- 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.
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Min Ho Kyung, Seok Jun Yoon, Hyeong Sik Ahn, Se min Hwang, Hyun Ju Seo, Kyoung Hoon Kim, Hyeung Keun Park
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J Prev Med Public Health. 2009;42(2):117-122.
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DOI: https://doi.org/10.3961/jpmph.2009.42.2.117
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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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Citations
Citations to this article as recorded by  - Factors Associated with Hospital Length of Stay among Women’s Cancer Patients: Based on the In-depth Injury Patient Surveillance System Data
Yoonjung Kang, Hyewon Lee
Journal of Health Informatics and Statistics.2022; 47(2): 148. CrossRef - The impact of global budgeting in Taiwan on inpatients with unexplained fever
Keh-Sen Liu, Tsung-Fu Yu, Hsing-Ju Wu, Chun-Yi Lin
Medicine.2019; 98(37): e17131. CrossRef - What happened to health service utilization, health care expenditures, and quality of care in patients with acute pancreatitis after implementation of global budgeting in Taiwan?
Ya-Lin Ko, Jyun-Wei Wang, Hui-Mei Hsu, Chia-Hung Kao, Chun-Yi Lin
Medicine.2018; 97(41): e12620. CrossRef - The impact of global budgeting on health service utilization, health care expenditures, and quality of care among patients with pneumonia in Taiwan
C.-Y. Lin, T. Ma, C.-C. Lin, C.-H. Kao
European Journal of Clinical Microbiology & Infectious Diseases.2016; 35(2): 219. CrossRef - Comparison of Hospital Standardized Mortality Ratio Using National Hospital Discharge Injury Data
Jong-Ho Park, Yoo-Mi Kim, Sung-Soo Kim, Won-Joong Kim, Sung-Hong Kang
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.
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Se Min Hwang, Seok Jun Yoon, Hyeong Sik Ahn, Hyong Gin An, Sang Hoo Kim, Min Ho Kyeong, Eun Kyoung Lee
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J Prev Med Public Health. 2009;42(1):49-58.
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DOI: https://doi.org/10.3961/jpmph.2009.42.1.49
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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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Citations
Citations to this article as recorded by - Impact of comorbidity assessment methods to predict non-cancer mortality risk in cancer patients: a retrospective observational study using the National Health Insurance Service claims-based data in Korea
Sanghee Lee, Yoon Jung Chang, Hyunsoon Cho
BMC Medical Research Methodology.2021;[Epub] CrossRef - 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.
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Kyeong Su Jeon, Seok Jun Yoon, Hyeong Sik Ahn, Hyun Woong Shin, Young Hye Yoon, Se Min Hwang, Min Ho Kyung
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J Prev Med Public Health. 2008;41(5):295-299.
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DOI: https://doi.org/10.3961/jpmph.2008.41.5.295
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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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Citations
Citations to this article as recorded by - Impact of Coinsurance Reduction Policy on Healthcare Utilization Among Children Under 15
Minah Park, Eun-Cheol Park, Hongin Noh, Sung-In Jang
Journal of Korean Medical Science.2023;[Epub] CrossRef - Incidence and prevalence of immune thrombocytopenia under the copayment waiver policy for pediatric patients in Korea: Data from the National Health Claims Database
Sung-Hoon Park, Sang Gyu Kwak, Ji Yoon Kim
Lupus.2021; 30(4): 655. CrossRef - Medical cost trends under national health insurance benefit extension in Republic of Korea
Jinha An, Sukil Kim
The International Journal of Health Planning and Management.2020; 35(6): 1351. CrossRef - Effects of a Dementia Screening Program on Healthcare Utilization in South Korea: A Difference-In-Difference Analysis
Su Jung Lee, Hyun-Ju Seo, Dong Young Lee, So-Hyun Moon
International Journal of Environmental Research and Public Health.2019; 16(20): 3837. CrossRef - Effect of Socioeconomic Status on Healthcare Utilization in Patients with Rare and Incurable Diseases
Jun Im, Myeong-Hui Kim, Jeong-Su Im, Dae-Gyu O
Korean Journal of Health Policy and Administration.2009; 19(4): 66. CrossRef
- Job Satisfaction, Subjective Class Identification and Associated Factors of Professional Socialization in Korean Physicians.
