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INTRODUCTION: We measured the short-term clinical and economic impacts of the National Health Insurance Service (NHIS) smoking cessation program, which subsidizes the cost of pharmacotherapy and medical consultations, by comparing the changes in prevalence and healthcare costs of smoking-related diseases among cessation service users, non-users, and never smokers. METHODS: Smokers who used the cessation service from 2015 to 2017 were included (n=779315). We used claims data from the NHIS, a mandatory, single-payer insurance covering the entire Korean population, to determine the number of patients with selected diseases, their healthcare utilization, and medical costs, and compared these amounts in the one year before and after enrollment. For further comparison, we also estimated disease prevalence and medical costs in matched controls by age, sex, income, and residential area, including never smokers and smokers who never used the cessation program. RESULTS: Across all 15 selected diseases, the number of patients, days spent in the hospital, and medical costs for 1 year were consistently higher after service enrollment than before. This pattern was observed for both men and women. Notably, decreased prevalence and medical costs for pneumonia were observed among individuals aged <50 years. Healthcare utilization for any kind of disease for 1 year was 97.7%, 91.1%, and 88.8% among cessation service users, never smokers, and smokers who did not use the cessation service, respectively. The disease-specific prevalence was also highest and increased more in the cessation service users compared with the control groups. CONCLUSIONS: Cessation service users were more likely to seek healthcare. Increased healthcare utilization in the first year after cessation service use may have resulted from smoking-related conditions that led individuals to attempt smoking cessation.
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OBJECTIVES: Recurrent respiratory papillomatosis (RRP) is caused by human papillomavirus (HPV) types 6 and 11 and is potentially preventable through vaccination. This study estimated the incidence of juvenile-onset RRP before the implementation of the national HPV vaccination program in Korea. METHODS: We conducted a cohort study using claims data provided by a mandatory insurance program to estimate the incidence of RRP and associated healthcare use. Patients with juvenile RRP were defined as those aged ≤12 years with ≥2 admissions or ≥2 outpatient visits during which they received the International Classification of Diseases, 10th revision code for benign neoplasms of the larynx (D14.1). RESULTS: During 2002-2014, 123 children (74 boys and 49 girls) were diagnosed with RRP. The patients had a mean of 6.5 person-years of follow-up. The incidence was estimated at 0.30/100,000 person-years. The median age at diagnosis was 4.0 years (mean, 4.3). Thirty-six (29.3%) patients underwent surgery, including 23 patients (18.7%) who underwent 2 or more surgical procedures. Severe disease, measured by more frequent surgical procedures and shorter time intervals between consecutive operations, was associated with a younger age at diagnosis. CONCLUSIONS: The estimated incidence of juvenile-onset RRP in Korea was similar to that reported in other countries. The RRP burden should continue to be monitored using National Health Insurance Service claims data.
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Infecções por Papillomavirus/epidemiologia , Infecções Respiratórias/epidemiologia , Idade de Início , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Revisão da Utilização de Seguros , Masculino , Infecções por Papillomavirus/terapia , República da Coreia/epidemiologia , Infecções Respiratórias/terapiaRESUMO
Infection is a major cause of cancers. We estimated the economic burden of cancers attributable to infection in 2014 in Korea, where cancer causing infection is prevalent, but the economic burden of it has never been examined. Cancer patients were defined as those having made medical claims as recorded by the National Health Insurance Service, which is a mandatory insurance for all citizen. We multiplied the costs by the population-attributable fraction for each type of cancer. The study included direct and indirect costs, where direct costs comprised direct medical and non-medical costs of inpatients and outpatients, while indirect costs were estimated by identifying future income loss due to premature death, productivity loss during hospitalization/outpatient visits, and job loss. In 2014, there were 100,054 infection-related cancer patients, accounting for 10.7% of all Korean cancer cases for that year. Direct costs of cancers associated with infection stood at nearly USD 676.9 million, while indirect costs were much higher at USD 2.57 billion. The average expenditure of a typical patient was USD 32,435. Economic burden of cancers attributable to infection is substantial in Korea, accounting for 0.23% of the national gross domestic product and 1.36% of national healthcare expenditure in 2014.
