Exploring possible causes of lower-than-expected suicide rates in Taiwan and South Korea during the 2020-2021 COVID-19 pandemic: a time trend analysis by sex, age, and method.

AIMS: Decreases in suicide rates during the coronavirus disease 2019 (COVID-19) pandemic were found in several countries, including Taiwan and South Korea. We investigated the pattern of the reduction in suicide by sex, age, method, and outbreak period in the two countries. METHODS: Suicide data for Taiwan (2015-2021) and South Korea (2017-2021) stratified by sex, age, method, and month were extracted from national mortality data files in the two countries. Negative binomial regression was used to estimate suicide rate ratios and 95% confidence intervals across outbreak and inter-outbreak periods during the pandemic, relative to that expected based on pre-pandemic trends, and their associations with economic and outbreak control stringency indicators. RESULTS: There were fewer-than-expected suicides in Taiwan (7%-16% fewer suicides over outbreaks and inter-outbreaks) and South Korea (17% fewer suicides in outbreaks III and IV). Fewer-than-expected suicides were found primarily in the working-age populations aged 25 to 64 years in Taiwan and those aged 45 to 64 years in South Korea. In both countries, fewer-than-expected suicides by charcoal burning during the pandemic were consistently found; the greatest reduction occurred when the outbreak control measures were most restricted. Increased time at residence was associated with decreased suicide rates in South Korea. CONCLUSION: Taiwan and South Korea showed reduced suicide rates during the COVID-19 pandemic in 2020-2021. Potential reasons for the decrease in suicides may include reduced access to suicide means during outbreaks in the two countries.

Impact of the Early COVID-19 Pandemic on Suicide Attempts and Suicide Deaths in South Korea, 2016-2020: An Interrupted Time Series Analysis.

OBJECTIVE: This study aimed to investigate the impact of coronavirus disease-2019 (COVID-19) on suicide attempts and suicide deaths in South Korea, focusing on age and sex differences. METHODS: We analyzed the monthly number of suicide attempts and suicide deaths during pre-pandemic (January 2016-February 2020) and pandemic (March-December 2020) periods using nationally representative databases. We conducted an interrupted time series analysis and calculated the relative risk (RR) with a 95% confidence interval (CI), categorizing subjects into adolescents (<18), young adults (18-29), middle-aged (30-59), and older adults (≥60). RESULTS: During the pandemic, the number of suicide attempts abruptly declined in adolescents (RR [95% CI] level change: 0.58 [0.45-0.75]) and older adults (RR [95% CI] level change: 0.74 [0.66-0.84]). In older males, there was a significant rebound in the suicide attempt trend (RR [95% CI] slope change: 1.03 [1.01-1.05]). The number of suicide deaths did not change among age/sex strata significantly except for older males. There was a brief decline in suicide deaths in older males, while the trend showed a following increase with marginal significance (RR [95% CI] level change: 0.76 [0.66-0.88], slope change: 1.02 [1.00-1.04]). CONCLUSION: This study suggests the heterogeneous impact of the COVID-19 pandemic on suicide attempts and suicide deaths across age and sex strata in South Korea. These findings highlight the need for more targeted mental health interventions, given the observed trends in suicide attempts and suicide deaths during the pandemic.

Risk of depression in amyotrophic lateral sclerosis: A nationwide cohort study in South Korea.

Depression is frequently reported in amyotrophic lateral sclerosis (ALS) due to the disastrous prognosis of progressive motor impairment, but the risk of depression in ALS is still unclear. Therefore, we investigated the risk of depression in ALS and analyzed the effect of ALS-related physical disability on the risk of developing depression using the Korean National Health Insurance Service (KNHIS) database. A total of 2241 ALS patients, as defined by the International Classification Diseases (ICD, G12.21) and Rare Intractable Disease codes (V123), and 1:10 sex- and age-matched controls were selected from the KNHIS. After applying exclusion criteria (non-participation in national health screening, history of depression, or having missing data), 595 ALS patients and 9896 non-ALS individuals were finally selected. Primary outcome is newly diagnosed depression during follow-up duration defined by ICD code (F32 or F33). A Cox regression model was used to examine the hazard ratios (HRs) after adjustment for potential confounders. During the follow-up period, 283 cases of depression in the ALS group and 1547 in the controls were recorded. The adjusted HR for depression in ALS was 9.1 (95% confidence interval [CI] 7.87-10.60). The risk of depression was slightly higher in the disabled ALS group (aHR 10.1, 95% CI 7.98-12.67) than in the non-disabled ALS group (aHR 8.78, 95% CI 7.42-10.39). The relative risk of depression was higher in younger patients than in older patients, and in obese patients than in non-obese patients. Our study showed that ALS patients have an increased risk of depression compared to non-ALS individuals.