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Hyung Gon Yoon, Seok Jun Yoon, In Kyoung Hwang, Yeong Bae Mun, Hee Young Lee
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J Prev Med Public Health. 2008;41(1):30-38.
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DOI: https://doi.org/10.3961/jpmph.2008.41.1.30
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4,591
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The aim of this study was to determine the relationship between the core properties of professional socialization and social status satisfaction, economic reward satisfaction, and subjective class identification. METHODS: Medical knowledge and skill, autonomy, and professional value factors were used as essential properties of professional socialization to determine the association with job satisfaction and subjective class identification. The authors used a self-administered questionnaire survey and collected nationwide data between July and August 2003, with 211 responses used for final analysis. RESULTS: 'Age' and 'trust and respect' were positively associated with social status satisfaction, and 'occupation' was negatively associated. 'Income' and 'trust and respect' were positively related to economic reward satisfaction, and 'practicing for oneself', and 'a sense of duty and attendance' were negatively related. 'Practicing for oneself', 'not believing explanations', and 'a sense of duty and attendance' had a positive relationship with subjective class identification. 'Income', 'knowledge system', 'medical mistakes', 'treating like goods', 'meaning and joy', and 'trust and respect' had a negative relationship. CONCLSIONS: The core property variables of professional socialization had a different relationship with social status satisfaction, economic reward satisfaction and subjective class identification. In particular, many core property variables were associated with subjective class identification positively or negatively. The development of professional socialization would help promote job satisfaction and subjective class identification.
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Citations
Citations to this article as recorded by - The Gap Between Physicians and the Public in Satisfaction with the National Health Insurance System in Korea
Kye-Hyun Kim, Eun-Cheol Park, Myung-Il Hahm
Journal of Korean Medical Science.2012; 27(6): 579. CrossRef - Qualitative Research on Experience of Primary Physicians Operating Their Primary Health Care Centers
Daegeun Lee, Myung Sun Yi, Eun Young Park, Sung Hee Jo, Sang Min Park
Korean Journal of Family Medicine.2010; 31(4): 275. CrossRef
- Estimating the Burden of Psychiatric Disorder in Korea.
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Jae Hyun Park, Seok Jun Yoon, Hee Young Lee, Hee Sook Cho, Jin Yong Lee, Sang Jun Eun, Jong Hyock Park, Yoon Kim, Yong Ik Kim, Young Soo Shin
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J Prev Med Public Health. 2006;39(1):39-45.
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This study estimated the burden of disease especially caused by psychiatric disorders in Korea by using DALY, a composite indicator that was recently developed by the Global Burden of Disease study group. METHODS: First, 11 of the major psychiatric disorders in Korea were selected based on the ICD-10. Second, the burden of disease due to premature death was estimated by using YLLs (years of life lost due to premature death). Third, for the calculation of the YLD (years lived with disability), the following parameters were estimated in the formula: the incidence rate, the prevalence rate and the disability weight of each psychiatric disorder. Last, we estimated the DALY of the psychiatric disorders by adding the YLLs and YLDs. RESULTS: The burden of psychiatric disorder per 100,000 people was attributed mainly to unipolar major depression (1,278 person-years), schizophrenia (638 person-years) and alcohol use disorder (287 person-years). For males, schizophrenia (596 person-years) and alcohol use disorder (491 person-years) caused the highest burden. For females, unipolar major depression (1,749 person-years) and schizophrenia (680 person-years) cause the highest burden. As analyzed by gender and age group, alcohol use disorder causes a higher burden than schizophrenia in men aged 40 years and older. For females, unipolar major depression causes the highest burden in all age groups. CONCLUSIONS: We found that each of the psychiatric disorders that cause the highest burden is different according to gender and age group. This study's results can provide a rational basis to plan a national health policy regarding the burden of disease caused by psychiatric disorders.
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- Estimating the Burden of Diseases due to High Alcohol Consumption in Korea.
