Journal of Preventive Medicine and Public Health

Se min Hwang

3 Articles

Prognostic Impact of Charlson Comorbidity Index Obtained from Medical Records and Claims Data on 1-year Mortality and Length of Stay in Gastric Cancer Patients.: Min Ho Kyung, Seok Jun Yoon, Hyeong Sik Ahn, Se min Hwang, Hyun Ju Seo, Kyoung Hoon Kim, Hyeung Keun Park; J Prev Med Public Health. 2009;42(2):117-122.; DOI: https://doi.org/10.3961/jpmph.2009.42.2.117

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OBJECTIVES
We tried to evaluate the agreement of the Charlson comorbidity index values (CCI) obtained from different sources (medical records and National Health Insurance claims data) for gastric cancer patients. We also attempted to assess the prognostic value of these data for predicting 1-year mortality and length of the hospital stay (length of stay). METHODS: Medical records of 284 gastric cancer patients were reviewed, and their National Health Insurance claims data and death certificates were also investigated. To evaluate agreement, the kappa coefficient was tested. Multiple logistic regression analysis and multiple linear regression analysis were performed to evaluate and compare the prognostic power for predicting 1 year mortality and length of stay. RESULTS: The CCI values for each comorbid condition obtained from 2 different data sources appeared to poorly agree (kappa: 0.00-0.59). It was appeared that the CCI values based on both sources were not valid prognostic indicators of 1-year mortality. Only medical record-based CCI was a valid prognostic indicator of length of stay, even after adjustment of covariables (beta = 0.112, 95% CI = [0.017-1.267]). CONCLUSIONS: There was a discrepancy between the data sources with regard to the value of CCI both for the prognostic power and its direction. Therefore, assuming that medical records are the gold standard for the source for CCI measurement, claims data is not an appropriate source for determining the CCI, at least for gastric cancer.

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Comparison of Hospital Standardized Mortality Ratio Using National Hospital Discharge Injury Data
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Journal of the Korea Academia-Industrial cooperation Society.2012; 13(4): 1739. CrossRef
Predictive Ability of Charlson Comorbidity Index on Outcomes From Lung Cancer
Apar Kishor Ganti, Emily Siedlik, Alissa S. Marr, Fausto R. Loberiza, Anne Kessinger
American Journal of Clinical Oncology.2011; 34(6): 593. CrossRef
Comparative Study on Three Algorithms of the ICD-10 Charlson Comorbidity Index with Myocardial Infarction Patients
Kyoung Hoon Kim
Journal of Preventive Medicine and Public Health.2010; 43(1): 42. CrossRef
The Impact of Medicaid Expansion to include population with low income on the preventable hospitalizations
Hyun-Chul Shin, Se-Ra Kim
Korean Journal of Health Policy and Administration.2010; 20(1): 87. CrossRef
Charlson Comorbidity Index as a Predictor of Long-Term Survival after Surgery for Breast Cancer: A Nationwide Retrospective Cohort Study in South Korea
Hye Kyung Woo, Jong Hyock Park, Han Sung Kang, So Young Kim, Sang Il Lee, Hyung Ho Nam
Journal of Breast Cancer.2010; 13(4): 409. CrossRef
A comparison of the Charlson comorbidity index derived from medical records and claims data from patients undergoing lung cancer surgery in Korea: a population-based investigation
Hyun-Ju Seo, Seok-Jun Yoon, Sang-Il Lee, Kun Sei Lee, Young Ho Yun, Eun-Jung Kim, In-Hwan Oh
BMC Health Services Research.2010;[Epub] CrossRef
Health Outcome Prediction Using the Charlson Comorbidity Index In Lung Cancer Patients
Se-Won Kim, Seok-Jun Yoon, Min-Ho Kyung, Young-Ho Yun, Young-Ae Kim, Eun-Jung Kim
Korean Journal of Health Policy and Administration.2009; 19(4): 18. CrossRef
Factors Affecting Health of the Rural Residents
Dong-Koog Son, Kyu-Sik Lee, Jong-Ku Park, Sang-Baek Koh, Ki-Nam Jin, Eun-Woo Nam, Hae-Jong Lee
Korean Journal of Health Policy and Administration.2009; 19(4): 1. CrossRef

Usefulness of Comorbidity Indices in Operative Gastric Cancer Cases.: Se Min Hwang, Seok Jun Yoon, Hyeong Sik Ahn, Hyong Gin An, Sang Hoo Kim, Min Ho Kyeong, Eun Kyoung Lee; J Prev Med Public Health. 2009;42(1):49-58.; DOI: https://doi.org/10.3961/jpmph.2009.42.1.49