Pathogenicity of Highly Pathogenic Avian Influenza A(H5N1) Viruses Isolated from Cats in Mice and Ferrets, South Korea, 2023.

The prevalence of highly pathogenic avian influenza (HPAI) A(H5N1) viruses has increased in wild birds and poultry worldwide, and concomitant outbreaks in mammals have occurred. During 2023, outbreaks of HPAI H5N1 virus infections were reported in cats in South Korea. The H5N1 clade 2.3.4.4b viruses isolated from 2 cats harbored mutations in the polymerase basic protein 2 gene encoding single amino acid substitutions E627K or D701N, which are associated with virus adaptation in mammals. Hence, we analyzed the pathogenicity and transmission of the cat-derived H5N1 viruses in other mammals. Both isolates caused fatal infections in mice and ferrets. We observed contact infections between ferrets, confirming the viruses had high pathogenicity and transmission in mammals. Most HPAI H5N1 virus infections in humans have occurred through direct contact with poultry or a contaminated environment. Therefore, One Health surveillance of mammals, wild birds, and poultry is needed to prevent potential zoonotic threats.

Regional disparities in health literacy for chronic diseases: focusing on healthcare resources and local extinction index.

Objective: This study compared disparities between community health characteristics and health literacy levels for hypertension and diabetes by combining community-level characteristics, such as the local extinction index and healthcare resources, with individual-level characteristics based on the Andersen healthcare utilization model. Method: Data obtained from the 2017, 2019, and 2021 Community Health Surveys, Korean Statistical Information Service, and National Health Insurance Service were analyzed. The analyses included spatial analysis, propensity score matching, and cross-analysis. Results: Twenty-five extinction-risk regions (ERRs) were identified in 2017, 26 in 2019, and 29 in 2021, indicating a high risk of extinction and insufficient healthcare resources in non-metropolitan regions. Based on analyses of demographic changes and unmet medical needs at the individual level, we observed increased age and economic activity, decreased healthcare access, and lower education levels in ERRs compared to non-extinction-risk regions (NERRs). No significant differences were found between the regions regarding diagnosis or medication use concerning the health literacy gap for hypertension and diabetes. However, individuals in ERRs were significantly less likely than those in NERRs to be aware of such diseases or educated about their management. Discussion: Given that healthcare services in ERRs focus on chronic disease management rather than prevention, we propose two directions to reduce health disparities in ERRs. First, the government should encourage cooperation with private healthcare organizations to ensure the provision of health education programs in vulnerable areas. Second, improvements in awareness and education regarding chronic disease management can be achieved through digital healthcare and telemedicine. This study identifies regional disparities in chronic disease prevention and management, providing a basis for policies to ensure healthier communities with health equity.

Performance of ChatGPT in the In-Training Examination for Anesthesiology and Pain Medicine Residents in South Korea: Observational Study.

BACKGROUND: ChatGPT has been tested in health care, including the US Medical Licensing Examination and specialty exams, showing near-passing results. Its performance in the field of anesthesiology has been assessed using English board examination questions; however, its effectiveness in Korea remains unexplored. OBJECTIVE: This study investigated the problem-solving performance of ChatGPT in the fields of anesthesiology and pain medicine in the Korean language context, highlighted advancements in artificial intelligence (AI), and explored its potential applications in medical education. METHODS: We investigated the performance (number of correct answers/number of questions) of GPT-4, GPT-3.5, and CLOVA X in the fields of anesthesiology and pain medicine, using in-training examinations that have been administered to Korean anesthesiology residents over the past 5 years, with an annual composition of 100 questions. Questions containing images, diagrams, or photographs were excluded from the analysis. Furthermore, to assess the performance differences of the GPT across different languages, we conducted a comparative analysis of the GPT-4's problem-solving proficiency using both the original Korean texts and their English translations. RESULTS: A total of 398 questions were analyzed. GPT-4 (67.8%) demonstrated a significantly better overall performance than GPT-3.5 (37.2%) and CLOVA-X (36.7%). However, GPT-3.5 and CLOVA X did not show significant differences in their overall performance. Additionally, the GPT-4 showed superior performance on questions translated into English, indicating a language processing discrepancy (English: 75.4% vs Korean: 67.8%; difference 7.5%; 95% CI 3.1%-11.9%; P=.001). CONCLUSIONS: This study underscores the potential of AI tools, such as ChatGPT, in medical education and practice but emphasizes the need for cautious application and further refinement, especially in non-English medical contexts. The findings suggest that although AI advancements are promising, they require careful evaluation and development to ensure acceptable performance across diverse linguistic and professional settings.

