Journal of Preventive Medicine and Public Health

Youngs Chang

3 Articles

The Impact of COVID-19 on Admissions and In-hospital Mortality of Patients With Stroke in Korea: An Interrupted Time Series Analysis: Youngs Chang, Soo-Hee Hwang, Haibin Bai, Seowoo Park, Eunbyul Cho, Dohoung Kim, Hyejin Lee, Jin Yong Lee; J Prev Med Public Health. 2025;58(1):60-71. Published online October 28, 2024; DOI: https://doi.org/10.3961/jpmph.24.432

1,342 View
219 Download
1 Web of Science
1 Crossref

Abstract Summary PDF Supplementary Material

Objectives
This study aimed to investigate the impact of coronavirus disease 2019 (COVID-19) on admission rates and in-hospital mortality among patients with ischemic and hemorrhagic stroke.
Methods
We constructed a dataset detailing the monthly hospitalizations and mortality rates of inpatients with stroke from January 2017 to December 2021. Employing an interrupted time series analysis, we explored the impact of COVID-19 on hospitalizations and 30-day in-hospital mortality among stroke patients.
Results
The number of ischemic stroke admissions decreased by 18.5%, from 5335 to 4348, immediately following the COVID-19 outbreak (p<0.001). The in-hospital mortality rate for ischemic stroke increased slightly from 3.3% to 3.4% immediately after the outbreak, although it showed a decreasing trend over time. The number of hemorrhagic stroke admissions fell by 7.5%, from 2014 to 1864, immediately following the COVID-19 outbreak. The 30-day in-hospital mortality rate for hemorrhagic stroke initially decreased from 12.9% to 12.7%, but subsequently showed an increasing trend.
Conclusions
We confirmed that COVID-19 impacted both the admission and death rates of stroke patients. The admission rate for both ischemic and hemorrhagic strokes decreased, while in-hospital mortality increased. Specifically, in-hospital mortality from ischemic stroke rose initially after the outbreak before stabilizing. Additionally, our findings indicate variable effects based on sex, age, and socioeconomic status, suggesting that certain groups may be more susceptible. This underscores the need to identify and support vulnerable populations to mitigate adverse health outcomes.

Summary

Korean summary
국민건강보험공단 데이터베이스를 자료원으로 하고 ITS 분석을 실시하여 코로나19가 뇌졸중 환자의 입원 및 30일 내 사망률에 미치는 영향을 조사했습니다. 그 결과 코로나19가 뇌졸중 환자의 입원율과 사망률에 모두 영향을 미친다는 사실을 확인했습니다. 특히, 75세 이상과 의료급여 수급자의 허혈성 및 출혈성 뇌졸중 입원율이 감소한 것으로 나타났습니다.

Key Message
Employing an interrupted time series analysis, we explored the impact of COVID-19 on hospitalizations and 30-day in-hospital mortality among stroke patients using the National Health Insurance Service Database. We confirmed that COVID-19 impacted both the admission and death rates of stroke patients. Specifically, ischemic and hemorrhagic stroke admission rates decreased among individuals over 75 and MA beneficiaries.

Citations

Citations to this article as recorded by

Who Dies Alone? Demographics, Underlying Diseases, and Healthcare Utilization Patterns of Lonely Death Individuals in Korea
Haibin Bai, Jae-ryun Lee, Min Jung Kang, Young-Ho Jun, Hye Yeon Koo, Jieun Yun, Jee Hoon Sohn, Jin Yong Lee, Hyejin Lee
Journal of Preventive Medicine and Public Health.2025; 58(2): 218. CrossRef

Cancer Patients’ Utilization of Tertiary Hospitals in Seoul Before and After the Benefit Expansion Policy: Sanghyun Cho, Youngs Chang, Yoon Kim; J Prev Med Public Health. 2019;52(1):41-50. Published online January 4, 2019; DOI: https://doi.org/10.3961/jpmph.18.166

7,501 View
153 Download
13 Crossref

Abstract Summary PDF Supplementary Material

Objectives
The aim of this study was to investigate cancer patients’ utilization of tertiary hospitals in Seoul before and after the benefit expansion policy implemented in 2013.
Methods
This was a before-and-after study using claims data of the Korean National Health Insurance Service from 2011 to 2016. The unit of analysis was inpatient episodes, and inpatient episodes involving a malignant neoplasm (International Classification of Diseases, Tenth Revision codes: C00-C97) were included in this study. The total sample (n=5 565 076) was divided into incident cases and prevalent cases according to medical use due to cancer in prior years. The tertiary hospitals in Seoul were divided into two groups (the five largest hospitals and the other tertiary hospitals in Seoul).
Results
The proportions of the incident and prevalent episodes occurring in tertiary hospitals in Seoul were 34.9% and 37.2%, respectively, of which more than 70% occurred in the five largest hospitals in Seoul. Utilization of tertiary hospitals in Seoul was higher for inpatient episodes involving cancer surgery, patients with a higher income, patients living in areas close to Seoul, and patients living in areas without a metropolitan city. The utilization of the five largest hospitals increased by 2 percentage points after the policy went into effect.
Conclusions
The utilization of tertiary hospitals in Seoul was concentrated among the five largest hospitals. Future research is necessary to identify the consequences of this utilization pattern.

