Journal of Preventive Medicine and Public Health

Hye Young Kang

10 Articles

Socioeconomic Costs of Stroke in Korea: Estimated from the Korea National Health Insurance Claims Database.: Seung ji Lim, Han joong Kim, Chung mo Nam, Hoo sun Chang, Young Hwa Jang, Sera Kim, Hye Young Kang; J Prev Med Public Health. 2009;42(4):251-260.; DOI: https://doi.org/10.3961/jpmph.2009.42.4.251

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OBJECTIVES
To estimate the annual socioeconomic costs of stroke in Korea in 2005 from a societal perspective. METHODS: We identified those 20 years or older who had at least one national health insurance (NHI) claims record with a primary or a secondary diagnosis of stroke (ICD-10 codes: I60-I69, G45) in 2005. Direct medical costs of the stroke were measured from the NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting the hospitals. Indirect costs were defined as patients' and caregivers' productivity loss associated with office visits or hospitalization. Also, the costs of productivity loss due to premature death from stroke were calculated. RESULTS: A total of 882,143 stroke patients were identified with prevalence for treatment of stroke at 2.44%. The total cost for the treatment of stroke in the nation was estimated to be 3,737 billion Korean won (KRW) which included direct costs at 1,130 billion KRW and indirect costs at 2,606 billion KRW. The per-capita cost of stroke was 3 million KRW for men and 2 million KRW for women. The total national spending for hemorrhagic and ischemic stroke was 1,323 billion KRW and 1,553 billion KRW, respectively, which together consisted of 77.0% of the total cost for stroke. Costs per patient for hemorrhagic and ischemic stroke were estimated at 6 million KRW and 2 million KRW, respectively. CONCLUSIONS: Stroke is a leading public health problem in Korea in terms of the economic burden. The indirect costs were identified as the largest component of the overall cost.

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Analysis of Total Hospital Charges, Length of Stay, and Cost of Rehabilitation by Hospital and Stroke Type
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Changwoo Shon, Hyung-Yun Choi, Jae-Jun Shim, So-Youn Park, Kyung Suk Lee, Seok-Jun Yoon, In-Hwan Oh
Japanese Journal of Infectious Diseases.2016; 69(1): 18. CrossRef
Validation of Stroke and Thrombolytic Therapy in Korean National Health Insurance Claim Data
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Suicidal ideation and attempts in patients with stroke: a population-based study
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The Epidemiology and Economic Burden ofClostridium difficileInfection in Korea
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Medical Utilization and Cost in Patients with Overlap Syndrome of Chronic Obstructive Pulmonary Disease and Asthma
Chin Kook Rhee, Hyoung Kyu Yoon, Kwang Ha Yoo, Young Sam Kim, Sei Won Lee, Yong Bum Park, Jin Hwa Lee, Yuri Kim, Kyungjoo Kim, Jinhee Kim, Yeon Mok Oh, Sang Do Lee
COPD: Journal of Chronic Obstructive Pulmonary Disease.2014; 11(2): 163. CrossRef
The costs of hepatitis A infections in South Korea
Kyohyun Kim, Baek-Geun Jeong, Moran Ki, Mira Park, Jin Kyung Park, Bo Youl Choi, Weon-Seob Yoo
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The Incidence and Prevalence of Diabetes Mellitus and Related Atherosclerotic Complications in Korea: A National Health Insurance Database Study
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PLoS ONE.2014; 9(10): e110650. CrossRef
Two-Year Direct Medical Costs of Stroke in Korea: A Multi-Centre Incidence-Based Study from Hospital Perspectives
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The Socioeconomic Burden of Coronary Heart Disease in Korea
Hoo-Sun Chang, Han-Joong Kim, Chung-Mo Nam, Seung-Ji Lim, Young-Hwa Jang, Sera Kim, Hye-Young Kang
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Prevalence of Treated Epilepsy in Korea Based on National Health Insurance Data
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Journal of Korean Medical Science.2012; 27(3): 285. CrossRef
The Factors Associated with Good Responses to Speech Therapy Combined with Transcranial Direct Current Stimulation in Post-stroke Aphasic Patients
Il-Young Jung, Jong Youb Lim, Eun Kyoung Kang, Hae Min Sohn, Nam-Jong Paik
Annals of Rehabilitation Medicine.2011; 35(4): 460. CrossRef
How Much Amount of Socioeconomic Loss Is Caused by Digestive Diseases?
Kyung Sik Park
The Korean Journal of Gastroenterology.2011; 58(6): 297. CrossRef
Health Care Costs of Digestive Diseases in Korea
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Estimating the Economic Burden of Osteoporotic Vertebral Fracture among Elderly Korean Women.: Hye Young Kang, Dae Ryong Kang, Young Hwa Jang, Sung Eun Park, Won Jung Choi, Seong Hwan Moon, Kyu Hyun Yang; J Prev Med Public Health. 2008;41(5):287-294.; DOI: https://doi.org/10.3961/jpmph.2008.41.5.287