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Efeitos Psicossociais da Doença , Neoplasias , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Custos de Cuidados de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/economia , Neoplasias/epidemiologia , Prevalência , República da Coreia/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Cancer is a major burden of disease and alcohol consumption is one of the major risk factors of cancer. This study aimed to estimate the economic burden of cancer types attributable to alcohol consumption in the Republic of Korea. METHODS: This study estimates the direct and indirect costs of cancer types attributable to alcohol consumption by applying cost-of-illness methods using the human capital approach and prevalence-based estimates. Claims data from the National Health Insurance Service for 2011-2016 were used. RESULTS: In Korea, there were 297,304 alcohol consumption-related cancer cases, of which 14,186 (4.8 %) were attributable to alcohol consumption in 2016. From 2011-2016, the socioeconomic burden of cancer attributable to alcohol consumption in Korea has increased steadily, even considering inflation adjustment. The total economic burden of cancer attributable to alcohol consumption in 2016 in Korea was approximately $476 million, of which $119 million were direct costs and $357 million were indirect costs. According to our analysis of annual cost per patient, the average costs were $37,432 for men and $11,930 for women. CONCLUSIONS: The economic burden of cancer types attributable to alcohol consumption in Korea is substantial and has increased between 2011 and 2016, mainly due to an increased number of patients.
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Consumo de Bebidas Alcoólicas/economia , Consumo de Bebidas Alcoólicas/epidemiologia , Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde/tendências , Neoplasias/economia , Neoplasias/epidemiologia , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Feminino , Humanos , Formulário de Reclamação de Seguro/economia , Formulário de Reclamação de Seguro/tendências , Masculino , Pessoa de Meia-Idade , Neoplasias/terapia , Prevalência , República da Coreia/epidemiologia , Fatores de RiscoRESUMO
INTRODUCTION: Associations between smoking, cancer and mortality are well established. Although cancer mortality rates have decreased in recent years, the economic burden of smoking-related cancers continues to increase. This study investigates the economic costs of cancers related to smoking in Korea in 2014. METHODS: Cancer patients were identified through National Health Insurance Services medical claims with ICD-10 cancer codes. We multiplied the costs by the population attributable fraction for each type of cancer and calculated direct and indirect costs, where direct costs comprise direct medical and non-medical costs of inpatients and outpatients, and indirect costs include estimates of future income loss due to premature death, productivity loss during hospitalization and outpatient visits, and job loss. RESULTS: In 2014, there were 79297 smoking-related cancer patients, accounting for 8.47% of all Korean cancer cases for that year. The direct cost of cancers due to smoking was approximately 595 million USD, whereas indirect costs were much higher, at nearly 2.2 billion USD. The average expenditure of a typical patient was 34815 USD. Lung, liver and stomach cancers were most prevalent and represented the most significant share of the economic burden, whereas the largest per-patient spending was for pancreatic, liver, and lung cancers. Lung, liver and stomach cancers had the highest economic impact on men, while lung, liver and ovarian cancers had the most significant economic impact on women. CONCLUSIONS: It is imperative that more stringent steps be taken to reduce the huge economic burden of cancers linked to smoking. ABBREVIATIONS: IARC: International Agency for Research on Cancer, PAF: population attributable fraction, NHIS: National Health Insurance Services, ICD-10: International Statistical Classification of Diseases and Related Health Problem 10th Revision, GDP: Gross Domestic Product, DALYs: Disability-Adjusted-Life-Years, WHO: World Health Organization, FCTC: Framework Convention on Tobacco Control.
