previous history of cesarean section, placenta previa, placental abruption, malpresentation, amniotic fluid abnormality, gestational anemia, infant body weight, pregnancy-induced hypertension, and chorioamnionitis were found to have statistically significant effects on the mode of delivery. It was confirmed that information about most of these risk factors was able to be collected through the national health insurance claims database in Korea. Performance of the risk-adjustment model was good (c statistic=0.815, Hosmer-Lemeshow test=0.0621). Risk factor adjustment did lead to some change in the rank of hospital cesarean section rates. The crude rates of three hospitals were beyond 95% confidence intervals of the predicted rates. Conclusions : Considering that cesarean section rates in Korean hospitals are too high, it is apparent that some policy interventions need to be introduced. The concept and methodology of risk adjustment should be used in the process of health policy development to lower the cesarean section rate in Korea.

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A Prospect for Growth and Economic Size of Foods-for-Elderly Industry -Focused on Health Functional Foods and Foods for Special Dietary Uses- (고령친화식품산업의 성장과 규모 전망 -건강기능식품과 특수용도식품을 중심으로-)

  • Jin, Hyun Joung;Woo, Hee Dong
    • Journal of Food Hygiene and Safety
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    • v.27 no.4
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    • pp.339-348
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    • 2012
  • The purpose of this study is to predict the economic size of foods-for-elderly market, which will be valuable information for establishing related policy and backup system. After setting the scope of related industry, detailed information for current market situation was investigated and a systematic forecast for market changes in the future was performed. Economic growth, changes in consumer expenditure and economic status of the elderly, current subscription of medical insurance and saving for pension were reflected. In addition, a survey toward related firms was completed and changes in aged population and incidence of chronic disease in the elderly were taken into account. Results show that the annual growth rate of the market was predicted to be the minimum 4.54% through the maximum 8.32% from 2010 to 2025 and its market size was forecasted to be the minimum 7,073 ten million won through the maximum 10,976 ten million won. It is expected that the market of foods-for-elderly will grow rapidly with development of foods technology and fast increase of aged population. Especially, growth of health functional foods and foods for special dietary uses for elderly will be distinguished. However, it seems that related firms are on the hedge, watching current trend of the related industry. This may results in insufficient supply against the demand. Therefore, policy for foods-for-elderly should be introduced and systematically administered, including R&D support, standardization and authentication for foods-for-elderly, construction of related database system.

Cohort profile: National Investigation of Birth Cohort in Korea study 2008 (NICKs-2008)

  • Kim, Ju Hee;Lee, Jung Eun;Shim, So Min;Ha, Eun Kyo;Yon, Dong Keon;Kim, Ok Hyang;Baek, Ji Hyeon;Koh, Hyun Yong;Chae, Kyu Young;Lee, Seung Won;Han, Man Yong
    • Clinical and Experimental Pediatrics
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    • v.64 no.9
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    • pp.480-488
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    • 2021
  • Background: An adequate large-scale pediatric cohort based on nationwide administrative data is lacking in Korea. Purpose: This study established the National Investigation of Birth Cohort in Korea study 2008 (NICKs-2008) based on data from a nationwide population-based health screening program and data on healthcare utilization for children. Methods: The NICKs-2008 study consisted of the Korean National Health Insurance System (NHIS) and the National Health Screening Program for Infants and Children (NHSPIC) databases comprising children born in 2008 (n=469,248) and 2009 (n=448,459) in the Republic of Korea. The NHIS database contains data on age, sex, residential area, income, healthcare utilization (International Classification of Diseases10 codes, procedure codes, and drug classification codes), and healthcare providers. The NHSPIC consists of 7 screening rounds. These screening sessions comprised physical examination, developmental screening (rounds 2-7), a general health questionnaire, and age-specific anticipatory guidance. Results: During the 10-year follow-up, 2,718 children (0.3%) died, including more boys than girls (hazard ratio, 1.145; P<0.001). A total of 848,048 children participated in at least 1 of the 7 rounds of the NHSPIC, while 96,046 participated in all 7 screening programs. A total of 823 infants (0.1%) weighed less than 1,000 g, 3,177 (0.4%) weighed 1,000-1,499 g, 37,166 (4.4%) weighed 1,500-2,499 g, 773,081 (91.4%) weighed 2,500-4,000 g, and 32,016 (5.1%) weighed over 4,000 g. There were 23,404 premature babies (5.5%) in 2008 compared to 23,368 (5.6%) in 2009. The developmental screening test indicated appropriate development in 95%-98% of children, follow-up requirements for 1%-4% of children, and recommendations for further evaluation for 1% of children. Conclusion: The NICKs-2008, which integrates data from the NHIS and NHSPIC databases, can be used to analyze disease onset prior to hospitalization based on information such as lifestyle, eating habits, and risk factors.