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Abstract PDF

OBJECTIVES
To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. METHODS: From 2002 to 2004, we identified all National Health Insurance claims records for women > or = 50 years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," Ysuch that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with > or = one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. RESULTS: During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. CONCLUSIONS: Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

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A Study of Prevalence and Awareness of Low Bone Density of Female Utilizing Dental Panoramic Radiographs
Sung Jin Kim, In-Ja Song, Eun Joo Lee, Suk-Ja Yoon
The Korean Journal of Oral and Maxillofacial Pathology.2024; 48(3): 23. CrossRef
A Review of Domestic and International Clinical Research Trends on Pharmacopuncture Treatment for Fractures
Hea Sun Chun
Journal of Physiology & Pathology in Korean Medicine.2023; 37(6): 185. CrossRef
Absolute Bed Rest Duration of 3 Days for Osteoporotic Vertebral Fractures: A Retrospective Study
Sung Tan Cho, Seung Joo Kim, Bum Joon Nam, Kun Woo Kim, Gyu Hyeon Lee, Jin Hwan Kim
Asian Spine Journal.2022; 16(6): 898. CrossRef
Estimating the future clinical and economic benefits of improving osteoporosis diagnosis and treatment among women in South Korea: a simulation projection model from 2020 to 2040
Micah Jackson, Kyu Hyun Yang, Matthew Gitlin, Zachary Wessler
Archives of Osteoporosis.2021;[Epub] CrossRef
Healthcare Resource Utilization and Direct Medical Costs for Patients With Osteoporotic Fractures in China
Jing Wu, Yi Qu, Ke Wang, Yu Chen
Value in Health Regional Issues.2019; 18: 106. CrossRef
A meta-analysis of breastfeeding and osteoporotic fracture risk in the females
X. Duan, J. Wang, X. Jiang
Osteoporosis International.2017; 28(2): 495. CrossRef
Economic Burden of Osteoporotic Fracture of the Elderly in South Korea: A National Survey
Jinhyun Kim, Eunhee Lee, Sungjae Kim, Tae Jin Lee
Value in Health Regional Issues.2016; 9: 36. CrossRef
Lifestyle and Genetic Predictors of Stiffness Index in Community-dwelling Elderly Korean Men and Women
Kyung-Ae Park, Yeon-Hwan Park, Min-Hee Suh, Smi Choi-Kwon
Asian Nursing Research.2015; 9(3): 251. CrossRef
The Epidemiology and Importance of Osteoporotic Spinal Compression Fracture in South Korea
Hun-Kyu Shin, Jong-Hyon Park
Journal of Korean Society of Spine Surgery.2015; 22(3): 99. CrossRef
The Socioeconomic Burden of Coronary Heart Disease in Korea
Hoo-Sun Chang, Han-Joong Kim, Chung-Mo Nam, Seung-Ji Lim, Young-Hwa Jang, Sera Kim, Hye-Young Kang
Journal of Preventive Medicine and Public Health.2012; 45(5): 291. CrossRef
Epidemiology and Economic Burden of Osteoporosis in South Korea
Yong-Chan Ha
Journal of the Korean Fracture Society.2011; 24(1): 114. CrossRef
How Much Amount of Socioeconomic Loss Is Caused by Digestive Diseases?
Kyung Sik Park
The Korean Journal of Gastroenterology.2011; 58(6): 297. CrossRef
Study of the Level of Osteoporosis Awareness among Women Dwelling in Urban Area
Miyoung Chung, Kyunghye Hwang, Euysoon Choi
Korean Journal of Women Health Nursing.2009; 15(4): 362. CrossRef

