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Lee S, Kim MJ, Lee SH, Kim HY, Kim HS, Oh IH. Comparison of Disability-Adjusted Life Years (DALYs) and Economic Burden on People With Drug-Susceptible Tuberculosis and Multidrug-Resistant Tuberculosis in Korea. Front Public Health 2022; 10:848370. [PMID: 35480575 PMCID: PMC9037376 DOI: 10.3389/fpubh.2022.848370] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/23/2022] [Indexed: 11/13/2022] Open
Abstract
In the future, tuberculosis (TB) will place a heavy burden on the aging population in Korea. To prepare for this crisis, it is important to analyze the disease burden trend of drug-susceptible tuberculosis (DS-TB) and multidrug-resistant tuberculosis (MDR-TB). Measuring disability-adjusted life years (DALYs) and economic burden on MDR-TB patients can help reduce the incidence of TB. Accordingly, in this study, we measured the DALYs and economic burden on DS-TB and MDR-TB patients in 2014-2017 using a combination of National Health Insurance claims data, Annual Report on the Notified TB data, and Statistics Korea's mortality data. The incidence-based DALY approach implemented involved the summation of years of life lost and years lived with disability. For measuring economic burden, direct and indirect costs incurred by patients were totaled. From 2014 to 2017, DALYs per 100,000 people with DS-TB were 56, 49, 46, and 40, respectively, and DALYs per 100,000 people with MDR-TB were 3, 2, 2, and 2, respectively. The economic burden for the DS-TB population from 2014 to 2017 was $143.89 million, $136.36 million, $122.85 million, and $116.62 million, respectively, while that for MDR-TB was $413.44 million, $380.25 million, $376.46 million and $408.14 million, respectively. The results showed a decreasing trend in DALYs and economic burden for DS-TB, whereas MDR-TB was still found to be burdensome without a specific trend. With respect to age, the economic burden for both DS-TB and MDR-TB was higher among men than among women till ≤ 79 years. Conversely, the economic burden for women aged ≥80 years was higher as compared to their male counterparts. In conclusion, the incidence and spread of TB in all areas of society must be suppressed through intensive management of MDR-TB in the older population. We hope that the national TB management project will proceed efficiently when the infectious disease management system is biased to one side due to the COVID-19 pandemic.
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Affiliation(s)
- SeungCheor Lee
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Moon Jung Kim
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Seung Heon Lee
- Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, South Korea
| | - Hae-Young Kim
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Hee-Sun Kim
- Department of Health Policy Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, South Korea
| | - In-Hwan Oh
- Department of Medicine (AgeTech-Service Convergence Major), School of Medicine, Kyung Hee University, Seoul, South Korea
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Kim YE, Jung YS, Ock M, Yoon SJ. DALY Estimation Approaches: Understanding and Using the Incidence-based Approach and the Prevalence-based Approach. J Prev Med Public Health 2022; 55:10-18. [PMID: 35135044 PMCID: PMC8841194 DOI: 10.3961/jpmph.21.597] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/12/2022] [Indexed: 11/24/2022] Open
Abstract
Disability-adjusted life-year (DALY) estimates may vary according to factors such as the standard life expectancy, age weighting, time preference and discount rate, calculation of disability weights, and selection of the estimation method. DALY estimation methods are divided into the following 3 approaches: the incidence-based approach, the pure prevalence-based approach, and the hybrid approach. These 3 DALY estimation approaches each reflect different perspectives on the burden of disease using unique characteristics, based on which the selection of a suitable approach may vary by the purpose of the study. The Global Burden of Disease studies, which previously estimated DALYs using the incidence-based approach, switched to using the hybrid approach in 2010, while the National Burden of Disease studies in Korea still mainly apply the incidence-based approach. In order to increase comparability with other international burden of disease studies, more DALY studies using the prevalence-based approach need to be conducted in Korea. However, with the limitations of the hybrid approach in mind, it is necessary to conduct more research using a disease classification system suitable for Korea. Furthermore, more detailed and valid data sources should be established before conducting studies using a broader variety of DALY estimation approaches. This review study will help researchers on burden of disease use an appropriate DALY estimation approach and will contribute to enhancing researchers’ ability to critically interpret burden of disease studies.
