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The current multimorbidity correction method in the Global Burden of Disease studies assumes the independent occurrence of diseases. Those studies use Monte-Carlo simulations to adjust for the presence of multiple disease conditions for all diseases. The present study investigated whether the above-mentioned assumption is reasonable based on the prevalence confirmed from actual data. This study compared multimorbidity-adjusted years of lived with disability (YLD) obtained by Monte-Carlo simulations and multimorbidity-adjusted YLD using multimorbidity prevalence derived from National Health Insurance Service data. The 5 most common diseases by sex and age groups were selected as diseases of interest. No significant differences were found between YLD estimations made using actual data and Monte-Carlo simulations, even though assumptions about the independent occurrence of diseases should be carefully applied. The prevalence was not well reflected according to disease characteristics in those under the age of 30, among whom there was a difference in YLD between the 2 methods. Therefore, when calculating the burden of diseases for Koreans over the age of 30, it is possible to calculate the YLD with correction for multimorbidity through Monte-Carlo simulation, but care should be taken with under-30s. It is useful to apply the efficiency and suitability of calibration for multiplicative methods using Monte-Carlo simulations in research on the domestic disease burden, especially in adults in their 30s and older. Further research should be carried out on multimorbidity correction methodology according to the characteristics of multiple diseases by sex and age.
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Background@#Injury is a social problem that causes health and property losses, and it is important to identify the size and trend of injury for efficient prevention and management.Therefore, this study analyzed the trends in injury mortality and hospitalization rates from 2005 to 2019 in Korea. @*Methods@#Using mortality data by Statistics Korea and Korea National Hospital Discharge In-depth injury survey by the Korea Disease Control and Prevention Agency (KDCA), age standardized rates were calculated for death and hospitalization to analyze trends and annual changes with the joinpoint regression model. In addition, annual changes in the hospitalization rate of the transport accident and fall injuries by age group were analyzed, which are the major causes of injuries. @*Results@#From 2005 to 2019, the injury mortality rate has been on the decline, but the injury hospitalization rate has been on the rise. The annual rate of change varied depending on the injury mechanism, but the mortality rate tended to decrease or remain similar level, while the rate of hospitalization has steadily increased. In addition, by age group, injury mortality and hospitalization rates were high in the elderly. In particular, the hospitalization rate of the elderly was higher when comparing the hospitalization rate of the children in transport accidents and falls. Pedestrian transport accidents tended to decrease under the age of 15, but remained similar for those aged 65 and older, and bicycle accidents tended to increase in both groups. In addition, hospitalization rates were higher in the fall, with both groups showing a statistically significant increase in hospitalization rates caused by falls. @*Conclusion@#This study analyzed the trend of injury mortality and hospitalization and found that transport accidents and falls may vary depending on the means or age of the accident.Since injury is a big social problem that is a burden of disease, safety education and legal sanctions for injury prevention should be further improved in the future, especially by prioritizing vulnerable groups by age and detailed mechanisms of injury.
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Background@#To evaluate the health status of healthcare workers (doctors and nurses) compared to those in the general population based on the National Health Insurance Service database and the cause of death data from Statistics Korea. @*Methods@#The subjects of this study were 104,484 doctors and 220,310 nurses working in healthcare facilities from 2002 to 2017, and who had undergone at least one general medical examination. Based on the subject definition, the subject data were extracted from the National Health Insurance healthcare facility database and qualification database. We collected medical use details included in the research database, general medical examination results, medical history included in the health examination database, and additional data on the cause of death from the National Statistics database to analyze the main cause of death and mortality. @*Results@#In terms of the major causes of death and mortality among healthcare workers, the mortality rate associated with intentional self-harm, injury, transportation accident, heart disease, addiction, and falling was significantly higher than that in the general population. Further, the prevalence of respiratory and gastrointestinal diseases was high. When analyzing the proportional mortality ratio (PMR) by cause of death for healthcare workers, the PMR values for death related to malignant neoplasm was the highest. In terms of diseases, both doctors and nurses had higher rates of infectious diseases such as maternal sepsis, rubella, and measles. @*Conclusion@#The health status of healthcare workers differs from that of the general population. Thus, it is important to consider the occupational characteristics of healthcare personnel. This study is unique in that it was conducted based on medical use indicators rather than survey data.