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Jung Kyu Lee, Yong Ik Kim, Seok Jun Yoon, Jin Yong Lee, Heeyoung Lee, Jong Hyock Park, Youngsoo Shin
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J Prev Med Public Health. 2005;38(2):175-181.
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This study estimated the burden of disease due to high alcohol consumption using DALY, a composite indicator recently developed by the Global Burden of Disease study group. The results were analyzed by age and sex. METHODS: Firstly, high alcohol consumption-related diseases, and their relative risk (RR), were selected. Secondly, population attributable fractions (PAFs) were computed using formulae, including the relative risk (RR) and prevalence of exposure (Pe). Thirdly, the DALYs of high alcohol consumption-related diseases were estimated. Lastly, the attributable burdens of diseases due to high alcohol consumption wereconcluded as being the sum of the products that multiplied the DALYs of high alcohol consumption-related diseases by their population attributable fraction (PAF). RESULTS: The burden of high alcohol consumption in Korea was 2992.3 person years (PYs) per 100, 000 persons in men, and 1426.6 in women. For men, the high alcohol consumption-induced diseases with the five biggest burdens were liver cirrhosis, hypertensive disease, liver cancer, cerebral infarction and intracerebral hemorrhage. For women, these were cerebral infarction, intracerebral hemorrhage, hypertensive disease, liver cirrhosis and liver cancer. CONCLUSION: This study highlighted the attributable fraction of diseases due to exposure to high alcohol consumption, by quantifying the results of exposure to risk factors. Therefore, it is now possible to assess interventions for risk factors in quantifiable terms in each population. Finally, measuring the risk factor burdens was expected to contribute to priority setting and effective resource allocation in public health policy.
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- Disability Weights for the Korean Burden of Disease Study: Focused on Comparison with Disability Weights in the Australian Burden of Disease Study.
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Young Kyung Do, Seok Jun Yoon, Jung Kyu Lee, Young Hoon Kwon, Sang Il Lee, Changyup Kim, Kidong Park, Yong Ik Kim, Youngsoo Shin
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J Prev Med Public Health. 2004;37(1):59-71.
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This study aimed to measure the disability weights for the Korean Burden of Disease study, and to compare them with those adopted in the Australian study to examine the validity and describe the distinctive features. METHODS: The standardized valuation protocol was developed from the Global Burden of Disease (GBD) study and the Dutch Disability Weights study. Disability weights were measured for 123 diseases of the Korean version of Disease Classification by three panels of 10 medical doctors each. Then, overall distribution, correlation coefficients, difference by each disease, and mean of differences by disease group were analyzed for comparison of disability weights between the Korean and Australian studies. RESULTS: Korean disability weights ranged from 0.037 to 0.927. While the rank correlation coefficient was moderate to high (rs=0.68), Korean disability weights were higher than the corresponding Australian ones in 79.7% of the 118 diseases. Of these, war, leprosy, and most injuries showed the biggest differences. On the contrary, many infectious and parasitic diseases comprised the greater part of diseases of which Korean disability weights were lower. The mean of the differences was the highest in injuries of GBD disease groups, and in cardiovascular disease, injuries, and malignant neoplasm of the Korean disease category. CONCLUSION: Korean disability weights were found to be valid on the basis of overall distribution pattern and correlation, and are expected to be used as basic data for broadening the scope of burden of disease study. However, some distinctive features still remain to be explored in following studies.
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- A Survey on Prenatal Environmental Risk Factors for Mothers of Low Birth Weight Infants in Asan-City.
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Heeyoung Lee, Seok Jun Yoon, Hyungsik Ahn, Mina Ha, Kyung Sim Koh, Kyung Ja June
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J Prev Med Public Health. 2004;37(1):11-16.
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In this study, we aimed to produce basic data on the prenatal environmental risk factors of low birth weight infants at a community level. METHODS: In 2000, we conducted the direct interview using questionnaire about prenatal environmental risk factors with low birth weight infant-delivered mothers and normal weight infant-delivered mothers in Asan-city, Chungcheongnamdo Province, Korea. The questions given to the mothers included past pregnancy history, menstrual status, disease history before and during the pregnancy, family history, environmental risk factors and exposure history. The responses of the two groups were compared to calculate the prenatal environmental risk factors of each group. RESULTS: Mothers' smoking was significantly associated with low birth weight infants (adjusted odds ratio (AOR) 3.27; 95% confidence interval (CI) 1.25-8.56) and preterm baby (AOR 4.20; 95% CI, 1.21-14.61). Other environmental risk factors were not significantly different between the two groups. CONCLUSION: Smoking of mothers can be a risk factor for the delivery of low birth weight infants. These results could provide the basic data on prenatal environmental risk factors of mothers of low birth weight infants and suggest research topics for further community-based evaluation.