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Affiliation(s)
- Young-Eun Kim
- Department of Big Data Strategy, National Health Insurance Service, Wonju, Korea
| | - Yoon-Sun Jung
- Institute for Future Public Health, Graduate School of Public Health, Korea University, Seoul, Korea
| | - Minsu Ock
- Department of Preventive Medicine, University of Ulsan College of Medicine, Ulsan, Korea
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- Corresponding author: Minsu Ock Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan 44033, Korea E-mail:
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
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Kim CB, Ock M, Jung YS, Kim KB, Kim YE, Kim KA, Yoon SJ. Estimation of Years Lived with Disability Using a Prevalence-Based Approach: Application to Major Psychiatric Disease in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9056. [PMID: 34501645 PMCID: PMC8431236 DOI: 10.3390/ijerph18179056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 11/16/2022]
Abstract
To help develop policies concerning the prevention of psychiatric disease in Korea, we reviewed the literature on this topic in different countries and used a prevalence-based approach to estimate the years lived with disability (YLDs) in Korean patients with major psychiatric diseases. We calculated YLDs by extracting data on the number of patients with mild, moderate, and severe cases of schizophrenia, bipolar disorder, and major depressive disorder, as classified by International Statistical Classification of Disease (ICD) codes. YLDs were highest for patients with major depressive disorder (1190.6; 73.9%), schizophrenia (303.3; 18.8%) and bipolar disorder (117.9; 7.3%). Men had higher YLDs for schizophrenia, 2502 (20-24 years); bipolar disorder, 477 (40-44 years); and major depressive disorder, 2034 (75-79 years). Women had higher YLDs for schizophrenia, 484 (45-49 years); bipolar disorder, 214 (≥80 years); and major depressive disorder, 3541 (75-79 years). The prevalence-based approach and severity distribution is useful for estimating long-term psychiatric disease burden and YLDs. However, YLD-estimation studies must compensate for the shortcomings of the ICD-10 by referencing the Diagnostic and Statistical Manual of Mental Disorders 5th edition, as well as updating the disability weight score according to disease severity.
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Affiliation(s)
- Chae-Bong Kim
- Department of Public Health, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea; (C.-B.K.); (Y.-S.J.); (K.-B.K.)
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan 44033, Korea;
| | - Yoon-Sun Jung
- Department of Public Health, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea; (C.-B.K.); (Y.-S.J.); (K.-B.K.)
| | - Ki-Beom Kim
- Department of Public Health, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea; (C.-B.K.); (Y.-S.J.); (K.-B.K.)
| | - Young-Eun Kim
- Department of Big Data Strategy, National Health Insurance Service, 32 Geongang-ro, Wonju 26464, Korea;
| | - Keun-A Kim
- School of Military Medicine, The Armed Force Medical Command, 90 Jaun-ro, Daejeon 34059, Korea;
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea
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Noh J, Jang H, Cho J, Kang DR, Kim TH, Shin DC, Kim C. Estimating the disease burden of lung cancer attributable to residential radon exposure in Korea during 2006-2015: A socio-economic approach. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 749:141573. [PMID: 32841859 DOI: 10.1016/j.scitotenv.2020.141573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 06/11/2023]
Abstract
Estimating the lung cancer disease burden can provide evidence for public health practitioners, researchers, and policymakers. This study uses claim data from lung cancer patients for 2006-2015 from the Korean National Health Insurance Service to estimate the lung cancer burdens attributable to residential radon in Korea using disability-adjusted life years (DALY) and patients' annual economic burden with societal perspectives using the cost-of-illness (COI) method. The number of patients increased during our study period (from 35,866 to 59,168). The disease burden and that attributable to residential radon, respectively, increased from 517.57 to 695.74 and 64.62 (95%; CIs 61.33-67.69) to 86.99 (95%; CIs 82.7-91.1) DALYs per 100,000 patients. The percentage of years lost due to disability among the DALY doubled from 8% to 17%. The cost for all the patients was US$2.33 billion, with US$292 (95%; CIs 278-306) million attributable to residential radon. During the last decade, the lung cancer disease burden increased by 1.34 times, with a doubled percentage of non-fatal burden and average annual growth rate of 9.5% of the total cost. Hence, the burden and cost of lung cancer in Korean provinces have been steadily increasing. The findings could be used as input data for future cost-effectiveness analysis of policies regarding radon reduction.