Pasteurella Infections in South Korea and Systematic Review and Meta-analysis of Pasteurella Bacteremia.

Pasteurella spp. can cause fatal zoonotic infections in humans. We performed a multicenter study to investigate the prevalence and clinical features of Pasteurella infections in South Korea during 2018‒2022. We also conducted a collaborative systematic review and meta-analysis of the global burden of Pasteurella bacteremia. The study included 283 cases found an increasing trend in Pasteurella infections. Blood cultures were positive in 8/35 (22.9%) cases sampled, for overall bacteremia-associated rate of 2.8% (8/283). Aging was a significant risk factor for bacteremia (odds ratio 1.05 [95% CI 1.01-1.10]), according to multivariate analyses. For the meta-analysis, we included a total of 2,012 cases from 10 studies. The pooled prevalence of bacteremia was 12.4% (95% CI 7.3%-18.6%) and of mortality 8.4% (95% CI 2.7%-16.5%). Our findings reflect the need for greater understanding of the increase in Pasteurella infections and the global burden of Pasteurella bacteremia to determine appropriate case management.

Perceptions of risk sharing agreements in South Korea from the viewpoints of key stakeholders: a convergent parallel mixed approach.

OBJECTIVES: In 2013, South Korea introduced risk-sharing agreements (RSAs) as a new reimbursement mechanism to enhance access to new medicines and to manage pharmaceutical expenditures. This study evaluates RSAs in South Korea from the viewpoints of key stakeholders. METHODS: In 2022, a survey and semi-structured interviews were conducted. Study participants were recruited from academia (n = 3), domestic (n = 4) and foreign (n = 6) manufacturers, and government agencies (n = 6) using a purposive sampling method. RESULTS: Key stakeholders perceived the objective of RSAs to be 'access to medicines' and understood RSAs to manage uncertainty about 'expenditures.' They responded that financial- and performance-based RSAs address uncertainty about 'expenditures' and 'clinical effectiveness,' respectively. All stakeholders agreed that RSAs have increased the likelihood that new medicines will be listed and have reduced out-of-pocket expenditures for patients. However, foreign manufacturers insisted that the benefits of RSAs are marginal, while the administrative burden on manufacturers is high. CONCLUSION: The gaps in perception between stakeholders could be narrowed by conducting a comprehensive evaluation. Financial- and performance-based RSAs need to be clearly distinguished and aligned to address the uncertainties of a new medicine in health systems.

Psychometric Properties of the Korean Version of the Revised Prolonged Grief Disorder Scale for Bereaved Adults.

This study aims to validate the Korean version of the Revised Prolonged Grief Disorder scale (PG-13-R-K) by exploring the psychometric properties of the revised Prolonged Grief Disorder scale in bereaved South Korean adults. A total of 694 bereaved individuals who had experienced the loss of a close person for a duration ranging from 12 to 24 months were included in this study and randomly divided into two separate datasets to conduct factor analyses. The results of both EFA and CFA revealed a single-factor structure for the PG-13-R-K. Moreover, the results of reliability and validity tests showed adequate internal consistency and concurrent validity. These findings suggest that the PG-13-R-K is a reliable and valid tool for assessing PGD symptoms among bereaved Korean adults. The limitations and implications of this study are thoroughly examined and discussed.

Treatment Patterns and Persistence Among Patients Newly Diagnosed With Migraine in South Korea: A Retrospective Analysis of Health Claims Data.

