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1.
J Autism Dev Disord ; 50(1): 333-339, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31630294

RESUMO

The prevalence of autism spectrum disorder (ASD) is increasing worldwide. We investigated the economic burden of ASD in South Korea using a nationally representative data source. The direct medical and non-medical costs, and indirect costs resulting from ASD were estimated. The total prevalence was 5.04 (per 100,000) in 2008, and 10.97 in 2015. The economic cost of ASD was estimated to be $2,700,596 in 2008 and $9,645,503 in 2015. Of the total economic cost in 2015, 72.3% was from direct costs and 27.7% from indirect costs, and 87.5% related to male patients and 12.5% to female patients. The results suggest that the increase in economic costs was greater than the increase in prevalence.

2.
Yonsei Med J ; 60(12): 1203-1208, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31769252

RESUMO

Little is known about the benefits of statin use on liver cancer mortality among patients with chronic hepatitis B (CHB) considering hypercholesterolemia and obesity. A nationwide retrospective cohort study was conducted using data from a Health Examination Cohort of the National Health Insurance Service of Korea. Data on CHB patients with no other concurrent liver disease were acquired, and statin use was defined as a cumulative daily dose ≥28. A 3-year landmark analysis was performed to avoid immortal time bias. Patients who started statin therapy within the landmark date were considered statin users. A Cox regression analysis was applied to assess associations between statin use and liver cancer mortality considering hypercholesterolemia and obesity. Among 13063 patients, 193 (1.5%) died of liver cancer during the mean follow-up period of 10.6 years. After adjusting for demographic and metabolic factors, statin use [hazard ratio (HR), 0.17; 95% confidence interval (CI), 0.04-0.70] and hypercholesterolemia (HR, 0.46; 95% CI, 0.24-0.88 for total cholesterol ≥240 mg/dL) were associated with a decreased risk of liver cancer mortality, whereas body mass index (BMI) ≥30 kg/m² was associated with an increased risk of liver cancer mortality (HR, 2.46; 95% CI, 1.20-5.06). This study showed that statin use was associated with decreased liver cancer mortality when adjusting for cholesterol levels and BMI. This study found that hypercholesterolemia was independently associated with decreased liver cancer mortality regardless of statin use.

3.
Artigo em Inglês | MEDLINE | ID: mdl-31640281

RESUMO

Despite the increasing prevalence and economic burden of dyslipidemia in South Korea, we have little data on the physical activity of patients. Thus, we aimed to investigate how quality of life among patients with dyslipidemia is influenced by a combination of the following variables: light physical activity (PA), sedentary behavior (SB), perceived body shape, and body mass index (BMI). We examined data from the Sixth Korean National Health and Nutrition Examination Survey (KNHANES VI 2015), collected in 2015 by the Korean Centers for Disease Control and Prevention. The analysis included 534 individuals with dyslipidemia out of 7380 survey participants. Latent profile analysis identified three latent classes of individuals based on their physical profiles. Class 1 patients (active; n = 48) were more active, possessed more positive views of their body shape, were less sedentary, and had a lower BMI than Class 3 patients (inactive; n = 154). Class 2 patients (moderate; n = 331) had profiles in between the other two classes. Additionally, Class 1 and 2 patients had better quality of life than Class 3 patients. Our results suggest that promoting light PA and altering perceived body shape through counselling may improve quality of life in patients with dyslipidemia.

4.
Medicine (Baltimore) ; 98(39): e17287, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574848

RESUMO

Evidence suggests that mental health is associated with multiple factors such as physical activity, sedentary behavior, and physical function in older adults. The present study used latent profile analysis to identify classes of older adults based on their health profile among a representative sample of Korean older adults with hypertension. Differences in mental health between these classes were also examined.Seven hundred and sixty seven participants (mean age = 70.23, SD = 6.08; men 45.6%) were included in the analysis.There were 3 latent classes (class 1: a physically inactive lifestyle with low physical function and body perception; class 2: a physically moderate lifestyle with moderate physical function and low body perception; class 3: a physically active lifestyle with high physical function and body perception). According to class comparisons, older adults in class 3 had significantly lower anxiety/depression levels than classes 1 and 2. Older adults in class 3 had significantly lower stress levels than class 1.It is possible that among older adults, having a positive attitude of one's body shape may also be important for improving anxiety/depression along with having a physically active lifestyle and maintaining physical function.