Summary

Korean summary
2014년부터 2016년까지 암 발생자 입원의 34.9%가 서울 소재 상급종합병원에서 이루어졌으며, 그중 73.9%가 5대 상급종합병원에서 이루어졌다. 4대 중증질환 보장성 강화 정책 후에 암환자의 서울 소재 상급종합병원 이용은 6.1%(2% 포인트) 증가하였으며, 5대 상급종합병원 이용률은 증가(정책 전: 23.6%, 정책 후: 25.8%), 그 외 서울 소재 상급종합병원 이용률은 감소하였다(정책 전: 9.3%, 정책 후: 9.1%).

Citations

Citations to this article as recorded by

Exploring the experiences of cancer patients: What drives them to seek treatment outside their residential area and what are the experiences resulting from that decision? A qualitative study
Jeehee Pyo, Mina Lee, Haneul Lee, Minsu Ock, Ali Haider Mohammed
PLOS ONE.2025; 20(3): e0319650. CrossRef
Relationship between patient outcomes and patterns of fragmented cancer care in older adults with gastric cancer: A nationwide cohort study in South Korea
Dong-Woo Choi, Seungju Kim, Sun Jung Kim, Dong Wook Kim, Kwang Sun Ryu, Jae Ho Kim, Yoon-Jung Chang, Kyu-Tae Han
Journal of Geriatric Oncology.2024; 15(2): 101685. CrossRef
Limitations of Obtaining Medical Information about Age-Related Macular Degeneration from Artificial Intelligence Chatbots
Dong Gyu Na, Yi Sang Yoon, Jae Hui Kim
Journal of Retina.2024; 9(2): 119. CrossRef
An Exploratory Study of Ideal Medical Systems Based on the Experiences of Laypeople in South Korea
Soo-Young Yu, Eunyoung E. Suh, Seongmi Lim, Ji-yeon Kim
Sage Open.2024;[Epub] CrossRef
Quality of life outcomes in terminal cancer patients attending regional cancer centers in South Korea: protocol for a prospective cohort study
Jung hye Kwon, Jung Hun Kang, Jung-Sik Huh, Su-Jin Koh, Kyu-Hyoung Lim, Byungho Choi, Rock Bum Kim, Young Jin Choi, Eun-Kee Song, Hyun Woo Lee, Ye-Seul Kim, Se-Il Go, Hwan Jung Yun, Sun Jin Sym, Hyewon Ryu, Myung-won Lee
BMC Cancer.2024;[Epub] CrossRef
Impact of Disability Status on Mortality in Patients with Gastric Cancer: A Nationwide Study Focusing on Regional Disparities
Woo-Ri Lee, Kyu-Tae Han, Mingee Choi, Seojin Park, Woorim Kim
Healthcare.2023; 11(5): 641. CrossRef
Descriptive Analysis of Gastric Cancer Mortality in Korea, 2000-2020
Tung Hoang, Hyeongtaek Woo, Sooyoung Cho, Jeeyoo Lee, Sayada Zartasha Kazmi, Aesun Shin
Cancer Research and Treatment.2023; 55(2): 603. CrossRef
A 6-year nationwide population-based study on the current status of gastric endoscopic resection in Korea using administrative data
Jae Yong Park, Mi-Sook Kim, Beom Jin Kim, Jae Gyu Kim
Scientific Reports.2023;[Epub] CrossRef
Cancer care patterns in South Korea: Types of hospital where patients receive care and outcomes using national health insurance claims data
Dong‐Woo Choi, Sun Jung Kim, Seungju Kim, Dong Wook Kim, Wonjeong Jeong, Kyu‐Tae Han
Cancer Medicine.2023; 12(13): 14707. CrossRef
Changes in the Utilization of Health Care Services by Cancer Patients during the COVID-19 Pandemic
Seung Hee Seo, Sooyoung Cho, Shin Hye Yoo, Bhumsuk Keam, Aesun Shin
Yonsei Medical Journal.2023; 64(7): 463. CrossRef
Impact of Cardiovascular Diseases on Mortality in Gastric Cancer Patients with Preexisting Chronic Disease
Kyu-Tae Han, Dong Wook Kim, Woorim Kim
Yonsei Medical Journal.2022; 63(11): 1043. CrossRef
Is time-to-treatment associated with higher mortality in Korean elderly lung cancer patients?
Kyu-Tae Han, Woorim Kim, Areum Song, Yeong Jun Ju, Dong-Woo Choi, Seungju Kim
Health Policy.2021; 125(8): 1047. CrossRef
Do Patients Residing in Provincial Areas Transport and Spend More on Cancer Treatment in Korea?
Woorim Kim, Kyu-Tae Han, Seungju Kim
International Journal of Environmental Research and Public Health.2021; 18(17): 9247. CrossRef