BACKGROUND AND PURPOSE: Migraine is one of the most common chronic neurological diseases worldwide. Although diverse treatment regimens have been recommended, there is insufficient evidence for which treatment patterns to apply in routine clinical settings. METHODS: We used nationwide claims data from South Korea for 2015-2021 to identify incident migraine patients with at least one prescription for migraine. Patients were categorized according to their initial treatment classes and followed up from the date of treatment initiation. Treatment regimens included prophylactic treatments (antidepressants, anticonvulsants, beta blockers, calcium-channel blockers, and renin-angiotensin-aldosterone system [RAAS] inhibitors) and acute treatments (acetaminophen, antiemetics, aspirin, ergotamine, nonsteroidal anti-inflammatory drugs [NSAIDs], opioids, and triptans). The treatment patterns of migraine were evaluated until the end of the study period, including the secular trends, prevalence, persistence, and changes in migraine treatment. RESULTS: Among the 761,350 included patients who received migraine treatment, the most frequently prescribed acute treatment was an NSAID (69.9%), followed by acetaminophen (50.0%). The most-prescribed prophylactic treatment was flunarizine (36.9%), followed by propranolol (24.4%). Among the patients, 54.8% received acute treatment, 13.5% received prophylactic treatment, and 31.6% received both treatment types. However, 65.7% of the patients discontinued their treatment within 3 months. The 3-month persistence rate was highest for triptans (25.2%) among the acute treatments and for RAAS inhibitors (62.0%) among the prophylactic treatments. CONCLUSIONS: While the prevalence rates of medication use were found to align with current migraine guidelines, frequent switching and rapid discontinuation of drugs were observed in routine clinical settings.

Customer verbal abuse is associated with depressive symptoms among high-workload cosmetics sales workers in South Korea.

This study sought to investigate whether association between customer verbal abuse and depressive symptoms differed by workload. We conducted a cross-sectional survey of 795 cosmetic sales workers at department store in South Korea. Experience of customer verbal abuse over the past one month was measured by using a yes/no question. Depressive symptoms during the preceding week were assessed by using 20 items from the Center for Epidemiologic Studies-Depression scale. Workload during the past week was measured by asking the number of customers a worker dealt with on average in a day and classified into two categories: 1) Low (15 people or less), and 2) High (more than 15 people). Cosmetics sales workers' experience of customer verbal abuse was associated with a higher prevalence of depressive symptoms (PR: 1.37, 95% CI: 1.15-1.63). After being stratified by workload, customer verbal abuse showed a statistically significant association with depressive symptoms among high workload groups (PR: 1.46, 95% CI: 1.19-1.79), whereas the association was not statistically significant among low workload group (PR: 1.23, 95% CI: 0.91-1.65). Our findings suggest that experience of customer verbal abuse could have a negative influence on depressive symptoms among high-workload cosmetics sales workers in South Korea.

Sex-Specific and Long-Term Trends of Asthma, Allergic Rhinitis, and Atopic Dermatitis in South Korea, 2007-2022: A Nationwide Representative Study.

INTRODUCTION: Although sex differences in allergic diseases such as atopic dermatitis (AD), allergic rhinitis (AR), and asthma are considered important, a limited number of studies during the COVID-19 pandemic investigated this aspect. Therefore, this study aimed to analyze sex-specific and long-term trends and risk factors for allergic diseases before and during the pandemic. METHODS: This study utilized data from the Korea National Health and Nutrition Examination Survey, 2007-2022, including 92,135 participants aged 19 years and older. This study used weighted multivariate regression analysis to examine the estimates of related factors and assessed weighted odds ratios or ß-coefficients for these factors across multiple categories. RESULTS: During the study period (2007-2022), the prevalence of AR was more common in females than in males. Particularly in 2022, the prevalence among females was 19.3% (95% confidence interval, 17.3-21.3), while among males, it was 15.6% (13.8-17.4). The prevalence of AD and asthma showed a slight disparity between males and females. Before and during the pandemic, the prevalence of AD and AR showed a continuous increase (AD: from 2.8% [2.5-3.2] in 2007-2009 to 4.7% [3.9-5.4] in 2022; AR: from 11.7% [11.1-12.4] in 2007-2009 to 17.4% [16.0-18.9] in 2022), while asthma maintained a relatively stable trend. Moreover, this study identified several sex-specific factors that seem to be associated with a higher prevalence of allergic diseases in females, such as high household income, smoking, and being overweight or obese. CONCLUSIONS: Throughout all the periods examined, females consistently exhibited a higher prevalence of AR compared to males. Moreover, the risk factors for males and females varied depending on the disease, with females generally facing a greater number of risk factors. Consequently, this study highlights the necessity for sex-specific health interventions and further research to comprehend the complex influence of socioeconomic factors and lifestyle choices on the prevalence and risk of AD, AR, and asthma.

A study on the relationship between job-stress and burnout: Focusing on job domain among medical technologists in South Korea.