Assuntos
Imagem Corporal/psicologia , Força da Mão , Hipertensão/psicologia , Postura Sentada , Caminhada , Idoso , Idoso de 80 Anos ou mais , Ansiedade/psicologia , Estudos Transversais , Depressão/psicologia , Exercício/psicologia , Feminino , Humanos , Hipertensão/fisiopatologia , Análise de Classes Latentes , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Percepção , República da Coreia , Estresse Psicológico/psicologia
5.
Am J Health Behav ; 43(6): 1040-1049, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31662164

RESUMO

Objectives: In this study, we examined factors of moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) in elderly Koreans. Methods: We used 2015 data from the Sixth National Health and Nutrition Examination Survey. To analyze physical activity (PA), we categorized participants were into those who met MVPA recommendations (150 minutes/week of moderate PA or 75 minutes/week of vigorous PA) or those who did not. We also categorized them into high SB (620-1200 minutes/day of sitting) and low SB (30-600 minutes/day). Results: Final analyses included 1501 adults over 60 years old (mean: 69.2 ± 6.2). We performed multiple logistic regressions examining impacts of grip strength and body mass index, along with self-reports of perceived health, sleep duration, and demographics on PA and SB. We found positive associations between meeting MVPA guidelines and self-perceived health and urban living, but negative associations with sleep duration and education. A strong grip, high self-perceived health, long sleep duration (8-14 hours), and living with a partner were factors of being less sedentary. High annual income was a factor of being more sedentary. Conclusion: Our findings support efforts that develop interventions promoting active lifestyles among elderly Koreans.

7.
Eur J Health Econ ; 20(9): 1409-1424, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31452084

RESUMO

OBJECTIVE: This systematic review examined the characteristics of published cost-effectiveness analyses of inpatient smoking cessation programs and assessed the methodological quality of the selected studies, to provide policymakers with economic evidence for this type of program. METHODS: A literature search was undertaken using a relevant database by three investigators. Only full economic evaluations with results in the form of the incremental cost-effectiveness ratio (ICER) were included. Costs were adjusted to 2016 US dollars using the Gross Domestic Product deflator and purchasing power parities. The British Medical Journal checklist was utilized to appraise the methodological quality of the included studies. RESULTS: Nine articles were ultimately selected. The inpatient smoking cessation programs appeared to be a highly cost-effective intervention according to the recommended cost-effectiveness thresholds by the World Health Organization or individual studies. The highest ICERs among the selected studies were $5593 per additional quit, $10,550 per life year gained, and $5680 per quality-adjusted life year gained. CONCLUSIONS: This study provides robust evidence supporting the cost-effectiveness of smoking cessation programs for hospitalized patients. In addition, the results indicated that the degree of cost-effectiveness of the inpatient smoking cessation program might not be related to either the components of the program or methodological variations in the cost-effectiveness analysis. Policymakers should provide hospitals with resources and strong incentives to promote wider implementation of the smoking cessation program.

8.
J Atten Disord ; : 1087054719864632, 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31364445

RESUMO

Objective: We investigated the economic burden and disability-adjusted life years (DALYs) for attention deficit/hyperactivity disorder (ADHD) in the Republic of Korea. Method: Using the National Health Insurance Service claims data for the population aged 19 years or younger, a prevalence-based approach was used to calculate the DALYs of ADHD. Direct medical costs, direct nonmedical costs, and indirect costs resulting from ADHD were estimated to calculate the economic burden of ADHD. Results: A total of 69,353 people in Korea were diagnosed with ADHD in 2012. The burden of ADHD as measured by the prevalence-based approach was 32,605 DALYs. The total economic burden of ADHD was US$47.55 million, which accounted for approximately 0.004% of Korean GDP (gross domestic product) in 2012. Conclusion: Our findings shed light on the considerable burden of ADHD, emphasizing the need for policies that can encourage ADHD treatment and enhance compliance.

