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Background@#Acute pancreatitis may increase the risk of pancreatic cancer, although this association remains unclear. Therefore, we aimed to investigate this association. @*Methods@#We retrospectively analyzed the 2002–2019 Korean National Health Insurance ServiceNational Sample Cohort using 1:3 propensity score matching for sex and age (acute pancreatitis, n = 4,494; matched controls, n = 13,482). We calculated the hazard ratio (HR) for pancreatic cancer risk in patients with acute pancreatitis using Cox proportional hazards regression. @*Results@#Acute pancreatitis was significantly associated with an increased risk of pancreatic cancer throughout the study period (adjusted HR, 7.56 [95% confidence interval, 5.00– 11.41]), which persisted for 2, 2–5, and > 5 years post-diagnosis (19.11 [9.60–38.05], 3.46 [1.35–8.33], and 2.73 [1.21–6.15], respectively). This pancreatitis-related pancreatic cancer risk became insignificant beyond 10 years of follow-up (1.24 [0.24–6.49]). Furthermore, this risk notably increased as the number of recurrent acute pancreatitis episodes increased (1 episode: 5.25 [3.31–8.33], 2 episodes: 11.35 [6.38–20.19], ≥ 3 episodes: 24.58 [13.66–44.26]). @*Conclusion@#Following an acute pancreatitis diagnosis, the risk of pancreatic cancer increases significantly in the initial years, with a rapid increase further accentuated with recurrent acute pancreatitis episodes. Additional study is needed to evaluate whether this increased risk of carcinogenesis is attributed to accumulated inflammation.
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Background@#Balancing parenting and work life poses challenges for women with children, potentially making them vulnerable to depression owing to their dual responsibilities.Investigating working mothers’ mental health status is important on both the individual and societal levels. This study aimed to explore the relationship between economic activity participation and depressive symptoms among working mothers. @*Methods@#This study was a cross-sectional study and used data from the Korea National Health and Nutrition Examination Survey collected in 2014, 2016, 2018, and 2020. The participants in the study were women aged 19 to 50 who were residing with their children.In the total, 3,151 participants were used in the analysis. The independent variable was economic activity, categorized into two groups: 1) economically active and 2) economically inactive. The dependent variable was the depressive symptoms, categorized as present for a Patient Health Questionnaire-9 score of ≥ 10 and absent for a score < 10. Multiple logistic regression analysis was performed to assess the association between economic activity and depressive symptoms, and sensitivity analyses were performed based on the severity of depressive symptoms. @*Results@#Among women with children, economically active women had reduced odds ratio of depressive symptoms compared with economically inactive women (odds ratio [OR], 0.54;95% confidence interval [CI], 0.36–0.80). In additional analysis, women working as wage earners had the lowest odds of depressive symptoms (OR, 0.43; 95% CI, 0.28–0.66). Women working an average of 40 hours or less per week were least likely to have depressive symptoms (OR, 0.42; 95% CI, 0.25–0.69). @*Conclusion@#Economic activity is significantly associated with depressive symptoms among women with children. Environmental support and policy approaches are needed to ensure that women remain economically active after childbirth.
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Background@#This study aims to contribute to the adjustment of the appropriate doctor manpower by analyzing the distribution, supply and demand, and estimation of the doctor manpower. @*Methods@#This study utilized the medical personnel data of the Ministry of Health and Welfare, population trend data of the National Statistical Office, and health insurance benefit performance data of the National Health Insurance Service. Based on 2021, we compared the number of doctors in actual supply and the number of doctors in demand according to the amount of medical use by gender and age for 250 regions. Logistic regression analysis and scenario analysis were performed to estimate the future medical workforce by considering the demand for doctors according to the future demographic structure, the size of the quota in medical schools, and the retirement rate. @*Results@#There were 186 regions in which the supply of doctors was below average, and the average ratio of the number of doctors in supply to demand in the region was 62.1%. @*Conclusion@#In order to increase the number of active doctors nationwide to at least 80%, 7,756 people must be allocated. The number of doctors in demand is estimated to decrease after increasing to 1.492 times in 2059. The future projected number of doctors is expected to increase to 1.349 times in 2050 and then decrease taking into account the doctor quota and the retirement rate.