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Affiliation(s)
- Juhwan Noh
- Department of Preventive Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea; Institute of Human Complexity and Systems Science, Yonsei University, Seoul, Republic of Korea.
| | - Heeseon Jang
- Department of Preventive Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea; Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.
| | - Jaelim Cho
- Institute of Human Complexity and Systems Science, Yonsei University, Seoul, Republic of Korea; School of Medicine, University of Auckland, Auckland, New Zealand; Institute for Environmental Research, Yonsei University, College of Medicine, Seoul, Republic of Korea.
| | - Dae Ryong Kang
- Center of Biomedical Data Science, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea.
| | - Tae Hyun Kim
- Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
| | - Dong Chun Shin
- Department of Preventive Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea; Institute for Environmental Research, Yonsei University, College of Medicine, Seoul, Republic of Korea.
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea; Institute of Human Complexity and Systems Science, Yonsei University, Seoul, Republic of Korea; Institute for Environmental Research, Yonsei University, College of Medicine, Seoul, Republic of Korea.
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5
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Park HY, Hwang J, Kim DH, Jeon SM, Choi SH, Kwon JW. Lifetime survival and medical costs of lung cancer: a semi-parametric estimation from South Korea. BMC Cancer 2020; 20:846. [PMID: 32883237 PMCID: PMC7650522 DOI: 10.1186/s12885-020-07353-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 08/27/2020] [Indexed: 02/08/2023] Open
Abstract
Background It is essential to have information on the disease burden of lung cancer at an individual level throughout the life; however, few such results have been reported. Thus, this study aimed to assess the lifetime disease burden in patients with lung cancer by assessing various factors, such as survival, years of life lost (YLL) and medical expenditure in South Korea based on real-world data and extrapolation. Methods Newly diagnosed lung cancer patients (n = 2919) in 2004–2010 were selected and observed until the end of 2015 using nationwide reimbursement claim database. The patients were categorised into the Surgery group, Chemo and/or Radiotherapy group (CTx/RTx), and Surgery+CTx/RTx according to their treatment modality. Age- and sex-matched control subjects were selected from among general population using the life table. The survival and cost data after diagnosis were analysed by a semi-parametric method, the Kaplan–Meier analysis for the first 100 months and rolling extrapolation algorithm for 101–300 months. YLL were derived from the difference in survival between patients and controls. Results Lifetime estimates (standard error) were 4.5 (0.2) years for patients and 14.5 (0.1) years for controls and the derived YLL duration was 10.0 (0.2) years. Lifetime survival years showed the following trend: Surgery (14.2 years) > Surgery+CTx/RTx (8.5 years) > CTx/RTx group (3.0 years), and YLL were increased as lifetime survival years decreased (2.3, 8.7, 12.2 years, respectively). The mean lifetime medical cost was estimated at 30,857 USD/patient. Patients in the Surgery group paid higher treatment cost in first year after diagnosis, but the overall mean cost per year was lower at 4359 USD compared with 7075USD of Surgery+CTx/RTx or 7626USD of CTx/RTx group. Conclusions Lung cancer has resulted in about 10 years of life lost in overall patients. The losses were associated with treatment modality, and the results indicated that diagnosing lung cancer in patients with low stage disease eligible for surgery is beneficial for reducing disease burden in terms of survival and treatment cost per year throughout the life.