9.
PLoS One ; 14(3): e0212607, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30830916

RESUMO

BACKGROUND: Retirement is one of the most important later-life status transitions related to changes in workforce participation, lifestyle, and social roles among older adults. The purpose of this study was to investigate the impact of retirement on depressive symptoms by gender in middle-aged and older adult Koreans, using a large, nationally representative sample. METHODS: Using year 2010 and 2012 data from the Korea Longitudinal Study of Aging, we investigated the relationship between adults' retirement status and depressive symptoms measured by the 10-item Center for Epidemiological Studies-Depression (CES-D10) scale. A series of propensity score matching models were calculated to test the potential retirement effect on adults' depressive symptoms. RESULTS: Overall, the level of depressive symptoms of the retired group was not different from that of the employed counterpart. In gender-stratified models, the gain of CES-D10 scores in the retired group was higher than that of the employed group for males, which was in the opposite direction among females. However, the propensity score matching model showed that the relationship between retirement status and CES-D10 score gain was significant for males but not for females. CONCLUSIONS: Our study reinforces the assertion that retirement could worsen depressive symptoms and could differ by gender. Intervention programs focused on the mental health of retired men need to be actively developed and widely implemented.


Assuntos
Depressão/epidemiologia , Aposentadoria , Caracteres Sexuais , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores Sexuais
10.
J Korean Med Sci ; 34(Suppl 1): e60, 2019 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-30923484

RESUMO

Background: For the Korean Burden of Disease (KBD) 2015 study, we have amended disability weights for causes of disease adapting the methodology of the KBD disability weight 2012 study. Methods: We conducted a self-administered web-based survey in Korea using ranking five causes of disease. A total of 605 physicians and medical college students who were attending in third or fourth grade of a regular course performed the survey. We converted the ranked data into paired comparison data and ran a probit regression. The predicted probabilities for each cause of disease were calculated from the coefficient estimates of the probit regression. 'Being dead (1)' and 'Full health (0)' were utilized as anchor points to rescale the predicted probability on a scale from 0 to 1. Results: As a result, disability weights for a total of 289 causes of disease were estimated. In particular, we calculated the disability weights of 60 causes of disease considering severity level. These results show that prejudice about the severity of cause of disease itself can affect the estimation of disability weight, when estimating the disability weight for causes of disease without consideration of severity. Furthermore, we have shown that disability weights can be estimated based on a ranking method which can maximize efficiency of data collection. Conclusion: Disability weights from this study can be used to estimate disability adjusted life year and healthy life expectancy. Furthermore, we expected that the use of the ranking method will increase gradually in disability weight studies.


Assuntos
Avaliação da Deficiência , Doença/etiologia , Índice de Gravidade de Doença , Adulto , Feminino , Humanos , Expectativa de Vida , Masculino , Médicos/psicologia , Anos de Vida Ajustados por Qualidade de Vida , República da Coreia , Estudantes de Medicina/psicologia , Inquéritos e Questionários , Navegador , Adulto Jovem
11.
J Korean Med Sci ; 34(Suppl 1): e75, 2019 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-30923488

RESUMO

Background: It is extremely important to objectively take a view of population health to provide useful information to decision makers, health-sector leaders, researchers, and informed citizens. This study aims to examine the burden of disease in Korea as of 2015, and to study how the burden of disease changes with the passage of time. Methods: We used results from the Korean National Burden of Disease and Injuries Study 2015 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive disability-adjusted life years (DALYs) by gender and age groups from 2007 to 2015. DALYs were calculated as the sum of the years of life lost (YLLs) and the years lived with disability (YLDs). Results: In 2015, the burden of disease for Korean people was calculated at 29,476 DALYs per 100,000 population. DALYs caused by low back pain were the highest, followed by diabetes mellitus and chronic obstructive pulmonary disease. The burden of disease showed a consistently increasing trend from 2007 to 2015. Although YLLs have been on the decrease since 2011, the increase in YLDs has contributed to the overall rise in DALYs. The DALYs per 100,000 population in 2015 increased by 28.1% compared to 2007. Conclusion: As for the diseases for which the burden of disease is substantially increasing, it is needed to establish appropriate policies in a timely manner. The results of this study are expected to be the basis for prioritizing public health and health care policies in Korea.