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This study examined the trend of healthcare status and compared the status of South Korea and other member of the Organization for Economic Cooperation and Development (OECD) using the OECD health statistics 2022. We used the OECD health statistics from 2022 and a position value for relative comparison (PARC) index to compare the five elements of the healthcare system. The study also used a Mann-Kendall test to analyze the trend of the PARC values from 2000 to the present year. The findings of the study indicate that many South Korea’s PARC values were higher than the OECD median. But practicing physician in supply part and medical cost were lower than OECD median but the trend significantly increased. Medical accessibility part and quality of care part except primary care, and mental health had a high relative position but the trend did not increased significantly. After outbreak of coronavirus disease 2019, there were changes in medical accessibility. Health screening and vaccinations showed an overall decline in 2020 compared to 2019. These results suggest that policymakers need to take necessary steps for a sustainable healthcare system in the country.
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Background@#To improve the support low-income individuals’ medical expenses, it is necessary to think about ways to enhance the Catastrophic Health Expenditure Support Program. This study proposes expanding support criteria and changing the income standard. @*Methods@#This study conducted simulations using national data from the National Health Insurance Service. Simulations performed for people who have used health services (n=172,764) in 2022 to confirm the Catastrophic Health Expenditure Support Program’s size based on changes to the subject selection criteria. @*Results@#As a result of the simulation with expanded criteria, the expected budget was estimated to increase between Korean won (KRW) 13.2 (11.5%) and 138.6 billion (37.4%), and the number of recipients increased between 41,979 (48.9%) and 150,317 (76.1%).The results of the simulation for the change in income criteria (applied to health insurance levels below the 50th percentile) estimated the expected budget to increase between KRW -8.9 (-7.8%) and 55.6 billion (15.0%) and the number of recipients to increase between -8,704 (-10.1%) and 41,693 (21.1%) compared to the current standard. @*Conclusion@#The 2023 Catastrophic Health Expenditure Support Program’s criteria were expanded as per the 20th Presidential Office’s national agenda to alleviate the burden of medical expenses on the low-income class. In addition, The Catastrophic Health Expenditure Support Program needs to be integrated with other medical expense support policies in the mid- to long-term, and a foundation must be prepared to ensure the consistency of each system.
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Background@#This study aims to compare the burden of disease in Korea with other Organization for Economic Cooperation and Development (OECD) countries using the OECD health statistics from 1985 to 2020. @*Methods@#We analyzed potential years of life lost (YLL) per 100,000 population using the Positive value for relative comparison (PARC) index, trend test, and average annual percentage change (AAPC) with logistic regression analysis. @*Results@#The relative disease burden was good for many diseases, but the disease burden was severe for a few diseases in Korea. Diseases with a high relative burden of disease in Korea are as follows; intentional self-harm (YLL2020 575.6, AAPCYLL 2.6%; PARC2020 -1.000, AAPCPARC -15.8%), malignant neoplasms of the liver (YLL2020 136.6, AAPCYLL -3.9%; PARC2020 -1.000, AAPCPARC 0.0%), malignant neoplasms of the stomach (YLL2020 9.0, AAPCYLL 3.2%; PARC2020 -0.556, AAPCPARC -22.9%), Parkinson's disease (YLL2020 575.6, AAPCYLL 2.6%; PARC2020 -1.000, AAPCPARC -15.8%). @*Conclusion@#Diseases with a high burden of disease are needed to be prioritized in the planning and execution of healthcare policies that can contribute to the efficient use of healthcare resources.