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Affiliation(s)
- Hae-Young Park
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, 41566, South Korea
| | - Jinseub Hwang
- Division of Mathematics and Big Data Science, Daegu University, Gyeongsan-si, 38453, South Korea
| | - Do-Hyang Kim
- Division of Mathematics and Big Data Science, Daegu University, Gyeongsan-si, 38453, South Korea
| | - Soo Min Jeon
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, 41566, South Korea
| | - Sun Ha Choi
- Lung Cancer Center, Kyungpook National University Chilgok Hospital, Daegu, 41404, South Korea
| | - Jin-Won Kwon
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, 41566, South Korea.
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Jang SY, Kim MJ, Cheong HK, Oh IH. Estimating Disability-Adjusted Life Years due to Tuberculosis in Korea through to the Year 2040. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5960. [PMID: 32824613 PMCID: PMC7459449 DOI: 10.3390/ijerph17165960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/06/2020] [Accepted: 08/14/2020] [Indexed: 11/18/2022]
Abstract
Despite efforts to reduce its incidence, tuberculosis continues to burden the rapidly aging Korean society. This study aimed to investigate the current trend of tuberculosis burden in Korea and its projections to 2040. We used National Health Insurance claims data to calculate the disability-adjusted life years due to tuberculosis in Korea. Disability-adjusted life years were measured by summing the years of life lost and the years lived with disability using an incidence-based approach. We modeled the incidence rates using a time-series model for the projection of disability-adjusted life years accrued from 2020 to 2040. The total disability-adjusted life years due to tuberculosis were 69, 64, 59, and 49 disability-adjusted life years/100,000 population in 2014, 2015, 2016, and 2017, respectively. In both sexes, disability-adjusted life years were the highest in those aged ≥80 years. Projected disability-adjusted life years showed a descending trend from 38 disability-adjusted life years/100,000 in 2020, to 14 disability-adjusted life years/100,000 in 2040. Conversely, the projected disability-adjusted life years increased among females aged ≥80 years. Although the tuberculosis burden in Korea is decreasing, a high burden remains among the elderly. Therefore, interventions targeting those vulnerable are required.
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Affiliation(s)
| | | | | | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; (S.Y.J.); (M.J.K.); (H.-K.C.)
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Kang HW, Yun SJ, Chung JI, Choi H, Kim JH, Yu HS, Ha YS, Cho IC, Kim HJ, Chung HC, Koh JS, Kim WJ, Park JH, Lee JY, Kim SY. National practice patterns and direct medical costs for prostate cancer in Korea across a 10 year period: a nationwide population-based study using a national health insurance database. BMC Health Serv Res 2019; 19:408. [PMID: 31234845 PMCID: PMC6591932 DOI: 10.1186/s12913-019-4218-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 06/05/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND A complete enumeration study was conducted to evaluate trends in national practice patterns and direct medical costs for prostate cancer (PCa) in Korea over a 10-year retrospective period using data from the Korean National Health Insurance Service. METHODS Reimbursement records for 874,924 patients diagnosed between 2002 and 2014 with primary PCa according to the International Classification of Disease (ICD) 10th revision code C61 were accessed. To assess direct medical costs for patients newly diagnosed after 2005, data from 68,596 patients managed between January 2005 and 31 December 2014 were evaluated. RESULTS From 2005 to 2014, the total number of PCa patients showed a 2.6-fold increase. Surgery and androgen deprivation therapy were the most common first-line treatment, alone or within the context of combined therapy. Surgery as a monotherapy was performed in 23.5% of patients in 2005, and in 39.4% of patients in 2014. From 2008, the rate of robot-assisted RP rose sharply, showing a similar rate to open RP in 2014. Average total treatment costs in the 12 months post-diagnosis were around 10 million Korean won. Average annual treatment costs thereafter were around 5 million Korean won. Out-of-pocket expenditure was highest in the first year post-diagnosis, and ranged from 12 to 17% thereafter. CONCLUSIONS Between 2005 and 2014, a substantial change was observed in the national practice pattern for PCa in Korea. The present data provide a reliable overview of treatment patterns and medical costs for PCa in Korea.