Assuntos
Carga Global da Doença/tendências , Anos de Vida Ajustados por Qualidade de Vida , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Criança , Pré-Escolar , Diabetes Mellitus/patologia , Feminino , Carga Global da Doença/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Dor Lombar/patologia , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/patologia , República da Coreia , Adulto Jovem
12.
J Korean Med Sci ; 34(Suppl 1): e80, 2019 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-30923489

RESUMO

Background: Disease burden can be represented by health-related parameters such as disability-adjusted life years and economic burden. Economic burden is an important index, as it estimates the maximum possible cost reduction if a disease is prevented. This study aimed to determine the economic burden of 238 diseases and 22 injuries in Korea in 2015. Methods: Economic burden was estimated with a human resources approach from a social perspective, and direct and indirect costs were calculated from insurance claims data and a cause of death database. Direct costs were divided into medical costs (including hospital admission, outpatient visit, and medication use) and nonmedical costs (including transportation and caregiver costs). Indirect costs from lost productivity, either from the use of healthcare service or premature death, were analyzed. Results: In 2015, the estimated economic burden was USD 133.7 billion (direct: USD 65.5 billion, indirect: USD 68.2 billion). The total cost of communicable diseases was USD 16.0 billion (11.9%); non-communicable diseases, USD 92.3 billion (69.1%); and injuries, USD 25.4 billion (19.0%). Self-harm had the highest costs (USD 8.3 billion), followed by low back pain (LBP, USD 6.6 billion). For men, self-harm had the highest cost (USD 7.1 billion), while LBP was the leading cost (USD 3.7 billion) for women. Conclusion: A high percentage of Korea's total socioeconomic disease burden is due to chronic diseases; however, unnoticed conditions such as infectious diseases, injuries, and LBP are high in certain age groups and differ by gender, emphasizing the need for targeted social interventions to manage and prevent disease risk factors.


Assuntos
Efeitos Psicossociais da Doença , Carga Global da Doença/economia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Criança , Pré-Escolar , Feminino , Carga Global da Doença/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , República da Coreia , Adulto Jovem
13.
J Korean Med Sci ; 34(Suppl 1): e81, 2019 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-30923490

RESUMO

Background: Burden of disease can be used to prioritize the healthcare budget allocation. We analyzed the research and development (R&D) budget of the Ministry of Health and Welfare (MOHW) in 2018 and compared the results with those of the 2015 Korean National Burden of Disease (KNBD) study. Methods: The 2018 MOHW R&D Project integrated implementation plan was used to analyze the R&D budget of the MOHW. The budget was allocated according to the KNBD disease group and according to the budget lines. The allocated budget was compared with the economic burden and the disability adjusted life years (DALYs) in 2015. Also, for budget targets for risk factors, DALYs of attributable risk factors were compared with corresponding budgets. Results: In 2018, the MOHW major R&D budget of USD 435.1 million accounted for 3% of the total government budget. Within the disease specific R&D budget, 35.9% was allocated to communicable disease groups, 64.1% to non-communicable diseases, and 0% to injury and violence. Among level 2 disease groups, neoplasm was ranked first. Among risk factors, climate change and behavioral risk were targeted for R&D. Conclusions: It would be difficult to say that current R&D allocations focus to minimize the burden of disease. A mismatch was observed between the R&D budget and the burden of disease in terms of economic burden and DALYs. There was a similar finding for risk factors R&D. A novel approach for allocating government R&D funding that is based on the goal of minimizing the disease burden in the Korean population should be considered.