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Background@#This study aimed to update suicide-related indicators, including the number of suicidal deaths, suicide rate, and the prevalence of suicidal ideation and suicide attempts. We observed trends in suicide-related indicators based on up-to-date information. @*Methods@#This study used five data sources to evaluate the trends of suicide-related indicators: Statistics Korea (1983–2021), Korean Wealth Panel Study (KOWEPS, 2012–2021), and Korea Health Panel Survey (KHP, 2010–2013, 2016–2019), Korean National Health and Nutrition Examination (KNHANES, 2007–2013, 2015–2021), Korean Community Health Survey (KCHS, 2008–2009, 2013, 2017, 2021). @*Results@#The suicide rate per 100,000 population increased from 25.7 in 2020 to 26.0 in 2021. The rates of suicidal ideation from recently available data were 4.28% (KNHANES, 2021), 6.52% (KCHS, 2021), 1.61% (KOWEPS) and 7.10% (KHP, 2019). The suicidal attempts rates were 0.46% (KNHANES, 2021) and 0.34% (KCHS, 2021). The annual percentage change (APC) of suicide rate showed that suicide rates increased in the younger population (APC=9.02% in 80 years). @*Conclusion@#The suicide rate and related indicators increased in 2021 compared to 2020. Thus, continuous observation and appropriate suicide prevention policies as well as studies about the factors that affected the increase in 2021 are needed.
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Unmet healthcare is an important indicator for measuring accessibility of healthcare services. We analyzed the following four data from a nationally representative sample of South Korean population: Korea Health and Nutrition Examination Survey (KNHANES, 2007 –2021), Community Health Survey (CHS, 2008–2021), Korea Health Panel Survey (KHP, 2011–2019), and Korean Welfare Panel Study (KOWEPS, 2006–2021). The proportion of individuals reporting unmet healthcare needs were 6.0% (KNHANES), 5.1% (CHS), and 13.1% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.4%, -9.4%, and -5.3%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.2% (KNAHANES), 0.5% (CHS), 2.7% (KHP), and 0.4% (KOWEPS). The APC was -10.4%, -16.1%, -11.5%, and -19.1%, respectively. Compared to the previous year, the rate of unmet healthcare needs decreased slightly, but the rate of unmet health care needs due to cost tended to increase. Overall, higher rates of unmet healthcare needs were reported in the low-income and the elderly population. Although it was confirmed through the APC that the rate of unmet healthcare experience has decreased over the past decade, it can be seen that there is still a disparity by income level and age. These results suggest the need for an appropriate health benefit coverage policy for the low-income and the elderly.
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The term “catastrophic health expenditure” means assessing the extent to which medical costs cause financial hardship for households. The aim of this research is to analyze the percentage of households that faced severe financial strain due to medical expenses from 2006 to 2021. This was achieved by utilizing data obtained from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). A trend analysis was conducted to examine the percentage of households that experienced catastrophic healthcare expenses. The households that experienced the catastrophic health expenditure was 2.49% in 2021 using the NaSTaB data. The trend analysis yielded a statistically significant result, indicating a decreasing trend (annual percent change [APC], -4.79; p<0.0001) in the proportion of households facing catastrophic health expenditures. Also, the results of the 2019 KHP and the 2021 HIES showed 1.09% and 2.44% for the households that experienced catastrophic health expenditure. The trend was increased according to the KHP (APC, 0.55; p=0.0004) and the HIES (APC, 7.04;p<0.0001). As a result, this study proposes that sustained attention and further interventions are necessary to ease the economic pressure caused by catastrophic health expenses, particularly for low-income households.
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Background@#On October 1, 2017, a new coinsurance reduction policy for children under 15 was introduced to minimize the lack of inpatient medical services for economic reasons and secure children’s access to medical care. @*Methods@#This study analyzes the effect of this coinsurance reduction policy on healthcare utilization using data from the National Health Insurance Service-National Sample Cohort between 2015 and 2019. Groups were classified by 3 case groups and a control group according to age. The dependent variables were inpatient cost, admission, length of hospitalization, outpatient cost and visit, and total cost. The difference-in-differences method was used to examine changes in healthcare utilization among the case and control groups after policy implementation. @*Results@#Children of the age group 1–5 exhibited an increase in inpatient services and a decrease in outpatient services. There was a 16.17% increase in inpatient cost, 8.55% increase in inpatient admission, 10.67% increase in inpatient length of hospitalization, −9.14% decline in outpatient cost, and −6.79% decline in outpatient visits. Regarding children in the age groups of 6–10 and 11–15, the effect of the policy was inconclusive. @*Conclusion@#The reduction in coinsurance rate policy in hospitalization among children has increased inpatient services and reduced outpatient services for 1–5-year-olds—a substitute effect was observed in this group. There is need for further research to examine the longterm effects of the coinsurance reduction policy.