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Affiliation(s)
- Ho Won Kang
- Department of Urology, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Seok-Joong Yun
- Department of Urology, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Jae Il Chung
- Department of Urology, Inje University Busan Paik Hospital, Busan, Korea
| | - Hoon Choi
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Seoul, Korea
| | - Ho Song Yu
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Yun-Sok Ha
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - In-Chang Cho
- Department of Urology, National Police Hospital, Seoul, Korea
| | - Hyung Joon Kim
- Department of Urology, Konyang University College of Medicine, Daejeon, Korea
| | - Hyun Chul Chung
- Department of Urology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jun Sung Koh
- Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Korea
| | - Wun-Jae Kim
- Department of Urology, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Jong-Hyock Park
- Department of Preventive Medicine/ Graduate School of Health Science Business Convergence, Chungbuk National University, Cheongju, Korea
| | - Ji Youl Lee
- Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Korea.
| | - So-Young Kim
- Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, 776 1sunhwan-ro, Seowon-gu, Cheonju, 28644, Korea.
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Yoon SJ, Go DS, Park H, Jo MW, Oh IH, Kim YE. The Korean National Burden of Disease Study: from Evidence to Policy. J Korean Med Sci 2019; 34:e89. [PMID: 30923492 PMCID: PMC6434148 DOI: 10.3346/jkms.2019.34.e89] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 08/27/2018] [Indexed: 01/26/2023] Open
Abstract
Following the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), disability-adjusted life years (DALYs) have been widely used as a summary measure of population health. The DALY metric is a comprehensive measurement of population health, enabling comparison among groups. However, the available data and reliance on estimates to supplement the data gap require contextualization at the national level, and the outcomes of which are more appropriate for national policymakers. The Korean National Burden of Disease (KNBD) study was initiated by the Research and Development Project of the Ministry of Health and Welfare, funded by a 5-year grant from 2013, to contextualize the GBD method to the Korean population. Here, we provide a comprehensive overview of the KNBD study with its achievements and challenges and discuss the implications for public health policies.
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Affiliation(s)
- Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Dun-Sol Go
- Department of Public Health, Graduate School, Korea University, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Young-Eun Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
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Ock M, Park B, Park H, Oh IH, Yoon SJ, Cho B, Jo MW. Disability Weights Measurement for 289 Causes of Disease Considering Disease Severity in Korea. J Korean Med Sci 2019; 34:e60. [PMID: 30923484 PMCID: PMC6434154 DOI: 10.3346/jkms.2019.34.e60] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/07/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND For the Korean Burden of Disease (KBD) 2015 study, we have amended disability weights for causes of disease adapting the methodology of the KBD disability weight 2012 study. METHODS We conducted a self-administered web-based survey in Korea using ranking five causes of disease. A total of 605 physicians and medical college students who were attending in third or fourth grade of a regular course performed the survey. We converted the ranked data into paired comparison data and ran a probit regression. The predicted probabilities for each cause of disease were calculated from the coefficient estimates of the probit regression. 'Being dead (1)' and 'Full health (0)' were utilized as anchor points to rescale the predicted probability on a scale from 0 to 1. RESULTS As a result, disability weights for a total of 289 causes of disease were estimated. In particular, we calculated the disability weights of 60 causes of disease considering severity level. These results show that prejudice about the severity of cause of disease itself can affect the estimation of disability weight, when estimating the disability weight for causes of disease without consideration of severity. Furthermore, we have shown that disability weights can be estimated based on a ranking method which can maximize efficiency of data collection. CONCLUSION Disability weights from this study can be used to estimate disability adjusted life year and healthy life expectancy. Furthermore, we expected that the use of the ranking method will increase gradually in disability weight studies.