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- Disability Weights for Diseases in Korea.
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Jung Kyu Lee, Seok Jun Yoon, Young Kyung Do, Young Hoon Kwon, Chang Yup Kim, Kidong Park, Yong Ik Kim, Young Soo Shin
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Korean J Prev Med. 2003;36(2):163-170.
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This study aimed to develop an evaluation protocol of disability weights using person trade-off, and to test the reliability of the developed protocol in a Korean context. METHODS: To develop the valuation protocol, the Global Burden of Disease (GBD) and the Dutch studies were replicated and modified. Sixteen indicator conditions were selected from the Korean version of disease classification, which was based on that of the GBD Study, and the person trade-off method referred to the Dutch method. RESULTS: The disability weights were valued in a two step panel study. The first step was a carefully designed group process by three panels, using person trade-off to establish the disability weights for sixteen selected indicator conditions. The second step consisted of interpolation of the remaining diseases, on a disability scale, by the individual members of three panels. The members of three panels were all medical doctors, with sufficient knowledge of the consequences of a broad variety of diseases. The internal consistency of the Korean disability weights was satisfactory. Considerable agreement existed within each panel and among the panels. CONCLUSIONS: It was feasible to use a modified evaluation protocol from those used in GBD and Dutch studies. This would provide a rational basis for an international comparative study of disability weights.
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- Study of Disability-Adjusted Life Expectancy(DALE) Using National Health Interview Survey in Korea.
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Young Hoon Kwon, Jung Kyu Lee, Young Kyung Do, Seok Jun Yoon, Chang Yup Kim, Yong Ik Kim, Young Soo Shin
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Korean J Prev Med. 2002;35(4):331-339.
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To measure DALE (Disability-Adjusted Life Expectancy) in Korea to find out how long Koreans live in a state of full heath. METHODS: DALE was calculated using the life table of 1999 and the disability prevalence from the National Health Interview Survey (NHIS), which was conducted with a sample of 13,523 households in 1998. The disability prevalence was measured using the annual prevalence of the long-term limitation of activities, which were divided into classes 1, 2, 3, 4, 5 and 6 according to the severity of the limitation. The disability weights were measured for each 6 class by conducting a survey of 16 healthcare professionals. The severity-adjusted disability prevalence was calculated by multiplying the disability prevalence of each class by the disability weights respectively. Healthy life years lost due to disability was calculated by multiplying the life expectancy by the severity-adjusted disability prevalence. Finally DALE was measured as the life expectancy minus healthy life years lost due to disability. RESUJLTS: DALE for 1999, which refers to the expectation of equivalent years of good health, were 72.5, 69.5 and 75.3 years, for total, for males and for females, respectively. The percentages for DALE out of the life expectancy were 95.8, 96.6 and 94.4% for total, for males and for females, respectively. CONCLUSIONS: DALE is a newly developed indicator, which could effectively show the healthy life expectancy of populations. A greater notice and use of DALE would be expected as life expectancies increase and the quality of life changes in Korea.
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- Quantifying the Burden of Cardiovascular Disease Attributable to Total Suspended Particulate and Sulfur Dioxide Using Years Lived with Disability.
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Seok Jun Yoon, Beom Man Ha, Jong Won Kang, Ho Jang Kwon
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Korean J Prev Med. 2002;35(2):92-98.