Cost-of-illness Study of Asthma in Korea: Estimated from the Korea National Health Insurance Claims Database.: Choon Seon Park, Hye Young Kang, Il Kwon, Dae Ryong Kang, Hye Young Jung; J Prev Med Public Health. 2006;39(5):397-403.

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Abstract PDF: OBJECTIVES
We estimated the asthma-related health care utilization and costs in Korea from the insurer's and societal perspective. METHODS: We extracted the insurance claims records from the Korea National Health Insurance claims database for determining the health care services provided to patients with asthma in 2003. Patients were defined as having asthma if they had > or =2 medical claims with diagnosis of asthma and they had been prescribed anti-asthma medicines. Annual claims records were aggeregated for each patient to produce patient-specific information on the total utilization and costs. The total asthma-related cost was the sum of the direct healthcare costs, the transportation costs for visits to healthcare providers and the patient's or caregivers' costs for the time spent on hospital or outpatient visits. RESULTS: A total of 699,603people were identified as asthma patients, yielding an asthma prevalence of 1.47%. Each asthma patient had 7.56 outpatient visits, 0.01 ED visits and 0.02 admissions per year to treat asthma.The per-capita insurance-covered costs increased with age, from 128,276 Won for children aged 1 to 14 years to 270,729 Won for those aged 75 or older. The total cost in the nation varied from 121,865 million to 174,949 million Won depending on the perspectives. From a societal perspective, direct healthcare costs accounted for 84.9%, transportation costs for 15.1% and time costs for 9.2% of the total costs. CONCLUSIONS: Hospitalizations and ED visits represented only a small portion of the asthma-related costs. Most of the societal burden was attributed to direct medical expenditures, with outpatient visits and medications emerging as the single largest cost components.; Summary

Estimating the Cost Saving Due to the Effect of Kremezin in Delaying the Initiation of Dialysis Treatments among Patients with Chronic Renal Failure.: Hye Young Kang, Woohyun Cho, Sunmi Lee, Hyung Jong Kim, Ho Yong Lee, Tae Wook Woo; J Prev Med Public Health. 2006;39(2):149-158.

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Abstract PDF: OBJECTIVES
We wanted to evaluate the economic value of a pharmaceutical product, Kremezin, for treating patients with chronic renal failure (CRF) by estimating the amount of cost savings due to its effect for delaying the initiation of dialysis treatments. METHODS: We defined a conventional treatment for CRF accompanied by Kremezin therapy as 'the treatment group' and only conventional treatment as 'the alternative group.' The types of costs included were direct medical and nonmedical costs and costs of productivity loss. The information on the effect of Kremezin was obtained from the results of earlier clinical studies. Cost information was derived from the administrative data for 20 hemodialysis and 20 peritoneal dialysis patients from one tertiary care hospital, and also from the administrative data of 10 hemodialysis patients from one free-standing dialysis center. Per-capita cost savings resulting from Kremezin therapy were separately estimated for the cases with delay for the onset of hemodialysis and the cases with immediate performance of peritoneal dialysis. By computing the weighted average for the cases of hemodialysis and peritoneal dialysis, the expected per-capita cost savings of a patient with CRF was obtained. Using a discount rate of 5%, future cost savings were converted to the present value. RESULTS: The present value of cumulative cost savings per patient with CRF from the societal perspective would be 18,555,000~29,410,000 Won or 72,104,000~112,523,000 Won if Kremezin delays the initiation of dialysis by 1 or 4 years. CONCLUSIONS: The estimated amount of cost savings resulting from treating CRF patients with Kremezin confirms that its effect for delaying the onset of dialysis treatments has a considerable economic value.; Summary