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Affiliation(s)
- Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Bomi Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Bogeum Cho
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
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Park B, Park B, Lee WK, Kim YE, Yoon SJ, Park H. Incidence-Based versus Prevalence-Based Approaches on Measuring Disability-Adjusted Life Years for Injury. J Korean Med Sci 2019; 34:e69. [PMID: 30923486 PMCID: PMC6434153 DOI: 10.3346/jkms.2019.34.e69] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 12/26/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Injury represents an important aspect of disease that affects everyone at some point in their lives. To better understand and prevent these injuries, various analytical methods have been developed to assess both the magnitude and features of injury burden. In this study, we attempted to estimate the injury burden of Korea in 2014 by comparing the prevalence-based approach used by the Global Burden of Diseases (GBD) team and the World Health Organization against an alternative incidence-based approach, and to assess the different implications of these measurements. METHODS The 10th Korean National Hospital Discharge survey data and causes of death statistics in 2014 were used as data sources. Years of life lost (YLL), years lived with disability (YLD) and disability-adjusted life years (DALYs) were calculated using both the incidence- and prevalence-based approaches. The Korean Classification of Diseases (KCD) version 5 diagnostic codes were used to classify the mechanism of injury. RESULTS The prevalence-based injury burden tended to be higher (1,670,229 DALYs) than the incidence-based injury burden (1,544,467 DALYs). The elderly population exhibited a higher prevalence-based YLD and DALY relative to incidence-based outcomes. In order of significance, the three most common causes of injury as calculated using an incidence-based approach were road injury, fall, and self-harm, compared with a prevalence-based method, which identified self-harm, road injury, and falls as the most common injuries. CONCLUSION An appropriate prevention program is needed for injuries with potential to cause long-lasting morbidity. Accordingly, a tailored injury-prevention strategy should be developed for each high-risk group.
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Affiliation(s)
- Bohyun Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Bomi Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Won Kyung Lee
- Department of Prevention and Management, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Young-Eun Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
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Ock M, Choi WJ, Jo MW. Trend analysis of major cancer statistics according to sex and severity levels in Korea. PLoS One 2018; 13:e0203110. [PMID: 30212475 PMCID: PMC6136735 DOI: 10.1371/journal.pone.0203110] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 08/15/2018] [Indexed: 12/27/2022] Open
Abstract
Existing epidemiologic reports or studies of cancer statistics in Korea lack sufficient data on cancer severity distributions and observed survival rates. This study analyzed trends in major cancer statistics according to sex and severity levels in Korea from 2006 to 2013. We included eight cancers (hepatocellular carcinoma, and thyroid, colorectal, gastric, lung, prostate, breast, and cervical cancer), using Korea Central Cancer Registry data. Severity level was classified by Surveillance, Epidemiology, and End Results (SEER) stage as follows: localized, regional, distant, or unknown. Numbers of incident cancer cases from 2006 to 2013 were described by sex and SEER stage. We estimated up to 8-year observed survival rates of major cancers by sex and SEER stage, and provided prevalence rates by sex and SEER stage in 2011, 2012, and 2013. Although increases in new cancer cases are slowing and the total number of incident cancer cases in 2013 decreased for the first time since 2006, the number of prevalent cancer cases was 663,530 in 2013, an increase of 13.3% compared to 2011. Among the five cancers affecting both sexes, sex-related differences in 5-year observed survival rates for lung cancer were greatest in the localized stage (men, 31.9%; women, 48.1%), regional stage (men, 20.0%; women, 31.3%), and unknown stage (men, 24.3%; women, 37.5%). The sum of the proportions of localized and regional stages for thyroid and breast cancer was over 90% in 2013, while the sum of the proportions of localized and regional stages for lung cancer was only 56.7% in 2013. Differences in observed survival rates between men and women were prominent in lung cancer for all SEER stages. The reported epidemiologic data from this study can be used to obtain a more valid measure of cancer burden using a summary measure of population health.