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To estimate the burden of cardiovascular disease attributable to the total suspended particulates (TSP) and sulfur dioxide (SO2) in Korea using the YLD (years lived with disability) measurement. METHODS: Congestive heart failure(CHF) and myocardial infarction (MI) were chosen as the main cardiovascular diseases whose causes are attributable to the TSP and SO2 levels. In order to calculate the YLD (years lived with a disability), the following parameters in the formula were estimated. : the incidence rate, the case fatality rate, The expected duration of a disability and the average age of onset were estimated. The expected duration of a disability and the average age of onset were calculated using the DISMOD method, as developed by the GBD researchers. The burden of cardiovascular disease due to TSP and SO2 was estimated using the number of years that the patient lived with a disability. RESULTS: The YLD of the CHF due to the TSP and SO2 was attributed to the TSP (94.4 person-year) and SO2 levels (35.0 person-year). The YLD of the MI due to the TSP and SO2 was attributed to the TSP (148.4 person-year) and SO2 levels(27.6 person-year). CONCLUSION: The YLD method employed in this study was appropriate for quantifying the burden of cardiovascular disease. Therefore, it would provide a rational basis for planning a national health policy regarding the disease burden of the risk factors in Korea.
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- Measuring the Burden of Major Cancers in Korea Using Healthy Life-Year (HeaLY).
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Yong Jun Choi, Seok Jun Yoon, Chang Yup Kim, Youngsoo Shin
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Korean J Prev Med. 2001;34(4):372-378.
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This study introduced the healthy life-year(HeaLY), a composite indicator of disease burden, and used it to estimate the burden of major cancers in Korea. METHODS: We collected data from the national death certificate database, the national health insurance claims database and the abridged life table. This data was used to create a spreadsheet and estimate the burden of major cancers by sex in terms of HeaLYs. RESULTS: The burden of 10 major cancers for males was 2,248.97 person-year in terms of HeaLYs. Stomach cancer, liver cancer, and lung cancer were responsible for 75.2% of the burden of 10 major cancers The disease burden of 10 major cancers for females was estimated to be 1,567.58 person-years. About two thirds of HeaLYs lost were from stomach cancer, liver cancer, lung cancer, colorectal cancer, and breast cancer. The rankings among 10 major cancers were somewhat different in terms of both HeaLYs and deaths as the HeaLY method considers both mortality and morbidity. CONCLUSIONS: Despite the limitations of the data sources, we conclude that HeaLY can aid in setting policy priorities concerning major cancers by estimating the disease burden of these cancers. Time-series analysis of the disease burden using HeaLY and DALY will elucidate the strengths and weaknesses of both methods.
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- Estimation of Attributable Burden due to Premature Death from Smoking in Korea.
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Seok Jun Yoon, Beom Man Ha, Jong Won Kang, Hye Chung Chang
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Korean J Prev Med. 2001;34(3):191-199.
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In this study, we focused on estimating the burden of premature death in Korea caused by smoking using the YLL (years of life lost due to premature death) measurement. METHODS: First, we determined parameters: such as age-specific standard life expectancy, age on death, sex, and cause of death by analyzing the national death certificate data and life table collected during 1997. These were provided by the National Statistical Office. Secondly, we estimated the age group- specific years of life lost due to premature death by employing the standard expected years of life lost (SEYLL) measurement. Thirdly, the burden of premature death caused by smoking was estimated using the YLLs measurement which was developed by the global burden of disease study group. Fourthly, We calculated the risk related to smoking using the population attributable risk. RESULTS: The following results were obtained in this study:1) Premature death that is attributable to smoking in males could be prevented in 60.9% (513,582 person-year) by non-smoking.2) The burden of premature death by smoking for female was prevented to 17.7% (513,582 person-year) by non-smoking. CONCLUSION: We found that the YLL method employed in this study was appropriate in quantifying the burden of premature death. This provides a rational basis for planning a national health policy regarding premature deaths caused by smoking and other related risk factors.
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- Estimating the Disability Weight of Major Cancers in Korea Using Delphi Method.
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Seok Jun Yoon, Young Dae Kwon, Byoung Yik Kim
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Korean J Prev Med. 2000;33(4):409-414.