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Objectives@#Anxiety disorder is among the most prevalent mental illnesses among adolescents. Early detection and proper treatment are important for preventing sequelae such as suicide and substance use disorder. Studies have suggested that sleep duration is associated with anxiety disorder in adolescents. In the present study, we investigated the association between sleep quality and anxiety in a nationally representative sample of Korean adolescents. @*Methods@#This cross-sectional study was conducted using data from the 2020 Korea Youth Risk Behavior Web-based Survey. The Generalized Anxiety Disorder-7 questionnaire was used to evaluate anxiety. The chi-square test was used to investigate and compare the general characteristics of the study population, and multiple logistic regression analysis was used to analyze the relationship between sleep quality and anxiety. @*Results@#In both sexes, anxiety was highly prevalent in participants with poor sleep quality (adjusted odds ratio [aOR], 1.56; 95% confidence interval [CI], 1.43 to 1.71 in boys; aOR, 1.30; 95% CI, 1.19 to 1.42 in girls). Regardless of sleep duration, participants with poor sleep quality showed a high aOR for anxiety. @*Conclusions@#This study identified a consistent relationship between sleep quality and anxiety in Korean adolescents regardless of sleep duration.
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Catastrophic health expenditure refers to measure the level of the economic burden of households due to medical expenses. The purpose of this study was to examine the proportion of households that experienced catastrophic health expenditure between 2006 and 2019 using available data from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). Trend test was used to analyze the proportion of households with catastrophic healthcare expenditure. The households experienced a catastrophic health expenditure of 2.44% in 2019 using the NaSTaB data. Trend analysis was significant with the decreasing trend (annual percentage change [APC], -4.49; p<0.0001) in the proportion of households with catastrophic health expenditure. Also, the results of the 2017 KHP and the 2016 HIES showed 2.20% and 2.92%. The trend was significantly increased in the KHP (APC, 1.79; p<0.0001) and the HIES (APC, 1.43; p<0.0001). Therefore, this study suggests that further public healthcare interventions to alleviate the burden of catastrophic health expenditure, especially for low-income households, are needed.
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Objectives@#The aim of this study was to identify the association between cohabitation status and sleep quality in family members of people with dementia (PwDs). @*Methods@#Data of 190 365 participants aged ≥19 years from the 2018 Korea Community Health Survey were analyzed. Participants were categorized according to their cohabitation status with PwDs. Multiple logistic regression and ordinal logistic regression analyses were performed to evaluate the relationship between the cohabitation status of PwDs’ relatives and sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI) and PSQI subscales. @*Results@#Compared to participants without PwDs in their families, both cohabitation and non-cohabitation with PwDs were associated with poor sleep quality (cohabitation, male: odds ratio [OR],1.28; 95% confidence interval [CI], 1.08 to 1.52; female: OR, 1.40; 95% CI, 1.20 to 1.64; non-cohabitation, male: OR, 1.14; 95% CI, 1.05 to 1.24; female: OR, 1.23; 95% CI, 1.14 to 1.33). In a subgroup analysis, non-cohabiting family members showed the highest odds of experiencing poor sleep quality when the PwD lived alone (male: OR, 1.48; 95% CI, 1.14 to 1.91; female: OR, 1.58; 95% CI, 1.24 to 2.01). Cohabiting male and female participants had higher odds of poor subjective sleep quality and use of sleeping medications than non-cohabiting male and female participants, respectively. @*Conclusions@#The residence of PwDs and cohabitation status may contribute to poor sleep quality among PwDs’ family members. The circumstances faced by cohabiting and non-cohabiting family members should be considered when evaluating sleep quality in family members of PwDs, and appropriate interventions may be needed to improve sleep quality in both cohabiting and non-cohabiting family members.