Assuntos
Carga Global da Doença/economia , Política de Saúde/economia , Humanos , Anos de Vida Ajustados por Qualidade de Vida , Pesquisa/economia , Alocação de Recursos
14.
J Korean Med Sci ; 34(Suppl 1): e89, 2019 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-30923492

RESUMO

Following the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), disability-adjusted life years (DALYs) have been widely used as a summary measure of population health. The DALY metric is a comprehensive measurement of population health, enabling comparison among groups. However, the available data and reliance on estimates to supplement the data gap require contextualization at the national level, and the outcomes of which are more appropriate for national policymakers. The Korean National Burden of Disease (KNBD) study was initiated by the Research and Development Project of the Ministry of Health and Welfare, funded by a 5-year grant from 2013, to contextualize the GBD method to the Korean population. Here, we provide a comprehensive overview of the KNBD study with its achievements and challenges and discuss the implications for public health policies.


Assuntos
Carga Global da Doença , Política de Saúde , Humanos , Saúde da População , Anos de Vida Ajustados por Qualidade de Vida , República da Coreia , Fatores de Risco
15.
Atherosclerosis ; 283: 43-51, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30776703

RESUMO

BACKGROUND AND AIMS: Our study aimed to investigate the association between high-density lipoprotein cholesterol (HDL-C) and all-cause and cause-specific mortality in Korean adults. METHODS: A total of 365,457 participants aged ≥40 years were selected from the Korean National Health Insurance Service-National Sample Cohort from 2009 to 2015. HDL-C level was categorized into <1.0, 1.0-1.19, 1.2-1.39, 1.4-1.59, 1.6-1.79 (reference), 1.8-1.99, 2.0-2.19 and ≥ 2.20 mmol/L. Cox proportional hazard models were used to examine the association between HDL-C level and mortality risk. RESULTS: In a median 3.5-year follow-up period, 9,350 participants (2.6%) died. Men with HDL-C level of 1.6-1.79 mmol/L and women with HDL-C level of 1.4-1.59 mmol/L had the lowest age-standardized mortality rates for all-cause death. However, for cardiovascular death, men with HDL-C level ≥2.20 mmol/L and women with HDL-C level of 1.8-1.99 mmol/L showed the lowest mortality rate. After adjusting for multiple covariates, the hazard ratios for all-cause and cancer deaths showed a U-shaped relationship with HDL-C level for both sexes. However, there were heterogenetic associations between HDL-C level and mortality risk of subtypes of cardiovascular disease by sex. For other causes of death except for cardiovascular and cancer death, elevated mortality risk was mainly due to external causes (ICD-10 code, S00-T98). CONCLUSIONS: In South Korea, very high HDL-C level was associated with increased risk of all-cause death. However, the increased all-cause mortality risk in people with very high HDL-C level was partly due to mortality risk from external causes.

16.
J Korean Med Sci ; 34(2): e22, 2019 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-30636948

RESUMO

Background: Several studies have been conducted regarding people with disabilities, however no studies have estimated the disease burden due to premature death. As such, we aimed to compare the years of life lost (YLLs) due to premature death between a population with disabilities and the total population of Korea. Methods: To calculate the YLLs in people with disabilities, we combined disability registration data from the 2002-2011 Ministry of Health and Welfare of Korea and the causes of mortality data by Statistics Korea for 3,158,231 people. Results: YLLs of people with disabilities were 517,337, which accounted for 23.4% of YLLs of the total population. YLLs per 100,000 people with disabilities were approximately 3.8 times higher than those in the total Korean population. Ischemic stroke was associated with the highest YLLs per 100,000 people, followed by ischemic heart disease, hemorrhagic, and other non-ischemic stroke, diabetes mellitus, and self-harm. Among individuals with physical disabilities, ischemic heart disease was associated with the highest YLLs. For intellectual disability, epilepsy contributed to the most YLLs. For individuals with mental disability, self-harm was the largest contributor to YLLs. Conclusion: The burden of disease was higher in the population with disabilities than that in the general population. Cardiovascular diseases and cancer had a higher burden of disease than did other diseases in the population with disabilities; thus, overall, non-communicable diseases have a higher burden of disease than communicable diseases or injuries in the population with disabilities than in the general population.