This study analyzed the relationship between job stress and burnout among medical technologists in South Korea by job domain. Most job stress factors showed significant correlations with burnout. Among the job stress factors, job demand, job instability, lack of reward, and occupational climate had significant impacts on burnout scores, with occupational climate exerting the greatest influence. In analysis of job stress factors influencing burnout according to job domain, the diagnostic testing department was most affected by lack of reward. In the departments of pathological examination, physiological testing, and health screening, occupational climate had a significant impact on burnout scores. This study demonstrated that the job-related stress experienced by medical technologists in South Korea is closely associated with burnout. To maintain work efficiency, it is essential that job-related burnout be addressed.

National Trends in the Prevalence of Unmet Health Care and Dental Care Needs During the COVID-19 Pandemic: Longitudinal Study in South Korea, 2009-2022.

BACKGROUND: Although previous studies have investigated trends in unmet health care and dental care needs, most have focused on specific groups, such as patients with chronic conditions and older adults, and have been limited by smaller data sets. OBJECTIVE: This study aims to investigate the trends and relative risk factors for unmet health care and dental care needs, as well as the impact of the COVID-19 pandemic on these needs. METHODS: We assessed unmet health care and dental care needs from 2009 to 2022 using data from the Korea Community Health Survey (KCHS). Our analysis included responses from 2,750,212 individuals. Unmet health care or dental care needs were defined as instances of not receiving medical or dental services deemed necessary by experts or desired by patients. RESULTS: From 2009 to 2022, the study included 2,700,705 individuals (1,229,671 men, 45.53%; 673,780, 24.95%, aged 19-39 years). Unmet health care needs decreased before the COVID-19 pandemic; however, during the pandemic, there was a noticeable increase (ßdiff 0.10, 95% CI 0.09-0.11). Unmet dental care needs declined before the pandemic and continued to decrease during the pandemic (ßdiff 0.23, 95% CI 0.22-0.24). Overall, the prevalence of unmet dental care needs was significantly higher than that for unmet health care needs. While the prevalence of unmet health care needs generally decreased over time, the ß difference during the pandemic increased compared with prepandemic values. CONCLUSIONS: Our study is the first to analyze national unmet health care and dental care needs in South Korea using nationally representative, long-term, and large-scale data from the KCHS. We found that while unmet health care needs decreased during COVID-19, the decline was slower compared with previous periods. This suggests a need for more targeted interventions to prevent unmet health care and dental care needs.

Public value judgments about the criteria for reimbursement of medicines in South Korea.

OBJECTIVES: This study quantified the public value (PV) of the criteria and sub-criteria in the current drug reimbursement systems in South Korea and examined sociodemographic factors that associated with PV. METHODS: The Analytic Hierarchy Process (AHP) was used to quantify the PVs of criteria and sub-criteria. We developed a questionnaire to generate pairwise comparison matrices among criteria and sub-criteria. From 27 March to 1 April 2023, we recruited 1,000 study participants using a quota sampling method stratified by age, sex, and region based on Korean census data. RESULTS: The PVs for the criteria were highest for clinical usefulness (28.5%), followed by cost-effectiveness (27.1%), budget impact (24.3%), and reimbursement in other countries (20.1%). The sociodemographic characteristics of the participants had a significant impact on the PVs of the criteria. Willingness to pay additional premiums for national health insurance was negatively associated with PV for clinical usefulness and cost-effectiveness and positively associated with PV for reimbursement in other countries. CONCLUSIONS: The public prioritized clinical usefulness and cost-effectiveness as the main criteria. However, the PVs of the criteria were divergent and associated with sociodemographic factors. Divergent public interests require an evidence-informed deliberative process for reimbursement decisions.

Nationwide seasonal monitoring of lipophilic marine algal toxins in shellfish and causative microalgae along the coasts of South Korea.

In this study, lipophilic marine algal toxins (LMATs)-producing microalgae were identified at 23 sites along the coasts of Korea, and distribution characteristics of LMATs in phytoplankton and mussels were investigated. The causative microalgae, including Gonyaulux spinifera, Dinophysis acuminata, D. caudata, and D. fortii, were observed in the study area, with notably higher densities during the summer. Significant correlations were found between the densities of these microalgae and the water temperature. Seasonal distribution patterns of LMATs in phytoplankton closely matched those observed in mussels. Notably, LMAT concentrations in mussels from the Yellow Sea were relatively high. PTX2 was detected predominantly in phytoplankton, and homo-yessotoxin was found mainly in mussels. Overall, LMAT concentrations were elevated in the summer, raising concerns about biotoxin contamination in shellfish. These results provide important insights into the dynamics of unmanaged marine biotoxins in Korea and offer baseline data for future safety management policies and inflow surveillance.