Trends in Inequality in Cigarette Smoking Prevalence by Income According to Recent Anti-smoking Policies in Korea: Use of Three National Surveys: Youngs Chang, Sanghyun Cho, Ikhan Kim, Jinwook Bahk, Young-Ho Khang; J Prev Med Public Health. 2018;51(6):310-319. Published online October 30, 2018; DOI: https://doi.org/10.3961/jpmph.18.225

8,971 View
161 Download
10 Crossref

Abstract PDF Supplementary Material

Objectives
This study examined trends in inequality in cigarette smoking prevalence by income according to recent anti-smoking policies in Korea.
Methods
The data used in this study were drawn from three nationally representative surveys, the Korea National Health and Nutrition Examination Survey, the Korea Community Health Survey, and the Social Survey of Statistics Korea. We calculated the age-standardized smoking prevalence, the slope index of inequality, and the relative index of inequality by income level as a socioeconomic position indicator.
Results
Smoking prevalence among men decreased during the study period, but the downward trend became especially pronounced in 2015, when the tobacco price was substantially increased. Inequalities in cigarette smoking by income were evident in both genders over the study period in all three national surveys examined. Absolute inequality tended to decrease between 2014 and 2015 among men. Absolute and relative inequality by income decreased between 2008 and 2016 in women aged 30-59, except between 2014 and 2015.
Conclusions
The recent anti-smoking policies in Korea resulted in a downward trend in smoking prevalence among men, but not in relative inequality, throughout the study period. Absolute inequality decreased over the study period among men aged 30-59. A more aggressive tax policy is warranted to further reduce socioeconomic inequalities in smoking in young adults in Korea.

Summary

Citations

Citations to this article as recorded by

Longitudinal assessment of smoking‐related knowledge, attitude, and practice for cancer prevention: an analysis of data from the Korean National Cancer Prevention Awareness and Practice Survey
Jeoung A Kwon, Naeun Kim, Jin-Kyoung Oh, Bohyun Park, Yoon-Jung Choi, Yoonjoo Choi, Byungmi Kim
BMC Public Health.2025;[Epub] CrossRef
Area Specific Gap in Current Male Smoking and Factors Associated with a Secondary Data Analysis Based on a Socio-Ecological Model
Soo Kyung Jeong, Gye Ae Kim, Min Kyung Lim, Youn Hee Kim, Cho Hee Choi, Sang Mi Lee, Hun Jae Lee
Journal of the Korean Society for Research on Nicotine and Tobacco.2022; 13(1): 20. CrossRef
Current Use of Heated Tobacco Products and Its Association with Socioeconomic Factors in Korean Adults: A Study Using Community Health Survey 2019
Sung Yeol Son, Seo Young Kang, Hong-Jun Cho
Journal of the Korean Society for Research on Nicotine and Tobacco.2022; 13(4): 140. CrossRef
Trends in Alcohol Consumption for Korean Adults from 1998 to 2018: Korea National Health and Nutritional Examination Survey
Sang Young Kim, Hyun Ja Kim
Nutrients.2021; 13(2): 609. CrossRef
Tobacco price increases in Korea and their impact on socioeconomic inequalities in smoking and subsequent socioeconomic inequalities in mortality: a modelling study
Hwa-Kyung Lim, Young-Ho Khang
Tobacco Control.2021; 30(2): 160. CrossRef
Age- and cause-specific contributions to the life expectancy gap between Medical Aid recipients and National Health Insurance beneficiaries in Korea, 2008–2017
Jinwook Bahk, Hee-Yeon Kang, Young-Ho Khang, Fernando A. Wilson
PLOS ONE.2020; 15(11): e0241755. CrossRef
A Multi-Disciplinary Study Into the Drivers of Smoking Cessation in South Korea
James E. Prieger, Anna Choi
SSRN Electronic Journal.2020;[Epub] CrossRef
Investigating the Drivers of Smoking Cessation: A Role of Alternative Nicotine Delivery Systems?
Sam Hampsher, James E. Prieger
SSRN Electronic Journal .2020;[Epub] CrossRef
Long-term trends in smoking prevalence and its socioeconomic inequalities in Korea, 1992–2016
Youngs Chang, Hee-Yeon Kang, Dohee Lim, Hong-Jun Cho, Young-Ho Khang
International Journal for Equity in Health.2019;[Epub] CrossRef
Socioeconomic Inequalities in e-Cigarette Use in Korea: Comparison with Inequalities in Conventional Cigarette Use Using Two National Surveys
Youngs Chang, Sanghyun Cho, Ikhan Kim, Young-Ho Khang
International Journal of Environmental Research and Public Health.2019; 16(22): 4458. CrossRef

Author index