Assuntos
Pessoas com Deficiência , Carga Global da Doença , Mortalidade Prematura , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Anos de Vida Ajustados por Qualidade de Vida , República da Coreia , Acidente Vascular Cerebral/mortalidade , Acidente Vascular Cerebral/patologia , Adulto Jovem
17.
Hepatol Int ; 13(2): 222-233, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30182166

RESUMO

BACKGROUND: Elevation of serum ferritin levels is frequently observed in non-alcoholic fatty liver disease (NAFLD) patients. Our study aims to examine the association between serum ferritin levels and NAFLD in Korean population. METHODS AND RESULTS: A total of 25,597 participants were selected from Korean National Health and Nutritional Examination Surveys 2007-2012. The NAFLD liver fat score (NLFS) was used to define NAFLD. Elevation of ALT levels was defined as ALT level > 40 IU/L for male and ALT level > 31 IU/L for female. Multiple logistic regression was used to examine the association of serum ferritin levels and NAFLD by sex. After adjusting for multiple covariates, the ORs (95% CI) of the elevated ALT levels were 1.56 (95% CI: 1.17-2.07), 1.84 (95% CI: 1.39-2.45), and 4.08 (95% CI: 3.08-5.40) for the second, third and fourth serum ferritin quartiles in male (p for trend < 0.01), 1.67 (95% CI: 1.24-2.23), 2.23 (95% CI: 1.68-2.96), and 5.72 (95% CI: 4.32-7.60) for the second, third and fourth serum ferritin quartiles in female (p for trend < 0.01). Serum ferritin levels were also significantly associated with NAFLD and liver fibrosis both in male and female. CONCLUSIONS: Elevation of serum ferritin level is significantly associated with NAFLD and blood ALT elevation in Korean general population.


Assuntos
Alanina Transaminase/sangue , Ferritinas/sangue , Cirrose Hepática/sangue , Hepatopatia Gordurosa não Alcoólica/sangue , Adulto , Aspartato Aminotransferases/sangue , Feminino , Humanos , Masculino , Inquéritos Nutricionais , República da Coreia , Adulto Jovem , gama-Glutamiltransferase/sangue
18.
BMJ Open ; 8(9): e023144, 2018 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-30269071

RESUMO

OBJECTIVES: The South Korean government has recently implemented policies to prevent suicide. However, there were few studies examining the recent changing trends in suicide rates. This study aims to examine the changing trends in suicide rates by time and age group. DESIGN: A descriptive study using nationwide mortality rates. SETTING: Data on the nationwide cause of death from 1993 to 2016 were obtained from Statistics Korea. PARTICIPANTS: People living in South Korea. INTERVENTIONS: Implementation of national suicide prevention policies (first: year 2004, second: year 2009). PRIMARY OUTCOME MEASURES: Suicide was defined as 'X60-X84' code according to the ICD-10 code. Age-standardised suicide rates were estimated, and a Joinpoint regression model was applied to describe the trends in suicide rate. RESULTS: From 2010 to 2016, the suicide rates in South Korea have been decreasing by 5.5% (95% CI -10.3% to -0.5%) annually. In terms of sex, the suicide rate for men had increased by 5.0% (95% CI 3.6% to 6.4%) annually from 1993 to 2010. However, there has been no statistically significant change from 2010 to 2016. For women, the suicide rate had increased by 7.5% (95% CI 6.3% to 8.7%) annually from 1993 to 2009, but since 2009, the suicide rate has been significantly decreasing by 6.1% (95% CI -9.1% to -3.0%) annually until 2016. In terms of the age group, the suicide rates among women of almost all age groups have been decreasing since 2010; however, the suicide rates of men aged between 30 and 49 years showed continuously increasing trends. CONCLUSION: Our results showed that there were differences in the changing trends in suicide rate by sex and age groups. Our finding suggests that there was a possible relationship between implementation of second national suicide prevention policies and a decline in suicide rate.