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Affiliation(s)
- Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Woong Jae Choi
- School of Biosystem and Biomedical Science, Korea University, Seoul, South Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, South Korea
- * E-mail:
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Kang DM, Kim JE, Kim YK, Lee HH, Kim SY. Occupational Burden of Asbestos-Related Diseases in Korea, 1998-2013: Asbestosis, Mesothelioma, Lung Cancer, Laryngeal Cancer, and Ovarian Cancer. J Korean Med Sci 2018; 33:e226. [PMID: 30140191 PMCID: PMC6105774 DOI: 10.3346/jkms.2018.33.e226] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 12/27/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Asbestos exposure causes asbestos-related diseases (ARDs) including asbestosis, malignant mesothelioma, lung cancer, laryngeal cancer, and ovarian cancer. Although Korea used substantial amounts of asbestos in the past, no study has focused on its occupational burden of disease (OBD). Therefore, this study aimed to determine the OBDs of ARDs in Korea. METHODS The CARcinogen Exposure (CAREX) database was used to determine the proportion of exposed population. Relative risks for lung cancer, laryngeal cancer, and ovarian cancer were used to determine the population-attributable fraction. Data for deaths caused by ARDs during 1998-2013 were obtained from the World Health Organization mortality database. The potential years of life lost (PYLL) and annual average PYLL (APYLL) indicated OBDs. RESULTS In Korea, the number of ARD-attributable deaths and PYLL due to all ARDs during 1998-2013 were 4,492 and 71,763.7, respectively. The number of attributable deaths and PYLL due to asbestosis, malignant mesothelioma, lung cancer, laryngeal cancer, and ovarian cancer were 37 and 554.2, 808 and 15,877.0, 3,256 and 47,375.9, 120 and 1,605.5, and 271 and 6,331.1, respectively; additionally, the APYLL were 15.0, 19.7, 14.6, 13.4, and 23.4, respectively, and the average age at death was 70.4, 62.6, 69.1, 69.9, and 61.8, respectively. Our study showed that although the use of asbestos has ceased in Korea, the incidence of ARDs tends to increase. CONCLUSION Therefore, efforts to reduce future OBDs of ARDs, including early detection and proper management of ARDs, are needed in Korea.
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Affiliation(s)
- Dong-Mug Kang
- Department of Preventive, Occupational and Environmental Medicine, School of Medicine, Pusan National University, Yangsan, Korea
- Department of Occupational and Environmental Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Environmental Health Center, Pusan National University Yangsan Hospital, Yangsan, Korea
- Busan Workers Health Center, Pusan National University, Busan, Korea
| | - Jong-Eun Kim
- Department of Occupational and Environmental Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Environmental Health Center, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Occupational and Environmental Medicine, GoodGangAn Hospital, Busan, Korea
| | - Young-Ki Kim
- Department of Preventive, Occupational and Environmental Medicine, School of Medicine, Pusan National University, Yangsan, Korea
- Environmental Health Center, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyun-Hee Lee
- Busan Workers Health Center, Pusan National University, Busan, Korea
| | - Se-Yeong Kim
- Department of Occupational and Environmental Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Busan Workers Health Center, Pusan National University, Busan, Korea
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13
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Kang HW, Jung HD, Lee JY, Kwon JK, Jeh SU, Cho KS, Ham WS, Choi YD. Prediction of organ-confined disease after robot-assisted radical prostatectomy in patients with clinically locally-advanced prostate cancer. Asian J Surg 2017; 42:120-125. [PMID: 29274670 DOI: 10.1016/j.asjsur.2017.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/30/2017] [Accepted: 10/25/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Little is known about the preoperative predictive factors that could identify subsets of favorable patients who can be possibly cured with robot-assisted radical prostatectomy (RARP) alone in locally advanced prostate cancer (LAPCa). Our study was designed to identify clinical predictors of pathologic organ-confined disease (pOCD) in RARP setting. METHODS Between 2007 and 2013, clinicopathological and oncological data from 273 consecutive men undergoing robot-assisted RP with extended PLND for clinically LAPCa were reviewed in a single-institution, retrospectively. After exclusion of patients who received neoadjuvant hormone treatment before surgery, 186 subjects satisfied the final inclusion criteria. RESULTS Fourty-three patients (23.1% of total cohort) with preoperative clinically LAPCa patients were down-staged to pOCD following RARP. Preoperative prostate-specific antigen (PSA) level, preoperative PSAD, positive core percent, maximal tumor volume in any core, and biopsy Gleason score were significantly associated with down-staging into pOCD following RARP. Multivariate logistic regression analysis revealed that lower preoperative PSA (≤10 ng/mL) and maximal tumor volume in any core (≤70%) were independent predictors of pOCD following RARP. CONCLUSIONS Approximately 23% of preoperative clinically LAPCa patients were down-staged to pOCD following RARP. Preoperative PSA and maximal tumor volume in any biopsy core might be useful clinical predictors of pOCD in clinically LAPCa patients in RARP setting.