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OBJECTIVES
The purpose of the current study was to evaluate the usefulness of the following four comorbidity indices in gastric cancer patients who underwent surgery: Charlson Comorbidity Index (CCI), Cumulative Illness rating scale (CIRS), Index of Co-existent Disease (ICED), and Kaplan-Feinstein Scale (KFS). METHODS: The study subjects were 614 adults who underwent surgery for gastric cancer at K hospital between 2005 and 2007. We examined the test-retest and inter-rater reliability of 4 comorbidity indices for 50 patients. Reliability was evaluated with Spearman rho coefficients for CCI and CIRS, while Kappa values were used for the ICED and KFS indices. Logistic regression was used to determine how these comorbidity indices affected unplanned readmission and death. Multiple regression was used for determining if the comorbidity indices affected length of stay and hospital costs. RESULTS: The test-retest reliability of CCI and CIRS was substantial (Spearman rho=0.746 and 0.775, respectively), while for ICED and KFS was moderate (Kappa=0.476 and 0.504, respectively). The inter-rater reliability of the CCI, CIRS, and ICED was moderate (Spearman rho=0.580 and 0.668, and Kappa=0.433, respectively), but for KFS was fair (Kappa=0.383). According to the results from logistic regression, unplanned readmissions and deaths were not significantly different between the comorbidity index scores. But, according to the results from multiple linear regression, the CIRS group showed a significantly increased length of hospital stay (p<0.01). Additionally, CCI showed a significant association with increased hospital costs (p<0.01). CONCLUSIONS: This study suggests that the CCI index may be useful in the estimation of comorbidities associated with hospital costs, while the CIRS index may be useful where estimatation of comorbiditie associated with the length of hospital stay are concerned.

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The Association between Charlson Comorbidity Index and the Medical Care Cost of Cancer: A Retrospective Study
Seok-Jun Yoon, Eun-Jung Kim, Hyun-Ju Seo, In-Hwan Oh
BioMed Research International.2015; 2015: 1. CrossRef
The Effect of Oral Cola Ingestion for Endoscopic Inspection of Remnant Stomach: Randomized Case Control Study
Ho Kim, Key Hyeon Kim, Ji Won Kim, Yong Jeoung, Yang Jae Yoo, Moon Kyung Joo, Beom Jae Lee, Ji Hoon Kim, Jong Eun Yeon, Jong-Jae Park, Kwan Soo Byun, Young Tae Bak, Sang Woo Lee
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2014; 14(1): 39. CrossRef
Development of Mortality Model of Severity-Adjustment Method of AMI Patients
Ji-Hye Lim, Mun-Hee Nam
Journal of the Korea Academia-Industrial cooperation Society.2012; 13(6): 2672. CrossRef
The Impact of Medicaid Expansion to include population with low income on the preventable hospitalizations
Hyun-Chul Shin, Se-Ra Kim
Korean Journal of Health Policy and Administration.2010; 20(1): 87. CrossRef
Charlson Comorbidity Index as a Predictor of Long-Term Survival after Surgery for Breast Cancer: A Nationwide Retrospective Cohort Study in South Korea
Hye Kyung Woo, Jong Hyock Park, Han Sung Kang, So Young Kim, Sang Il Lee, Hyung Ho Nam
Journal of Breast Cancer.2010; 13(4): 409. CrossRef
Health Outcome Prediction Using the Charlson Comorbidity Index In Lung Cancer Patients
Se-Won Kim, Seok-Jun Yoon, Min-Ho Kyung, Young-Ho Yun, Young-Ae Kim, Eun-Jung Kim
Korean Journal of Health Policy and Administration.2009; 19(4): 18. CrossRef
Factors Affecting Health of the Rural Residents
Dong-Koog Son, Kyu-Sik Lee, Jong-Ku Park, Sang-Baek Koh, Ki-Nam Jin, Eun-Woo Nam, Hae-Jong Lee
Korean Journal of Health Policy and Administration.2009; 19(4): 1. CrossRef

The Effect of the Cost Exemption Policy for Hospitalized Children under 6 Years Old on the Medical Utilization in Korea.: Kyeong Su Jeon, Seok Jun Yoon, Hyeong Sik Ahn, Hyun Woong Shin, Young Hye Yoon, Se Min Hwang, Min Ho Kyung; J Prev Med Public Health. 2008;41(5):295-299.; DOI: https://doi.org/10.3961/jpmph.2008.41.5.295

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Abstract PDF

OBJECTIVES
The Korean government in January 2006 instigated an exemption policy for hospitalized children under the age of six years old. This study examines how this policy affected the utilization of medical care in Korea. METHODS: A total of 1,513,797 claim records from the Health Insurance Review Agency were analyzed by complete enumeration methods. The changes of medical utilization were compared from 2005 to 2006. In addition, the changes of medical utilization between 2004 and 2005 were compared as a pseudocontrol group. RESULTS: The admission rate increased 1.14-fold from 15.20% in 2004 to 17.32% in 2005, and this further increased 1.08-fold to 18.65% in 2006. The increase of patients with a common cold (1.2-fold) was higher than that of both the general patients (1.08-fold) and the patients with the top 10 fatal diseases (0.91-fold). The average length of stay per case for clinics showed the highest increase rates (1.06-fold). The rates of patients with the common cold showed a higher increase (1.05-fold) than that of the general patients. The average medical expense per case was increased by 1.10-fold from 2005 to 2006, which was higher than that from 2004 to 2005 (1.04-fold). The increase rate for patients with the common cold was higher at 1.18-fold than that of the general patients. CONCLUSIONS: The cost exemption policy has especially led to an increase in the utilization of clinics and the utilization by patients with a common cold.

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