Body Mass Index as a Determinant of Lower Limb Function and Community Well-Being in Older Adults: Analysis of 2020 National Older Korean Survey Data.

This epidemiological research investigated the relationship between body mass index (BMI) and lower limb function and community well-being among the older population (≥65 years old) in South Korea. Using the 2020 National Survey of Older Koreans (N = 10 097; Mage = 73.6 ± 6.63; MBMI = 23.6 ± 2.61), the study identified underweight (2.3%), normal (72.8%), and obese (24.9%) groups. Findings revealed significant associations between BMI and lower limb function, with underweight individuals facing greater physical challenges (P < .05-.01). Underweight participants were also found to live farther from key community locations, possibly reflecting social and environmental factors (P < .01) and expressed higher dissatisfaction with community environments (Ps < .05-.01). The study emphasizes the need for tailored community planning and health care strategies, focusing on the unique needs of the underweight older adults, considering South Korea's rapidly increasing older population.

Evaluation of South Korean marine waste resources for hydrochar production: Effect of process variables.

This study assessed the hydrochar production potential of fish and crustacean waste from 8 marine species (Scomber japonicus, Trichiurus lepturus, Larimichthys polyactis, Trachurus trachurus, Paralichthys olivaceus Litopenaeus vannamei, Portunus trituberculatus, and Penaeus monodon) through hydrothermal carbonization (HTC) of their waste fractions. The impact of reaction temperature (200 - 240°C), fixed residence time (5 h), and water-to-biomass ratio (7) on HTC was analyzed. The results showed that hydrochar yields varied between fish (15.1 - 21.5 %) and crustaceans (36.9 - 69.3 %). The elemental composition and surface properties of the hydrochar were influenced by reaction temperature, as indicated by the pH point of zero charge. The adsorption capacity of hydrochar was tested for methylene blue (MB, 2.7 - 10.8 mg/g) and methyl orange (MO, 5.9 - 9.2 mg/g), with MO showing higher adsorption, except for Scomber japonicus, Larimichthys polyactis, and Trachurus trachurus. These findings highlight the significant potential for converting marine waste into valuable hydrochar, contributing to waste management and sustainable resource utilization.

The Impact of Minimum Wage Policy on Alcohol Use Disorder: A Quasi-Experimental Study in South Korea.

South Korea's 2018 minimum wage hike was examined for its impact on potential alcohol use disorders among affected individuals, using data from the Korea Welfare Panel Study (2015-2019). The study sample was restricted to workers aged 19-64 employed over the study years. The treatment group was identified as those below minimum wages, and the control group as those earning more than minimum wages in 2016-2017 (n=3,117 control, n=578 treatment). Using outcomes derived from the Alcohol Use Disorders Identification Test, our results from difference-in-differences models showed that the 2018 wage hike was linked to a 1.9% increase in the 'high risk' of alcohol use disorder and a 3.6% rise in hazardous consumption in the treatment group. Notably, the effects were more pronounced among men and those aged 50-64. Additionally, we confirmed that the spillover effects extended to workers earning up to 20% above the minimum wage. This study underscores the unintended substance use risk of minimum wage policies in the East Asian context. As wage policies are implemented, integrated public health campaigns targeting at-risk groups are required.

Predicting Asthma Exacerbation Risk in the Adult South Korean Population Using Integrated Health Data and Machine Learning Models.

Asthma is a chronic inflammatory airway disease with significant burden; exacerbations can severely affect quality of life and healthcare costs. Advances in big data analysis and artificial intelligence have made it easier to predict future exacerbations more accurately. This study used an integrated dataset of Korean National Health Insurance, meteorological, air pollution, and viral data from national public databases to develop a model to predict asthma exacerbations on a daily basis in South Korea. We merged these sources and applied random forest, AdaBoost, XGBoost, and LightGBM machine learning models to compare their performances at predicting future exacerbations. Of the models, XGBoost (AUROC of 0.68 and accuracy of 0.96) and LightGBM (AUROC of 0.67 and accuracy of 0.96) were the most promising. Common important variables were the number of visits and exacerbations per year, and medical resource utilization, including the prescription of asthma medications. Comorbid diabetes, hypertension, gastroesophageal reflux, arthritis, metabolic syndrome, osteoporosis, and ischemic heart disease were also associated with elevated exacerbation risk. The models examined in this study highlight the importance of previous exacerbations, use of medical resources, and comorbidities in the prediction of future exacerbations in patients with asthma.