ABSTRACT
This study estimated the prevalence and incidence rate of schizophrenia, schizotypal, and delusional disorders (SSDD) in Korea from 2008 to 2017 and analyzed the hospital admission rate, re-admission rate, and hospitalization period. It used the Korean nationwide National Health Insurance Service claims database. SSDD patients who had at least one visit to Korea's primary, secondary, or tertiary referral hospitals with a diagnosis of SSDD, according to the International Classification of Diseases, 10th Revision (ICD-10), were identified as SSDD cases if coded as F20-F29. Data were analyzed using frequency statistics. Results showed that the 12-month prevalence rate of SSDD increased steadily from 0.40% in 2008 to 0.45% in 2017. Analysis of the three-year cumulative prevalence rate of SSDD showed an increase from 0.51% in 2011 to 0.54% in 2017. In 2017, the five-year cumulative prevalence rate was 0.61%, and the 10-year cumulative prevalence rate was 0.75%. The hospital admission rate among SSDD patients decreased from 2008 (30.04%) to 2017 (28.53%). The incidence of SSDD was 0.05% and no yearly change was observed. The proportion of SSDD inpatients whose first hospital visit resulted in immediate hospitalization was 22.4% in 2017. Epidemiological indicators such as prevalence, incidence, and hospitalization rate play an important role in planning social and financial resource allocation. Therefore, efforts to produce more accurate epidemiological indicators are very important and this study's findings could have a significant social impact.
Subject(s)
Hospitalization/statistics & numerical data , Schizophrenia, Paranoid/epidemiology , Schizophrenia/epidemiology , Schizotypal Personality Disorder/epidemiology , Adult , Aged , Databases, Factual , Female , Humans , Incidence , Male , Middle Aged , National Health Programs/statistics & numerical data , Prevalence , Republic of Korea/epidemiology , Schizophrenia/diagnosis , Schizophrenia/physiopathology , Schizophrenia, Paranoid/diagnosis , Schizophrenia, Paranoid/physiopathology , Schizotypal Personality Disorder/diagnosis , Schizotypal Personality Disorder/physiopathologyABSTRACT
In South Korea, people may increase their medical coverage by purchasing private health insurance to augment low coverage provided by the National Health Insurance (NHI). Frequent and excessive use of medical care by those with private health insurance is an issue, especially for musculoskeletal disorders that require excessive care and contribute to moral hazard. In South Korea, since private health insurance is structurally linked to the scope of coverage with public health insurance, this increased use of medical care may adversely affect public health insurance finances. This study aimed to analyze the effects of private health insurance on medical care use for patients with musculoskeletal disorders. We used the Korea Health Panel 2014 to 2015 data that included 5622 participants who used medical care for musculoskeletal disorders in 2015. Two groups were created: those who purchased private health insurance (n = 3588) and those without private insurance (n = 2034). We compared their medical utilization using logistic regression, negative binomial regression, and multiple linear regression to determine the associations of private health insurance with medical care use. Medical expenditures by private health insurance purchasers were higher than those of non-purchasers for outpatient care (P < .001), but no differences were found for inpatient care. Our findings suggest that the expansion of private health insurance further burdened the NHI financially, ultimately increasing the burden of medical expenses for the population. Research should implement demonstration studies with different groups of diseases.
Subject(s)
Insurance, Health , Musculoskeletal Diseases , Health Expenditures , Humans , Musculoskeletal Diseases/therapy , National Health Programs , Republic of KoreaABSTRACT
OBJECTIVES: It is essential to measure and monitor the burden of dental caries and periodontal disease (PD) in Korea's ageing population due to their potential impact on morbidity, quality of life and economic condition. This study aimed to quantify the size of burden of dental caries and PD using the disability-adjusted life years (DALYs), and their trends. METHODS: DALYs were estimated using incidence-based approaches to calculate the burden of dental caries and PD from 2013 to 2015 in Korea. Incidence and prevalence were estimated using medical claim data by specific algorithms. Additionally, sensitivity analysis was conducted to investigate possible weakness in the study methodology. To conduct the sensitivity analysis, we modified the algorithms to estimate prevalence and incidence. RESULTS: The burden of dental caries and PD increased by 39.2% and 57.0%, respectively, between 2013 and 2015. In 2015, dental caries and PD ranked 11th and 25th, respectively, in terms of the leading causes of DALYs. The burden of dental caries was the most substantial in children aged 0-9 years, while that of PD was the most substantial among those in their ages of 40 and 50 (per 100 000 population). After sensitivity analysis with a modified disease algorithm, the magnitude of disease burden changed considerably. CONCLUSIONS: Dental caries and PD constitute substantial burdens in South Korea. Despite the known limitations, medical claims data can be a powerful resource for conducting timely and cost-effective measurements of oral health. In countries, where universal dental schemes are available, there is need to estimate the burden of oral disease using claims data, for methodical advances in the research field.