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Brief Report
Characteristics and Health Care Spending of Persistently and Transiently High-cost Older Adults in Korea
Sungchul Park, Giryeon Bae
J Prev Med Public Health. 2023;56(5):475-480.   Published online September 4, 2023
DOI: https://doi.org/10.3961/jpmph.23.270
  • 579 View
  • 51 Download
AbstractAbstract AbstractSummary PDF
Objectives
This study examined differences in health care spending and characteristics among older adults in Korea by high-cost status (persistently, transiently, and never high-cost).
Methods
We identified 1 364 119 older adults using data from the Korean National Insurance Claims Database for 2017-2019. Outcomes included average annual total health care spending and high-cost status for 2017-2019. Linear regression was used to estimate differences in the outcomes while adjusting for individual-level characteristics.
Results
Persistently and transiently high-cost older adults had higher health care spending than never high-cost older adults, but the difference in health care spending was greater among persistently high-cost older adults than among transiently high-cost older adults (US$20 437 vs. 5486). Despite demographic and socioeconomic differences between transiently high-cost and never high-cost older adults, the presence of comorbid conditions remained the most significant factor. However, there were no or small differences in the prevalence of comorbid conditions between persistently high-cost and transiently high-cost older adults. Rather, notable differences were observed in socioeconomic status, including disability and receipt of Medical Aid.
Conclusions
Medical risk factors contribute to high health care spending to some extent, but social risk factors may be a source of persistent high-cost status among older adults in Korea.
Summary
Korean summary
- 한국에서 65세 이상의 고령층 고비용 환자 그룹 내에서 두 개의 이질적인 그룹을 발견하였다. - 지속적으로 고비용인 환자는 일시적으로 고비용인 환자보다 의료비 지출이 유의미하게 더 많았다. - 두 그룹의 특성을 비교한 결과, 건강요인의 차이도 있었지만 그보다는 사회적 요인의 차이가 더 컸다.
Key Message
- High-cost older adults are heterogeneous in terms of health care spending and sample characteristics in Korea. - Persistently high-cost older adults had significantly higher health care spending than transiently high-cost older adults. - Medical risk factors contribute to high health care spending to some extent, but social risk factors may be a source of persistent high-cost status among older adults.
Original Articles
Identifying, Measuring, and Ranking Social Determinants of Health for Health Promotion Interventions Targeting Informal Settlement Residents
Farhad Nosrati Nejad, Mohammad Reza Ghamari, Seyed Hossein Mohaqeqi Kamal, Seyed Saeed Tabatabaee
J Prev Med Public Health. 2023;56(4):327-337.   Published online June 26, 2023
DOI: https://doi.org/10.3961/jpmph.23.059
  • 1,233 View
  • 114 Download
AbstractAbstract PDF
Objectives
Considering the importance of social determinants of health (SDHs) in promoting the health of residents of informal settlements and their diversity, abundance, and breadth, this study aimed to identify, measure, and rank SDHs for health promotion interventions targeting informal settlement residents in a metropolitan area in Iran.
Methods
Using a hybrid method, this study was conducted in 3 phases from 2019 to 2020. SDHs were identified by reviewing studies and using the Delphi method. To examine the SDHs among informal settlement residents, a cross-sectional analysis was conducted using researcher-made questionnaires. Multilayer perceptron analysis using an artificial neural network was used to rank the SDHs by priority.
Results
Of the 96 determinants identified in the first phase of the study, 43 were examined, and 15 were identified as high-priority SDHs for use in health-promotion interventions for informal settlement residents in the study area. They included individual health literacy, nutrition, occupational factors, housing-related factors, and access to public resources.
Conclusions
Since identifying and addressing SDHs could improve health justice and mitigate the poor health status of settlement residents, ranking these determinants by priority using artificial intelligence will enable policymakers to improve the health of settlement residents through interventions targeting the most important SDHs.
Summary
Social and Policy Determinants of COVID-19 Infection Across 23 Countries: An Ecological Study
Kyungsik Kim, Young-Do Jeung, Jeoungbin Choi, Sue K. Park
J Prev Med Public Health. 2022;55(2):144-152.   Published online February 10, 2022
DOI: https://doi.org/10.3961/jpmph.21.396
  • 3,185 View
  • 132 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study aimed to identify the social and policy determinants of coronavirus disease 2019 (COVID-19) infection across 23 countries.
Methods
COVID-19 indicators (incidence, mortality, and fatality) for each country were calculated by direct and indirect standardization. Multivariable regression analyses were used to identify the social and policy determinants of COVID-19 infection.
Results
A higher number of doctors per population was related to lower incidence, mortality, and fatality rates of COVID-19 in 23 countries (β=-0.672, -0.445, and -0.564, respectively). The number of nurses/midwives per population was associated with lower mortality and fatality rates of COVID-19 in 23 countries (β=-0.215 and -0.372, respectively). Strengthening of policy restriction indicators, such as restrictions of public gatherings, was related to lower COVID-19 incidence (β=-0.423). A national Bacillus Calmette–Guérin vaccination policy conducted among special groups or in the past was associated with a higher incidence of COVID-19 in 23 countries (β=0.341). The proportion of the elderly population (aged over 70 years) was related to higher mortality and fatality rates (β=0.209 and 0.350, respectively), and income support was associated with mortality and fatality rates (β=-0.362 and -0.449, respectively).
Conclusions
These findings do not imply causality because this was a country-based correlation study. However, COVID-19 transmission can be influenced by social and policy determinants such as integrated health systems and policy responses to COVID-19. Various social and policy determinants should be considered when planning responses to COVID-19.
Summary
Korean summary
본 연구는 23개국의 코로나 19 감염 지표 (발생, 사망, 치명)과 관련있는 사회적, 정책적 요소를 확인하고자 하는생태학적 연구이다. 이는 코로나 19 감염 지표에 대한 인과성을 제시하는 연구가 아니기에 주의 깊은 해석이 필요하며 본 연구에서 제시한 사회적, 정책적 요소를 통해 코로나 19 감염에 대한 국가적인 정책을 고려할 수 있을 것으로 기대된다.