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To estimate the weighting for the disability caused by major cancers in Korea using the Delphi method. METHODS: We selected 19 panelists to estimate the disability weighting of major cancers in Korea by using the Delphi method. To select the relevant kinds of cancers, we used National Death Certificate Data produced by the National Statistical Office in 1996. Then the stability of each delphi round was calculated by using the coefficient of variance. RESULTS: The disability weight of major cancers for males was pancreas cancer(0.36), liver cancer(0.35), esophageal cancer(0.30), stomach cancer(0.27), lung cancer(0.26), and colorectal cancer(0.30). The disability weight of major cancers for females was pancreas cancer(0.36), liver cancer(0.34), esophageal cancer(0.29), stomach cancer(0.28), lung cancer(0.26), and colorectal cancer(0.28). CONCLUSION: The results of this study will provide baseline data useful for the measurement of the burden of disease caused by cancers in Korea.
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- Measuring the Burden of Major Cancers due to Premature Death in Korea.
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Seok Jun Yoon, Yong Ik Kim, Chang Yup Kim, Hyejung Chang
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Korean J Prev Med. 2000;33(2):231-238.
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To estimate the burden of diseases in Korea especially caused by major cancers using the YLL(years of life lost due to premature death) measurement. METHODS: First, we determined the parameters: such as age-specific standard life expectancy, age on death, sex, cause of death by analyzing the national death certificate data and life table collected during 1996 provided by the National Statistical Office. Secondly, we estimated the age group-specific YLL by employing standard expected years of life lost(SEYLL). Thirdly, final burden of disease due to premature death was estimated by using YLLs measurement which developed by global burden of disease study group. RESULTS: The burden of premature death by cancer for male was attributed mainly to liver cancer(514.5 person-year), stomach cancer(436.4 person-year), and lung cancer(367.7 person-year). Each of these cancers was responsible for the loss of over 100 person-year based on our YLL measurement. The burden of premature death by cancer for female was attributed mainly to liver cancer(135.1 person-year), stomach cancer(252.1 person-year), and lung cancer(121.8 person-year). Each of these cancers was responsible for the loss of over 100 person year based on our YLL measurement. CONCLUSION: We found the YLL method employed in this study was appropriate to quantify the burden of premature death. Thereby, it would provide a rational bases to plan a national health policy regarding premature death caused by cancer.
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Summary
- An Application of Delphi Method to the Assessment of Current Status of Cancer Research.
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Young Ho Khang, Seok Jun Yoon, Gil Won Kang, Chang Yup Kim, Keun Young Yoo, Young Soo Shin
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Korean J Prev Med. 1998;31(4):844-856.
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Abstract
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- Globally, cancer research has been considered one of the most important field of biomedical researches. Recently, in Korea, there are increasing concerns about cancer research and the development of national cancer control programme. For the efficient investment in cancer research at the national level, strategic approach is needed based on the nationwide information about current status of research. However even the basic data on cancer research have not been systematically collected, and are not available when necessary. The aim of this study is to assess current status of cancer research. For this purpose, this study applied two round Delphi method in which fifteen experts in cancer research fields participated. They rated each items on the initial list at the first round, and modified their responses at the second round. Panels responded that pathogenesis of cancer, research and development of cancer drug, and oncogene, etc. are the most urgent and important research fields. They assessed national level of cancer research as being 49.6% of the world highest level. Coefficient of variation tended to be lowered with the iteration. Predictive stability was evaluated to be lower in items of urgency than in items of importance and research level. Although this study shares the same limitations in the selection of the experts with many other Delphi studies, it provides a primary data that would be required to plan the national strategy of the cancer research.
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Summary
- Medical Care Utilization of Tuberculosis Patients in Private Sector.
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Gil Won Kang, Seok Jun Yoon, Chang Yup Kim, Young Soo Shin
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Korean J Prev Med. 1998;31(4):814-827.