Impacts of Implementing Case Payment System to Medical Aid Hemodialysis Patients on Dialysis Frequencies and Expenditure.: Sunhee Lee, Hanjoong Kim, Seungho Shin, Woohyun Cho, Hye Young Kang; J Prev Med Public Health. 2004;37(3):260-266.

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Abstract PDF: OBJECTIVES
To assess the impacts of implementing case payment system (CPS) to Medical Aid (MA) hemodialysis patients on the frequencies and expenditure of dialysis. METHODS: Fifty-eight clinics and 35 tertiary care hospitals were identified as having a minimum of 10 hemodialysis patients for each of the MA and Medical Insurance (MI) programs, who received hemodialysis from the same dialysis facilities for both periods of July 2001 and July 2002. From these facilities, a total of 2, 167 MA and 2, 928 MI patients were identified as the study subjects. Using electronic claims data, the changes in the total number of monthly treatments and charges for outpatient hemodialysis treatments for each patient after the introduction of the CPS were compared between the MA and MI patients. Multiple regression analyses were performed to examine the independent impact of the CPS on the utilization and expenditure of dialysis treatments among the MA patients. RESULTS: There was a significant decrease in the total charges for the hemodialysis treatments of the MA patients, 3.4% (p< 0.05), whereas a significant increase was observed for the MI patients, 2.5% (p< 0.05). For both the MA and MI patients, the frequency of the monthly hemodialysis treatments were significantly increased, 5.5 (from 12.1 to 12.7) and 7.8% (from 11.6 to 12.5), for the MA and MI patients, respectively. However, a multivariate regression analysis showed no significant difference in the changes in the total number of monthly hemodialysis treatments between the MA and MI patients after implementation of the CPS. Another regression model, regressing on the changes in the monthly claims of dialysis treatments, showed a significant negative coefficient for the MA ( (=-70725, p< 0.05). CONCLUSION: The significant decrease in the total charges for hemodialysis treatments among MA as compared to MI patients suggests that there was a cost reduction in the MA program following the introduction of the CPS.; Summary

Assessing the Factors Influencing Patient Satisfaction after Receiving Laser in situ Keratomileusis (LASIK) .: Woohyun Cho, Hye Young Kang, Ji Yoon Kim, Yoon Chung, Jongho Lee, Jemyung Lee; J Prev Med Public Health. 2004;37(2):111-119.

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Abstract PDF: PURPOSE
To identify those factors influencing the post-operative satisfaction in myopia patients receiving laser in situ keratomileusis (LASIK) METHODS: This study included 288 consecutive patients who received LASIK between July and December 2001 from two eye clinics located in Seoul and Pusan. Factors that were considered to influence post-operative satisfaction included pre-operative baseline characteristics, pre-operative expectation for treatment outcomes, and treatment outcomes. Before undergoing LASIK, study subjects were asked to rate the degree of their expectation for the improvement of visual functions and symptoms after LASIK on a 5-point Likert-type scale: where 1 referred to 'somewhat worse, ' 2 to 'no change, ' 3 to 'somewhat improved, ' 4 to 'improved, ' and 5 to 'very improved.' Self-administered questionnaire was used to evaluate baseline visual functions and symptoms on a 5-point scale before LASIK. At 6 months after LASIK, the evaluation was repeated to measure treatment outcomes in terms of the difference in the score before and after LASIK. Post-operative satisfaction was also measured at 6 months on a 5-point scale. Multiple regression analysis was performed to examine the independent relationship between influencing factors and postoperative satisfaction. RESULTS: A total of 171 patients (59.4%) participated in the 6-month follow-up investigation. The average expectation scores for the improvement in visual functions and symptoms were 3.8 and 3.4, respectively. The average score for the 7 questions assessing satisfaction was 4.0. The results of the regression analysis showed that the post-operative satisfaction increased with improvement in the visual function (beta=0.16, p< 0.05) and symptoms (beta=0.25, p< 0.05), the degree of preoperative refractive error (beta=0.26-0.67, p< 0.05) and in male patients (beta=0.31, p< 0.1). The pre-operative expectation was not a statistically significant factor in explaining postoperative satisfaction in the regression model. CONCLUSION: The finding from this study was that patients with very severe myopia tended to be more satisfied with the treatment than those with mild myopia, which implies that LASIK can be more beneficial to those suffering from a severe visual condition. Patient satisfaction was also significantly affected by the treatment outcomes experienced after LASIK. This suggests that improving the clinical outcome is the most fundamental requirement for the improvement of patient satisfaction.; Summary