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Objectives@#The aim of this study was to evaluate the subjective level of health-related quality of life of Korean healthcare workers using various quality-of-life instruments. @*Methods@#This study included 992 participants, who were doctors and nurses. A survey was conducted between November 28 and December 4, 2019. Data from 954 participants divided into 3 groups (physicians, residents, and nurses) were analyzed. Four measurement tools (29 questions) were used in the survey to evaluate subjective health status and well-being. @*Results@#In the Mayo Well-being Index, burnout during work (88.5%) and emotional difficulties caused by work (84.0%) were frequently cited by the respondents. Regarding questions on burnout and emotional difficulties, residents and nurses had the highest scores (91.0 and 89.6%, respectively). Emotional problems, such as anxiety, depression, and irritability, accounted for a high percentage (73.1%) of the total, while 82.2% of respondents reported that their work schedules interfered with their leisure and family time. There was no significant difference among the groups in subjective health status. However, 10.1% of the residents experienced very low quality of life, which was a higher proportion than that of physicians (2.7%) and nurses (5.2%). @*Conclusions@#The level of well-being that Korean medical workers experienced in relation to work was lower than the results of the United States healthcare workers surveyed using the same tool. This study was unique in that it conducted a subjective quality-of-life survey on Korean healthcare workers.
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Subject(s)
Acquired Immunodeficiency Syndrome , Health Planning , Health Policy , HIV , Korea , Methods , Mortality , Nervous System Diseases , Prevalence , Republic of Korea , Tuberculosis , ViolenceABSTRACT
BACKGROUND@#Evaluation of mortality and prevalence trends is important for health planning and priority decision-making in health policy. This study was performed to examine disease-specific mortality and prevalence trends for diseases in Korea from 2002 to 2015.@*METHODS@#In this study, 206 mutually exclusive diseases and injuries were classified into 21 cause clusters, which were divided into three cause groups: 1) communicable, maternal, neonatal, and nutritional conditions; 2) non-communicable diseases (NCDs); and 3) injuries. Cause specific trends for age-standardized mortality and prevalence rates were analyzed by the joinpoint regression method.@*RESULTS@#Between 2002 and 2015, the age-standardized mortality declined to about 177 per 100,000 population, while the age-standardized prevalence rate increased to approximately 68,065 per 100,000 population. Among the 21 cause clusters, most of the disease mortality rates showed decreasing trends. However, neurological disorders, self-harm, and interpersonal violence included periods during which the mortality rates increased in 2002–2015. In addition, the trends for prevalence rates of human immunodeficiency virus infection and acquired immune deficiency syndrome, tuberculosis, transport injuries, and self-harm, and interpersonal violence differed from the overall prevalence rates. The annual percent change in prevalence rates for transport injuries increased during 2004–2007, and then decreased. The self-harm and interpersonal violence prevalence rates decreased from 2004 to 2014.@*CONCLUSION@#Between 2002 and 2015, overall decreasing trends in the mortality rate and increasing trends in the prevalence rate were observed for all causes in Korea. Especially, NCDs represented an important part of the increasing trends in Korea. For clusters of diseases with unusual trends, proper management must be considered.
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BACKGROUND@#Evaluation of mortality and prevalence trends is important for health planning and priority decision-making in health policy. This study was performed to examine disease-specific mortality and prevalence trends for diseases in Korea from 2002 to 2015.@*METHODS@#In this study, 206 mutually exclusive diseases and injuries were classified into 21 cause clusters, which were divided into three cause groups: 1) communicable, maternal, neonatal, and nutritional conditions; 2) non-communicable diseases (NCDs); and 3) injuries. Cause specific trends for age-standardized mortality and prevalence rates were analyzed by the joinpoint regression method.@*RESULTS@#Between 2002 and 2015, the age-standardized mortality declined to about 177 per 100,000 population, while the age-standardized prevalence rate increased to approximately 68,065 per 100,000 population. Among the 21 cause clusters, most of the disease mortality rates showed decreasing trends. However, neurological disorders, self-harm, and interpersonal violence included periods during which the mortality rates increased in 2002–2015. In addition, the trends for prevalence rates of human immunodeficiency virus infection and acquired immune deficiency syndrome, tuberculosis, transport injuries, and self-harm, and interpersonal violence differed from the overall prevalence rates. The annual percent change in prevalence rates for transport injuries increased during 2004–2007, and then decreased. The self-harm and interpersonal violence prevalence rates decreased from 2004 to 2014.@*CONCLUSION@#Between 2002 and 2015, overall decreasing trends in the mortality rate and increasing trends in the prevalence rate were observed for all causes in Korea. Especially, NCDs represented an important part of the increasing trends in Korea. For clusters of diseases with unusual trends, proper management must be considered.