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Background@#Many studies have reported noticeable increases in the proportion of employees working either relatively short or relatively long hours. Such trends have been accompanied by an increasing concern regarding work hour mismatches defined as a discrepancy between actual and preferred work hours. The aim of this study was to investigate association between work hour mismatch and depression. @*Methods@#Data regarding work hour mismatches for 47,551 adults were extracted from the 2017 Korean Working Conditions Survey. The World Health Organization-Five Well-Being Index was used to measure depression. Multiple logistic regression analyses were performed to examine the association between work hour mismatch and depression. @*Results@#Men and women workers with work hour mismatch were more likely to have depression [underemployed males: odds ratio (OR) = 1.30, 95% confidence interval (CI) = 1.14–1.49, overemployed males: OR = 1.28, 95% CI = 1.18–1.40; underemployed females: OR = 1.37, 95% CI = 1.20–1.56, overemployed females: OR = 1.12, 95% CI = 1.02–1.23]. Underemployed workers, workers who worked more than 52 hours per week, and workers with a high income level, all had higher ORs for depression. The greater the discrepancy between actual and preferred work hours, the higher OR for depression among both underemployed and overemployed workers. @*Conclusions@#A difference between actual and preferred work hours was associated with depression. Underemployed workers had a higher risk of depression than that of overemployed workers. As a work hour mismatch negatively affected workers' mental health, it is important to reduce work hours mismatches as well as shorten the absolute number of work hours.
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Background@#This study aims to measure regional healthcare differences in Korea, and define relatively underserved areas. @*Methods@#We employed position value for relative comparison index (PARC) to measure the healthcare status of 250 areas using 137 indicators in five following domains: healthcare demand, supply, accessibility, service utilization, and outcome. We performed a sensitivity analysis using t-SNE (t-distributed stochastic neighboring embedding). @*Results@#Based on PARC values, 83 areas were defined as relatively underserved areas, 49 of which were categorized as moderate and 34 as severe. The provincial regions with the most underserved areas were Gyeongbuk (16 areas), Gangwon (13), Jeonnam (13), and Gyeongnam (12). @*Conclusion@#This study suggests a relative comparison approach to define relatively underserved areas in healthcare. Further studies incorporating various perspectives and methods are required for policy implications.
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The objective of this study is to investigate the healthcare status of South Korea and other member countries of the Organization for Economic Cooperation and Development (OECD) using OECD health statistics 2020. We employed the position value for relative comparison index to measure the healthcare status in five following components: demand, supply, accessibility, quality, and cost. The Mann-Kendall test was used to analyze for increasing or decreasing trend of the position value for relative comparison values from 2000 to the recent year. Results showed that Korea was positioned above than the OECD median values in most of components, but lower than the median values in certain indices including healthcare employment, primary care, and mental health care. This study sheds some light on healthcare issues to be improved and the policy-makes can take into account for prior setting process.
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Unmet healthcare is an important indicator to measure accessibility of healthcare services. To examine the latest status of unmet healthcare needs in South Korea, the four different data which is composed of nationally representative sample of South Korean population were used; the Korea Health and Nutrition Examination Survey (KNAHANES, 2007–2019), the Community Health Survey (CHS, 2008–2019), the Korea Health Panel Survey (KHP, 2011–2017), and the Korean Welfare Panel Study (KOWEPS, 2006–2019). The proportion of individuals reporting unmet healthcare needs were 5.8% (KNHANES), 5.3% (CHS), and 11.6% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.5%, -8.0%, and -6.5%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.1% (KNAHANES), 0.7% (CHS), 2.4% (KHP), and 0.4% (KOWEPS). The APC was -10.5%, -14.2%, -12.2%, and -19.6%, respectively. Compared to last year, the rate of unmet healthcare needs has declined in general.However, the low-income and the elderly population were reporting the highest rate of unmet health care needs, and the disparity between lowest and highest groups were remained. These results suggest that adequate benefit coverage is needed for low-income and elderly population.