Association of Hospital Procedure Volume with Post-Transplant Survival for Allogeneic Bone Marrow Transplantation.: Choon Seon Park, Hee Kyung Moon, Hye Young Kang, Yoo Hong Min, Woo Hyun Cho; J Prev Med Public Health. 2004;37(1):26-36.

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Abstract PDF: OBJECTIVE
To examine the association between hospital procedure volume and treatment outcomes following allogeneic bone marrow transplantation (allo-BMT). METHODS: Out of 1, 050 patients who received allo-BMTs between 1998 and 2000 in 21 Korean hospitals, 752 with first allo-BMT and complete data were included in this study. Study subjects were divided into the following three groups according to cumulative hospital experience of all-BMTs during the study period: low (< 30 cases), medium (30-49) and high (> or =50 cases) volume. Patient outcome was defined as early survival at day 100 and one-year survival. Multiple logistic regression analyses were performed to examine the association between hospital experience and survival at day 100 and one year. RESULTS: When the low volume group was defined as the reference group, the adjusted relative risks (RR) of survival at day 100 for the high volume group were 2.46 (95% CI, 1.13-5.36) for all patients, 2.61 (1.04-6.57) for those with leukemia, and 2.20 (0.47-10.32) for those with aplastic anemia. For one-year survival, adjusted RR for the high volume group were 2.52 (1.40-4.51) for all patients, 1.99 (1.01-3.93) for leukemia, and 6.50 (1.57-26.80) for aplastic anemia. None of the RR for the medium volume group was statistically significant. Patient factors showing significant relationship with survival were donor-recipient relation, human leukocyte antigen matching status, time from diagnosis to transplant, and disease stage. CONCLUSION: The study results suggest that the cumulative experience of hospitals in providing allo-BMT is positively associated with patient survival.; Summary

Factors Associated with the Degree of Quality Improvement Implementation.: Sun Hee Lee, Kui Son Choi, Hye Young Kang, Woo Hyun Cho, Yoo Mi Chae; Korean J Prev Med. 2001;34(4):363-371.

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Abstract PDF: OBJECTIVES
To assess the degree of quality improvement (QI) implementation and to identify its associated factors. METHODS: A mailed questionnaire survey of the QI staffs at hospitals with 400 beds or more was conducted between September 15 and October 30, 2000. Of the 108 hospitals eligible for inclusion in our study, 79 participated, yielding a response rate of 73.1%. After excluding 12 hospitals that did not perform any QI activities, 117 responses from 67 hospitals were used in our analysis. The degree of QI implementation was measured using the Malcolm Baldrige National Quality Award Criteria (MBNQAC). Factors evaluated for association with the degree of QI implementation were cultural, technical, strategic, and structural factors of the hospitals. RESULTS: The average QI implementation score across the 7 dimensions of MBNQAC was 3.34 on a 5-point scale, with the highest score for the area of customer satisfaction (3.88) followed by information and analysis (3.59) and quality management (3.35). The results of regression analysis showed that hospitals with a etter information system (p<0.05) and using scientific and systematic problem solving approach (p<0.01) tended to perform a higher degree of QI implementation. While statistically insignificant, positive associations were observed for the factors of group or developmental culture, the degree of employee empowerment, and the use of prospective strategy. CONCLUSIONS: It appears that the most important factors contributing to active implementation of QI in Korean hospitals were the use of scientific skills in decision making, and having a quality information system to produce precise and valid information.; Summary