Assuntos
Suicídio/tendências , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Distribuição por Sexo , Suicídio/estatística & dados numéricos , Adulto Jovem
19.
J Korean Med Sci ; 33(37): e251, 2018 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-30190659

RESUMO

Background: Ambient fine particulate matter (PM2.5) is the major environmental health risk factor in Korea. Exposure to PM2.5 has been a growing public concern nationwide. With the rapid aging of the Korean population, the health effects attributable to long-term exposure to PM2.5 were expected to increase further in the future. We aimed to estimate premature deaths attributable to long-term exposure to ambient PM2.5 in Korea. Methods: A modelled estimation of long-term exposure to PM2.5 was used to calculate the nationwide exposure level. Hazard ratios of long-term exposure to PM2.5 were obtained from a large prospective cohort study in North America. Modified cause of death (CoD) data, which applied the garbage code reclassification algorithm, were used to calculate premature deaths attributable to long-term exposure to PM2.5. Results: From 1990 to 2013, the average population-weighted PM2.5 concentration in Korea was 30.2 µg/m3. The estimated number of premature deaths was 17,203 (95% confidence interval [CI], 11,056-22,772). The most common CoD was ischemic stroke (5,382; 3,101-7,403), followed by cancer of trachea, bronchus, and lung (4,958; 2,857-6,820), hemorrhagic stroke (3,452; 1,989-4,748), and ischemic heart disease (3,432; 1,383-5,358). Conclusion: Premature deaths due to long-term exposure to PM2.5 accounted for 6.4% of all deaths in Korea. However, individual efforts alone cannot prevent the effects of air pollution. This disease burden study can serve as a basis for the establishment of government policies and budgets and can be used to assess the effectiveness of environmental health policies.


Assuntos
Mortalidade Prematura , Poluentes Atmosféricos , Poluição do Ar , Exposição Ambiental , Feminino , Humanos , Masculino , Material Particulado , Estudos Prospectivos , República da Coreia
20.
BMJ Open ; 8(6): e020280, 2018 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-29961008

RESUMO

OBJECTIVES: To determine changes in antipsychotic drug usage in all South Korean patients with schizophrenia in 2011-2015 and factors affecting their utilisation in 2015. DESIGN AND SETTING: Retrospective cohort study using health insurance claims data on patients with schizophrenia in South Korea in 2011-2015. PARTICIPANTS: All treated patients with schizophrenia in South Korea in 2011-2015. The number of patients with schizophrenia was 171 302 in 2011, 175 488 in 2012, 177 763 in 2013, 180 079 in 2014 and 183 427 in 2015. MAIN OUTCOME MEASURES: Changes in antipsychotic drug usage and factors affecting the use of antipsychotics. RESULTS: Among patients with schizophrenia, there were tendencies of decreased use of antipsychotic combination therapy of typical drugs (from 11.5% to 7.5%) but increased use of combination therapy of atypical drugs (from 21.8% to 29.0%). Factors affecting the use of typical drugs were sex, age, geographical region, type of benefits/insurances and type of medical institutions. Use of typical antipsychotics was increased by age (OR=1.02, 95% CI 1.02 to 1.02). It was higher in men (OR=1.27, 95% CI 1.23 to 1.30) than that in women. It was higher in Medicaid benefiters (OR=4.49, 95% CI 4.35 to 4.64) than that in patients with health insurance. Use of typical drugs was higher among patients treated in general hospitals (OR=1.46, 95% CI 1.32 to 1.64), primary hospitals (OR=3.25, 95% CI 2.95 to 3.59), long-term care hospitals (OR=3.00, 95% CI 2.59 to 3.49) and clinics (OR=8.87, 95% CI 8.06 to 9.76) compared with that in tertiary care hospitals. Compared with metropolitan region, higher use of typical antipsychotics was seen in Gangwon (OR=1.14, 95% CI 1.05 to 1.25), Jeolla (OR=1.32, 95% CI 1.26 to 1.39) and Gyeongsang (OR=1.14, 95% CI 1.10 to 1.18) provinces. CONCLUSIONS: Results of this study confirmed changes of antipsychotic drug usage from typical to atypical antipsychotics in the treatment of schizophrenia and identified factors affecting the use of typical drugs, in contrast with current treatment trend in South Korea. These results may be used in the improvement of a medical system.


Assuntos
Antipsicóticos/uso terapêutico , Padrões de Prática Médica/estatística & dados numéricos , Padrões de Prática Médica/tendências , Esquizofrenia/tratamento farmacológico , Adulto , Antipsicóticos/economia , Feminino , Humanos , Seguro Saúde/economia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , República da Coreia , Estudos Retrospectivos
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