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This study aimed to update suicide-related indicators including suicidal ideation, suicide attempts, and the number of suicidal deaths.Based on up-to-date information, we observed the trends of suicide-related indicators. In this study, five data sources were used to observe the trends of suicide-related indicators: Statistics Korea (1983–2019), Korean National Health and Nutrition Examination (KNHANES, ‘07–13, ‘15–19), Korean Community Health Survey (KCHS, ‘08–09, ‘13, ‘17), Korean Wealth Panel Study (KOWEPS, ‘12–19), and Korea Health Panel Survey (KHP, ‘10–13, ‘16-17). The suicide rate, which peaked in 2011, declined until 2017 and then started to rise again from 2018, recording a suicide rate of 26.9 per 100,000 people in 2019. The rate of suicidal ideation estimated based on the recently available data was 4.62% (KNHANES, ‘19), 3.51% (KHP, ‘16), 2.87% (KHP, ‘17), and 1.70% (KOWEPS, ‘19). That of suicide attempt as recent year was 0.43% (KNHANES, ‘19), 0.07% (KOWEPS, ‘19). Annual percentage change of death by intentional self-harm was -2.11% (Statistics Korea), and that of suicidal ideation was -14.7% (KNHANES), -2.5% (KCHS), -10.6% (KOWEPS), and -11.3% (KHP). Annual percentage change of suicide attempt was -5.0% (KNHANES), -4.4% (KCHS), and -11.3% (KOWEPS). The lower the income level, the higher the probability of experiencing suicide ideation and suicide attempts. Considering the recent increase in suicide rate in contrast to the continuing decline in suicidal ideation and suicide attempts, continuous data observation and appropriate policies regarding suicide prevention are needed.
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Catastrophic health expenditure refers to measure the level of the economic burden of households due to medical expenses. The purpose of this study was to examine the proportion of households that experienced catastrophic health expenditure between 2006 and 2019 using available data from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). Trend test was used to analyze the proportion of households with catastrophic healthcare expenditure. The households experienced a catastrophic health expenditure of 2.44% in 2019 using the NaSTaB data. Trend analysis was significant with the decreasing trend (annual percentage change [APC], -4.49; p<0.0001) in the proportion of households with catastrophic health expenditure. Also, the results of the 2017 KHP and the 2016 HIES showed 2.20% and 2.92%. The trend was significantly increased in the KHP (APC, 1.79; p<0.0001) and the HIES (APC, 1.43; p<0.0001). Therefore, this study suggests that further public healthcare interventions to alleviate the burden of catastrophic health expenditure, especially for low-income households, are needed.
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Objectives@#The aim of this study was to identify the association between cohabitation status and sleep quality in family members of people with dementia (PwDs). @*Methods@#Data of 190 365 participants aged ≥19 years from the 2018 Korea Community Health Survey were analyzed. Participants were categorized according to their cohabitation status with PwDs. Multiple logistic regression and ordinal logistic regression analyses were performed to evaluate the relationship between the cohabitation status of PwDs’ relatives and sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI) and PSQI subscales. @*Results@#Compared to participants without PwDs in their families, both cohabitation and non-cohabitation with PwDs were associated with poor sleep quality (cohabitation, male: odds ratio [OR],1.28; 95% confidence interval [CI], 1.08 to 1.52; female: OR, 1.40; 95% CI, 1.20 to 1.64; non-cohabitation, male: OR, 1.14; 95% CI, 1.05 to 1.24; female: OR, 1.23; 95% CI, 1.14 to 1.33). In a subgroup analysis, non-cohabiting family members showed the highest odds of experiencing poor sleep quality when the PwD lived alone (male: OR, 1.48; 95% CI, 1.14 to 1.91; female: OR, 1.58; 95% CI, 1.24 to 2.01). Cohabiting male and female participants had higher odds of poor subjective sleep quality and use of sleeping medications than non-cohabiting male and female participants, respectively. @*Conclusions@#The residence of PwDs and cohabitation status may contribute to poor sleep quality among PwDs’ family members. The circumstances faced by cohabiting and non-cohabiting family members should be considered when evaluating sleep quality in family members of PwDs, and appropriate interventions may be needed to improve sleep quality in both cohabiting and non-cohabiting family members.