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OBJECTIVE: We aimed to evaluate trends in the prevalence of human papillomavirus (HPV)-related diseases in the era before the introduction of organised HPV vaccination programmes in the Republic of Korea. METHODS: This cross-sectional study used National Health Insurance Service data from 2002 to 2015 and included participants who were diagnosed with the following HPV-related diseases (codes from the International Classification of Diseases, 10th Revision): genital warts (A63.0); cancer in the head and neck (C00-C10), anus (C21), vulva (C51), vagina (C52), cervix uteri (C53) and penis (C60); carcinoma in situ (CIS) of the lip/oral cavity/pharynx (D00.0), anus (D01.3), cervix (D06), vulva (D07.1), vagina (D07.2) and penis (D07.4); benign neoplasms of the larynx (D14.1); and dysplasia of the cervix (N87), vagina (N89) and vulva (N90). For each diagnosis, the fraction of cases attributable to HPV in Korea was assessed based on the percentages of diseases attributable to HPV reported in some international studies. The age-standardised prevalence was estimated using the direct population-based method. RESULTS: The overall age-standardised prevalence of HPV-related diseases increased from 2002 to 2015, mainly due to increased prevalence of genital warts in men and cervical dysplasia and CIS in women. In women, genital wart prevalence increased from 2002 (24.4 per 100 000) to 2011 (57.1) and then decreased until 2015 (53.5); in men, the prevalence increased steadily from 2002 (22.9) to 2015 (109.4). The prevalence of cervical dysplasia and CIS increased (from 86.5 in 2002 to 484.5 in 2015, and from 60.3 in 2002 to 114.9 in 2015, respectively), but that of cervical cancer decreased (from 120.0 in 2002 to 106.9 in 2015). CONCLUSIONS: Non-organised HPV vaccination and organised cervical cancer screening may have contributed to the downward trend in genital wart prevalence and the upward trend in cervical abnormalities among women.
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Papillomaviridae/imunologia , Infecções por Papillomavirus/epidemiologia , Adolescente , Adulto , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Revisão da Utilização de Seguros , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/etiologia , Infecções por Papillomavirus/prevenção & controle , Prevalência , República da Coreia/epidemiologia , Vacinação , Adulto JovemRESUMO
BACKGROUND: This prevalence-based, cost-of-illness study estimated the health care costs of human papillomavirus (HPV) infection-associated diseases in the era before the introduction of organized HPV vaccination for 12-year-old girls in 2016, South Korea. METHODS: The claims data provided by the National Health Insurance Service was used to estimate the prevalence of HPV-associated diseases and their direct medical costs, including costs related to hospitalizations, outpatient visits, and medications. RESULTS: A total of 1.3â¯million men and women used medical services for HPV-attributed diseases between 2002 and 2015. Among women, the most common diseases attributable to HPV were cervical dysplasia (64.4%), anogenital warts (12.9%), cervical carcinoma in situ (10.7%) and cervical cancer (2.6%), whereas anogenital warts (80.6%), benign neoplasms of larynx (14.3%), and anal cancers (8.9%) were most common among men. In 2015, the healthcare cost attributable to HPV was 124.9â¯million US dollars (USD) representing 69.0% of the annual cost of all HPV-associated diseases. At a cost of 75.1â¯million USD, cervical cancer contributed the largest economic burden in 2015 followed by cervical dysplasia (19.4â¯million USD) and cervical carcinoma in situ (10.7â¯million USD). These three conditions represented 58.2% of the total annual cost of all HPV-associated diseases, while 84.2% of the total annual cost was attributable to HPV. Annual health care costs increased from 42.6â¯million USD in 2002 to 180.9â¯million USD in 2015. CONCLUSION: The healthcare costs associated with HPV-related diseases in Korea are substantial and increased between 2002 and 2015 mainly caused by increased number of patients. Expanding the target age for HPV vaccination of girls and introducing HPV vaccination for boys are possible ways of reducing the economic burden of HPV-associated disease and should be considered.