Analysis of Socioeconomic Costs of Smoking in Korea.: Han Joong Kim, Tae Kyu Park, Sun Ha Jee, Hye Young Kang, Chung Mo Nam; Korean J Prev Med. 2001;34(3):183-190.

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Abstract PDF: OBJECTIVE
To estimate the annual economic costs attributable to cigarette smoking in Korea. METHODS: The costs were classified as being direct medical and non-medical costs, indirect costs and others. We focused on those costs related that are incurred in the treatment of selected diseases (cardiovascular diseases, respiratory diseases, and cancers), which have been proven to be caused by smoking. In addition to the basic costs of treatment, the additional amount of costs occurred due to smoking was obtained by computing the population attributable risk (PAR%) caused by smoking. To compute the PAR%, relative risks of smoking to the number of outpatient visits, hospitalizations, and the death were estimated using the Cox proportional hazard model, respectively. Our major data source was the 'Korea Medical Insurance Corporation (KMIC) cohort study,' which was composed of a total of 115,682 male and 67,932 female beneficiaries who had complete records of their smoking histories in the year of 1992. RESULTS: The annual costs that could be attributable to smoking were estimated to be in the range of 2,847,500 million Won to 3,959,100 million Won. The maximum estimate of 3,959,100 million Won includes 233,100 million Won for medical costs, 5,100 million Won for transportation costs, 27,600 million Won for care giver's economic costs, 69,100 million Won in productivity loss, 3,435,000 million Won lost because of premature death, 172,100 million Won in costs resulting from passive smoke inhalation and 17,100 million Won for costs that resulted from fires that were caused by careless smoking. CONCLUSION: Our study confirms that the magnitude of the economic burden of smoking to Korean society is substantial. Therefore, this study provides strong evidence that there is a strong need for a national policy of tobacco control in Korea.; Summary

Cost-benefit Analysis of Mandatory Prescription in Korea.: Young Keon Jee, Han Joong Kim, Eun Cheol Park, Hye Young Kang; Korean J Prev Med. 2000;33(4):484-494.

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Abstract PDF: OBJECTIVE
To evaluate the relative benefits and the costs associated with the introduction of the new pharmaceutical provision called 'Mandatory Prescription Syste m' which separates the role of physicians from that of pharmacists with respect to the prescription and dispensation of from the perspective of consumers (i.e., patients). METHODS: The costs of the system were measured by considering both direct and indirect costs. Direct costs included additional payments for ambulatory care and dispensing fees that occurred under the new system. Indirect costs consisted of transportation expenses and costs related to time spent for physician consultation, waiting for the prescriptions to be filled, and extra traveling. Benefits identified in this study were the reduction of drug misuse and overuse, and the overall decrease in drug consumption among the Korean population. Sensitivity analysis was performed for the inclusion of benefits for outpatients of hospitals, price elasticity, and increased fees for established patients. RESULTS: The net benefit was estimated to be about minus 1,862 billion won and the benefit-cost ratio was 0.478. This indicates that the costs of 'Mandatory Prescription' outweigh its benefits, relative to the previous system. The sensitivity analysis results for all the variables considered in this study consistently showed the benefit-cost ratio to be less than 1. CONCLUSION: The results of this study suggest that implementing Mandatory Prescription System in Korea might be inefficient from the consumer's perspective. The results of this study do not coincide with the results of previous studies, presumably because of the differences in study design and in which items of costs and benefits were considered.; Summary

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