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BACKGROUND@#Projection of future trends in disease burden can facilitate setting of priorities for health policies and resource allocation. We report here projections of disease-specific mortality and the burdens of various diseases in Korea from 2016 to 2030.@*METHODS@#Separate age- and sex-specific projection models for 21 major cause clusters from 2016 to 2030 were developed by applying coherent functional data models based on historical trends from 2002 to 2015. The age- and sex-specific years of life lost (YLL) for each cause cluster were projected based on the projected number of deaths. Years lived with disability (YLD) projections were derived using the 2015 age- and sex-specific YLD to YLL ratio. The disability-adjusted life years (DALYs) was the sum of YLL and YLD.@*RESULTS@#The total number of deaths is projected to increase from 275,777 in 2015 to 421,700 in 2030, while the age-standardized death rate is projected to decrease from 586.9 in 2015 to 447.3 in 2030. The largest number of deaths is projected to be a result of neoplasms (75,758 deaths for males; 44,660 deaths for females), followed by cardiovascular and circulatory diseases (34,795 deaths for males; 48,553 deaths for females). The three leading causes of DALYs for both sexes are projected to be chronic respiratory diseases, musculoskeletal disorders, and other non-communicable diseases (NCDs).@*CONCLUSION@#We demonstrate that NCDs will continue to account for the majority of the disease burden in Korea in the future.
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OBJECTIVES: The increase in the obesity rate in adult males in Korea is higher than countries in the Organization for Economic Co-operation and Development and other Asian countries. We examined the trends and prevalence of major risk factors for cardiovascular disease by evaluating the weight status amongst adults from 2007 to 2015. METHODS: The study included 37,402 adults, who participated in the Korea National Health and Nutrition Examination Survey. The prevalence trends of cardiovascular disease risk factors were estimated for each body mass index group. RESULTS: From 2007 to 2015, significant increases in the prevalence of hypertension, diabetes, and hypercholesterolemia were observed in normal weight adults (0.03 percentage point (%p), 0.06%p, and 0.13%p, respectively). Amongst the overweight and obese adults, a significant increase in the prevalence of hypercholesterolemia was observed, During this period, the prevalence of smoking decreased amongst obese adults and no significant changes in drinking habits and physical activity were noted across all body mass index groups. CONCLUSION: The prevalence of obesity in Korean adults is increasing, and it is necessary to implement interventions to prevent further weight gain and obesity-associated cardiovascular disease.
Subject(s)
Adult , Humans , Male , Asian People , Body Mass Index , Cardiovascular Diseases , Drinking , Hypercholesterolemia , Hypertension , Korea , Motor Activity , Nutrition Surveys , Obesity , Overweight , Prevalence , Risk Factors , Smoke , Smoking , Weight GainABSTRACT
BACKGROUND: The purpose of this study is to evaluate the outcomes of clinical education program for nurses in regional public hospital, utilizing the Kirkpatrick's model. METHODS: Kirkpatrik's 4-level model was applied to this study. Trainees were asked to fill out questionnaires in the middle and at the end of the program. Also administrators of excellent trainees were asked to fill out the questionnaires regarding nursing management performance after 1-2 months from the end of the training course. RESULTS: All trainees had positive reactions to the clinical education program. Not only the results of individual level (satisfaction and achievement scores, academic achievement scores, practical application rate, and educational transition factors) but also the scores of organization level (nursing management performance scores) are improved. CONCLUSION: By showing a correlation between the effectiveness factors we need to verify the relationship between these factors in a future study. In addition, development of quantitative and qualitative performance indicators are needed. To establish a long-term education system, it is required to applying the excellent trainee's successful experiences.