Citations

Citations to this article as recorded by  
  • COVID 19 mortality as a reflection of the quality of health in EU countries
    Beáta Stehlíková, Zuzana Vincúrová, Ivan Brezina, Ilona Švihlíková
    Economics & Sociology.2023; 16(3): 138.     CrossRef
  • Social and Policy Determinants of COVID-19
    Rujittika Mungmunpuntipantip, Viroj Wiwanitkit
    Journal of Preventive Medicine and Public Health.2022; 55(3): 307.     CrossRef
  • Social and Policy Determinants of COVID-19 Infection Across 23 Countries: An Ecological Study
    Kyungsik Kim, Sue K. Park
    Journal of Preventive Medicine and Public Health.2022; 55(3): 308.     CrossRef
  • Country-level and regional COVID-19 burden and determinants across OECD member states and partner countries
    Nlandu Roger Ngatu, Kazuto Tayama, Kanae Kanda, Tomohiro Hirao
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  • The association between tobacco or nicotine product use behaviors and non-compliance with mask-wearing during the COVID-19 pandemic: a cross-sectional study in Korea
    Da-eun Lee, Heewon Kang, Sung-il Cho
    Epidemiology and Health.2022; 44: e2022087.     CrossRef
Scoping Review
The Most Important Social Determinants of Slum Dwellers’ Health: A Scoping Review
Farhad Nosrati Nejad, Mohammad Reza Ghamari, Seyed Hossein Mohaqeqi Kamal, Seyed Saeed Tabatabaee, Raheleh Ganjali
J Prev Med Public Health. 2021;54(4):265-274.   Published online July 8, 2021
DOI: https://doi.org/10.3961/jpmph.21.073
  • 4,371 View
  • 210 Download
  • 3 Crossref
AbstractAbstract PDF
Objectives
Given the importance of social determinants of health in promoting the health of slum residents, this study was conducted with the aim of identifying the main dimensions and components of these determinants.
Methods
This scoping review study was conducted according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). A comprehensive search was performed of PubMed, ProQuest, Scopus, and Web of Science for articles conducted from 2010 to the end of 2019. Studies were selected based on inclusion criteria, with a special focus on studies dealing with the social determinants of physical and mental health or illness.
Results
Thirty-three articles were selected to extract information on the social determinants of health. After reviewing the articles, 7 main dimensions (housing, socioeconomic status of the family, nutrition, neighborhood characteristics, social support and social capital, occupational factors, and health behaviors) and 87 components were extracted as social determinants of health among slum dwellers.
Conclusions
This framework could be used by planners, managers, and policy-makers when making decisions affecting the health of these settlements’ residents due to the common characteristics of slums around the world, especially in developing countries.
Summary

Citations

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  • “For my safety and wellbeing, I always travel to seek health care in a distant facility”—the role of place and stigma in HIV testing decisions among GBMSM – BSGH 002
    Edem Yaw Zigah, Gamji Rabiu Abu-Ba'are, Osman Wumpini Shamrock, Henry Delali Dakpui, Amos Apreku, Donte T. Boyd, LaRon E. Nelson, Kwasi Torpey
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    Journal of Preventive Medicine and Public Health.2023; 56(4): 327.     CrossRef
  • Do Community-based Livelihood Interventions Affect Sexual and Reproductive Health and Rights of Young People in Slum Areas of Uganda: a Difference-in-difference with Kernel Propensity Score Matching Analysis
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COVID-19: Original Article
Social Determinants of COVID-19 in Massachusetts, United States: An Ecological Study
Devan Hawkins
J Prev Med Public Health. 2020;53(4):220-227.   Published online June 24, 2020
DOI: https://doi.org/10.3961/jpmph.20.256
  • 7,257 View
  • 347 Download
  • 61 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
The aim of this study was to assess how different social determinants of health (SDoH) may be related to variability in coronavirus disease 2019 (COVID-19) rates in cities and towns in Massachusetts (MA).
Methods
Data about the total number of cases, tests, and rates of COVID-19 as of June 10, 2020 were obtained for cities and towns in MA. The data on COVID-19 were matched with data on various SDoH variables at the city and town level from the American Community Survey. These variables included information about income, poverty, employment, renting, and insurance coverage. We compared COVID-19 rates according to these SDoH variables.
Results
There were clear gradients in the rates of COVID-19 according to SDoH variables. Communities with more poverty, lower income, lower insurance coverage, more unemployment, and a higher percentage of the workforce employed in essential services, including healthcare, had higher rates of COVID-19. Most of these differences were not accounted for by different rates of testing in these cities and towns.
Conclusions
SDoH variables may explain some of the variability in the risk of COVID-19 across cities and towns in MA. Data about SDoH should be part of the standard surveillance for COVID-19. Efforts should be made to address social factors that may be putting communities at an elevated risk.
Summary

Citations

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JPMPH : Journal of Preventive Medicine and Public Health