Impact of the COVID-19 Pandemic on Admission and Mortality Among Patients With Severe Emergency Diseases at Emergency Departments in Korea in 2020: Registry Data From the National Emergency Department Information System.

We aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on admissions of patients with acute myocardial infarction, stroke, and severe trauma, and their excess mortality in emergency departments (EDs) in South Korea using registry data from the National Emergency Department Information System (NEDIS) for patients attending EDs of regional and local emergency medical centers. During the outbreak period of 2020, there were 350,698 ED visits, which was lower than the total in 2019 (392,627 visits). Multiple logistic regression revealed that, compared with 2019, there was significantly higher ED mortality rate during the COVID-19 outbreak in 2020 (adjusted odds ratio, 1.10; 95% confidence interval, 1.07-1.13). This finding implies that during the early outbreak period, people might have avoided seeking medical care even for acute and life-threatening conditions, or transfer times at the scene to the hospital arrival were delayed, or treatment for the patients in EDs were delayed.

Gender Differences in the Relationship between Type 2 Diabetes Mellitus and Employment: Evidence from the Korea Health Panel Study.

Previous studies have analyzed the impact of diabetes mellitus on labor market participation by men and women, but gender difference between type 2 diabetes mellitus (T2DM) and employment has not been the focus. This study aims to explore gender differences between T2DM and employment status. Data from the Korea Health Panel Study, 2013-2015 were analyzed by distinguishingT2DM and non-diabetes (N = 11,216). The empirical model was established and the generalized two-stage least squares (2SLS) was estimated, controlling for endogeneity. A family history of diabetes, as an instrumental variable, was related to an individual's genetic predisposition to develop diabetes. The estimated results for the 2SLS showed the interaction effects between T2DM and employment. T2DM had a statistically significant and negative effect on employment for women only. The comparison with non-diabetes showed that women with T2DM had a lower probability of employment by 51.9% (p < 0.05). Exposing gender bias in employment suggests that healthcare policies and disease management programs for diabetic patients should adopt gender-specific remedies.

Psychometric properties of a short self-reported measure of medication adherence among patients with hypertension treated in a busy clinical setting in Korea.

BACKGROUND: We examined the psychometric properties of the Korean version of the 8-item Morisky Medication Adherence Scale (MMAS-8) among adults with hypertension. METHODS: A total of 373 adults with hypertension were given face-to-face interviews in 2 cardiology clinics at 2 large teaching hospitals in Seoul, South Korea. Blood pressure was measured twice, and medical records were reviewed. About one-third of the participants (n = 109) were randomly selected for a 2-week test-retest evaluation of reliability via telephone interview. RESULTS: Internal consistency reliability was moderate (Cronbach α = 0.56), and test-retest reliability was excellent (intraclass correlation = 0.91; P < 0.001), although a ceiling effect was detected. The correlation of MMAS-8 scores with scores for the original 4-item scale indicated that convergent validity was good (r = 0.92; P < 0.01). A low MMAS-8 score was significantly associated with poor blood pressure control (χ(2) = 29.86; P < 0.001; adjusted odds ratio = 5.08; 95% CI, 2.56-10.08). Using a cut-off point of 6, sensitivity and specificity were 64.3% and 72.9%, respectively. Exploratory factor analysis identified 3 dimensions of the scale, with poor fit for the 1-dimensional construct using confirmatory factory analysis. CONCLUSIONS: The MMAS-8 had satisfactory reliability and validity and thus might be suitable for assessment and counseling regarding medication adherence among adults with hypertension in a busy clinical setting in Korea.

Reliability and validity of a self-reported measure of medication adherence in patients with type 2 diabetes mellitus in Korea.

OBJECTIVE: This study examined the psychometric properties of the Korean version of the eight-item Morisky Medication Adherence Scale (MMAS-8) to measure adherence to diabetes medication in patients with type 2 diabetes mellitus. METHODS: The English version of the MMAS-8 was translated into Korean and administered to patient with type 2 diabetes mellitus via face-to-face interviews, conducted by an independent interviewer. Patient characteristics and glycosylated haemoglobin (HbA1c) levels were assessed at the same clinic visit. A proportion of patients was randomly selected for 2-week test-retest reliability via telephone interviews. Convergent validity of the MMAS-8 against a four-item MMAS, correlations with HbA1c levels and construct validity of the MMAS-8 were evaluated. RESULTS: In total, 317 patients were included; 70 completed the 2-week test-retest interview. Internal consistency reliability was moderate and test-retest reliability of the MMAS-8 was excellent, although a ceiling effect was detected. Good convergent validity was shown by the high correlation of the new scale scores with the original MMAS-4. A significant association was found between MMAS-8 scores and HbA1c levels. Using glycaemic control as a gold standard, sensitivity was 74.1% and specificity was 38.3%. Explanatory factor analysis identified three dimensions of the scale. CONCLUSIONS: In light of acceptable reliability and validity, the MMAS-8 is a simple and quick method for the assessment of medication adherence among patient with type 2 diabetes mellitus, in a busy clinic setting.