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Affiliation(s)
- Ho Won Kang
- Department of Urology, College of Medicine, Chungbuk National University Hospital, Chungbuk National University, Cheongju, South Korea
| | - Hae Do Jung
- Department of Urology, Yong-In Severance Hospital, Yonsei University College of Medicine, Yong-In, South Korea
| | - Joo Yong Lee
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Kyou Kwon
- Department of Urology, Severance Check-Up, Yonsei University Health System, Seoul, South Korea
| | - Seong Uk Jeh
- Department of Urology, Gyeongsang National University School of Medicine, Jinju, South Korea
| | - Kang Su Cho
- Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Won Sik Ham
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Deuk Choi
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
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Bae JM. Strategies for Appropriate Patient-centered Care to Decrease the Nationwide Cost of Cancers in Korea. J Prev Med Public Health 2017; 50:217-227. [PMID: 28768400 PMCID: PMC5541273 DOI: 10.3961/jpmph.17.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 06/16/2017] [Indexed: 12/29/2022] Open
Abstract
In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.
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Affiliation(s)
- Jong-Myon Bae
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
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Lim HS, Shin EJ, Yeom JW, Park YH, Kim SK. Association between Nutrient Intake and Metabolic Syndrome in Patients with Colorectal Cancer. Clin Nutr Res 2017; 6:38-46. [PMID: 28168180 PMCID: PMC5288551 DOI: 10.7762/cnr.2017.6.1.38] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 01/20/2017] [Accepted: 01/26/2017] [Indexed: 01/05/2023] Open
Abstract
The purpose of this study was to investigate the difference of nutritional status according to metabolic syndrome in colorectal cancer patients. The subjects were divided into 2 groups (metabolic syndrome group and normal group) according to the presence or absence of metabolic syndrome in 143 patients diagnosed with colorectal cancer, and their lifestyle and nutritional status were analyzed. Recall method was used for the dietary survey, and metabolic syndrome was defined as the presence of 3 or more of waist circumference, fasting blood glucose, triglyceride, high-density lipoprotein (HDL)-cholesterol, and blood pressure. This study showed that the metabolic syndrome group had a low age, a high body mass index (BMI), and a high drinking rate. The intake of energy, protein, fat, calcium, and phosphorus was significantly higher in the metabolic syndrome group than in the normal group, and the intake of β-carotene, vitamin C, and folic acid was significantly low. The intake of cholesterol, fatty acid, saturated fatty acid, and polyunsaturated fatty acid was also higher in the metabolic syndrome group. Higher BMI, alcohol consumption, intake of fat, total fatty acid or saturated fatty acid increased the risk of metabolic syndrome, but fiber, vitamin C, or folic acid intake lowered the risk.Weight management and balanced nutritional intake should be emphasized to prevent metabolic syndrome and to improve the condition in patients with colorectal cancer.
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Affiliation(s)
- Hee-Sook Lim
- Department of Clinical Nutrition, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea.; Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan 31151, Korea
| | - Eung-Jin Shin
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea
| | - Jeong-Won Yeom
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea
| | - Yoon-Hyung Park
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan 31151, Korea
| | - Soon-Kyung Kim
- Department of Food Sciences & Nutrition, Soonchunhyang University, Asan 31538, Korea
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