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Abstract
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- In this study we analyzed the insurance claims data to investigate the medical care utilization pattern of tuberculosis patients in private sector. We selected the claims of principal or secondary diagnosis with tuberculosis from claims database of National Federation of Medical Insurance, from December 1995 to November 1996. Both spell-based analysis and person-based analysis were carried out. In spell-based analysis, type and location of treatment facilities, distribution of diagnoses, number of outpatient/inpatient treatments were analyzed. Additionally in person-based analysis, number of tuberculosis patients, demographic characteristics, number of treatments per person, frequency and pattern of change in source of care were analyzed. The results were as follows 1. The number of treatments with tuberculosis was 863,641 from 1 December 1995 to 30 November 1996. The number of patients was 313.964. 2. Most of tuberculosis patients in private sector were treated in general hospital(45.8%) and clinics(42.2%) 3. About 77.7% of tuberculosis patients who were treated more than two times did not change the source of carey. 18,9% of tuberculosis patients changed source of care only once. Even when we limited tuberculosis patient to those who were treated more than five times and whose treatment period were longer than six months, 94.7% of patients did not change source of care at all, or changed treatment facility only once. 4. The probability of change in source of care was higher in pulmonary tuberculosis, in twenties, and in rural area respectively than other tuberculosis. In conclusion, healer shopping of tuberculosis patients was not serious as expected. However special attention is needed to pulmonary tuberculosis in twenties and rural area
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Summary
- Burden of disease of major cancers assessment using years of lives with disability in Korea.
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Seok Jun Yoon, Hye Jung Chang, Young Soo Shin
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Korean J Prev Med. 1998;31(4):801-813.
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Abstract
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- This study was carried out for the burden of disease of major cancers assessment using years of lives with disability in Korea. With the years of lives with disability, this indicator was applied in order to estimate burden of major cancer disease. For this work, We also estimated incidence rate, remission rate, case fatality rate, average age of onset, expected duration with disability in each cancer disease. As sources of information, national health insurance data and national mortality registration data were analyzed. The results of the study are as follows; The top five causes of the burden of major cancer disease are evaluated as stomach cancer, liver cancer, colon and rectum cancer , esophageal cancer, lung cancer in male. The top five causes of the burden of major cancer disease are evaluated as stomach cancer, esophageal cancer, liver cancer, uterine cervix cancer ovarian cancer in female. The process of evaluating the burden disease of major cancers in Korea has not finished with this paper. This study should be seen as the first in a series in Korea. It is necessary to analyse with more accuracy the assumptions behind the methodology.
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Summary
- Adoption and Its Determining Factors of Computerized Tomography in Korea.
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Seok Jun Yoon, Sun Mean Kim, Chul Hwan Kang, Chang Yup Kim, Young Soo Shin
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Korean J Prev Med. 1997;30(1):195-207.
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Abstract
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- High price equipment is one of the major factors that increases national health expenditure in developed countries. Computerized Tomography(CT), one of the important high price equipment, has been concerns of health service researchers and policy makers in many countries. In Korea, CT, first introduced in 1984, have spreaded nationwide with rapid speed. Though the Committee for Approving Import of High Price Medical Equipment, founded in 1981, tried to regulate the introduction of high price medical equipment including CT, the effort resulted in failure. The exact situation of diffusion of the high price equipment, however, was not yet investigated. We aimed at the description of the diffusion of CT in Korea and analysis of influencing factors in hospitals for the adoption of CT. We mainly used the database of CT, made in 1996 by the National Federation of Medical Insurance for the purpose of insurance payment for CT. Also characteristics of hospitals were gathered from yearbooks published by the central and local governments and by the Korean Hospital Association. We calculated the cumulative number of the CT per one million population year by year. In turn, multiple linear logistic regression was done to fine out the contributing factors for the adoption of CT by each hospital. In the logistic regression model, it is regarded as dependent factor whether a hospital retained CT or not in 1988 and 1993. The major categories of the independent factors were hospital characteristics, environmental factors and competitive conditions of hospitals at the period of the adoption. The results are as follows : Numberof CT scanners per one million persons in Korea marked more higher level compared with those of most OECD countries. Major influencing factors on the adoption of CT scanners were hospital characteristics, such as hospital referral level, and competitive condition of hospitals, such as number of CT scanners per 10,000 persons in each district where the hospital was located. In Korea, CT diffused with rather rapid speed, comparable with those of the United States and Japan. The major factors contributing on the adoption of CT for hospitals were competitive condition and hospital characteristics rather than regional health care need for Ct. In conclusion, a kind of regulating mechanism would be necessary for the prevention of the indiscreet adoption and inefficient use of high price equipment including CT.
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