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Data Profile
Data resource profile: the Korean Community Health Status Indicators (K-CHSI) database
Hye-Eun Lee, Yeon-gyeong Kim, Jin-Young Jeong, Dong-Hyun Kim
Epidemiol Health. 2023;45:e2023016.   Published online February 2, 2023
DOI: https://doi.org/10.4178/epih.e2023016
  • 4,134 View
  • 95 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Korean Community Health Status Indicators (K-CHSI) is a model-based database containing annual data on health outcomes and determinants at the municipal level (<i>si/gun/gu</i>-level regions, including mid-sized cities, counties, and districts). K-CHSI’s health outcomes include overall mortality, disease incidence, prevalence rates, and self-reported health. Health determinants were measured in 5 domains: socio-demographic factors, health behaviors, social environment, physical environment, and the healthcare system. The data sources are 71 public databases, including Causes of Death Statistics, Cancer Registration Statistics, Community Health Survey, Population Census, and Census on Establishments and Statistics of Urban Plans. This dataset covers Korea’s 17 metropolitan cities and provinces, with data from approximately 250 municipal regions (<i>si/gun/gu</i>). The current version of the database (DB version 1.3) was built using 12 years of data from 2008 to 2019. All data included in K-CHSI may be downloaded via the Korea Community Health Survey site, with no login requirement (https://chs.kdca.go.kr/chs/recsRoom/dataBaseMain.do). K-CHSI covers extensive health outcomes and health determinants at the municipal level over a period of more than 10 years, which enables ecological and time-series analyses of the relationships among various health outcomes and related factors.
Summary
Korean summary
지역사회 건강관련요인 데이터베이스는 17개 광역시도와 약 250개 시군구의 건강 결과 및 결정 요인에 대한 연간 데이터를 포함하는 모델 기반 데이터베이스이다. 본 데이터베이스의 건강 결과에는 사망률, 질병 발생률, 유병률, 자가 보고 건강상태 등이 포함되며 건강 결정 요인은 인구사회학적 환경, 건강 행태, 사회적 환경, 물리적 환경, 보건의료 체계의 5개 영역으로 구성되었다. 데이터는 질병관리청 지역사회건강조사 사이트에서 로그인 없이 다운로드할 수 있다(https://chs.kdca.go.kr/chs/recsRoom/dataBaseMain.do).
Key Message
Korean Community Health Status Indicators (K-CHSI) is a model-based database containing annual data on health outcomes and determinants from 17 metropolitan cities and provinces, with data from approximately 250 municipal regions (si/gun/gu). K-CHSI’s health outcomes include overall mortality, disease incidence, prevalence rates, and self-reported health. Health determinants were measured in 5 domains: socio-demographic factors, health behaviors, social environment, physical environment, and the healthcare system. The data included in K-CHSI may be downloaded via the Korea Community Health Survey site, with no login requirement (https://chs.kdca.go.kr/chs/recsRoom/dataBaseMain.do).
Original Articles
Evaluation of the accessibility and its equity of the national public-private mix program for tuberculosis in Korea: a multilevel analysis
Hyunjin Son, Changhoon Kim
Epidemiol Health. 2023;45:e2023002.   Published online December 7, 2022
DOI: https://doi.org/10.4178/epih.e2023002
  • 3,496 View
  • 138 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
To examine the effect of individual and area-level characteristics on the probability of public-private mix (PPM) support (PPM coverage) for tuberculosis (TB).
METHODS
This study is a retrospective cohort design using TB reporting and treatment management data in Korea. We analyzed PPM coverage through multilevel logistic regression and empirical Bayesian estimation according to individual and area-level characteristics and their interaction.
RESULTS
Patients aged 0-29 years, women, of Korean nationality, treated at a general hospital, a one-time reporting, urban areas, and the lowest deprivation index (DI) showed higher PPM coverage. Due to the cross-level interaction, PPM coverage in the urban areas (slope=-0.048, p<0.001) had a higher level but a steeper negative deprivation gradient than in rural areas (slope= -0.015, p<0.001). For a general hospital, the PPM coverage in urban is high but more significantly decreased than in rural areas with the higher DI (urban: slope=-0.047, p<0.001; rural: slope=-0.031, p<0.001). For clinics and hospitals, the effect of DI did not appear in urban areas, but in rural areas, the higher the DI, the higher the PPM coverage with a slope of 0.046 (p<0.001) and 0.063 (p<0.001), respectively.
CONCLUSIONS
The PPM program created a significant disparity in PPM coverage between urban-rural areas and type of healthcare provider according to DI. Considering the high risk of TB incidence in areas with higher DI, institutional improvement and program redesign are needed to improve accessibility and equity.
Summary
Korean summary
다수준 분석을 통해 시행하여 PPM(Public-Private Mix) 사업의 주요한 평가 지표인 PPM coverage를 접근성과 형평성 관점에서 검토하였다. PPM 사업은 전반적으로 치료지원 수준을 높이는 효과가 있었지만, 도시화수준, 박탈 수준과 치료지원기관 선택의 3원 교차수준 교호작용의 결과로 지역간 PPM coverage에 지역박탈지수에 따른 큰 기울기를 가진 격차를 만들었다. 지역박탈수준이 큰 지역의 높은 결핵 발생 위험을 고려하면 효율성과 함께 형평성 수준을 향상시킬 수 있는 제도적 개선과 프로그램의 보완이 필요하다.
Key Message
This study analyzed the effect of individual and area-level characteristics on the probability of public-private mix (PPM) coverage for tuberculosis (TB) in Korea. The PPM program created a significant disparity in PPM coverage between urban-rural areas and type of healthcare provider according to deprivation index (DI). Given the high TB risk in areas with high DI, there is a need for institutional improvement and program redesign to improve accessibility and equity.
Inequitable distribution of excess mortality during the COVID-19 pandemic in Korea, 2020
Jin-Hwan Kim, Saerom Kim, Eunhye Park, Chang-yup Kim
Epidemiol Health. 2022;44:e2022081.   Published online September 26, 2022
DOI: https://doi.org/10.4178/epih.e2022081
  • 6,875 View
  • 260 Download
  • 2 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
This study analyzed inequities in excess mortality according to region and socioeconomic position to explain the distribution of excess mortality in Korea in 2020.
METHODS
We acquired weekly all-cause mortality data from January 2015 to December 2020 from (1) the National Health Insurance Database and (2) Vital Statistics. Excess mortality for 2020 was calculated by comparing the weekly observed and expected deaths from the same period (2015-2019) using quasi-Poisson regression.
RESULTS
An inequitable distribution of excess mortality was identified. The estimated excess mortality in Korea was -29,112 (95% confidence interval, -29,832 to -28,391), corresponding to -55 per 100,000, and the ratio of observed deaths to expected deaths was 0.91. Negative excess mortality was observed except for females in the 0-14 age group. Male Medical Aid beneficiaries showed positive excess mortality, while non-disabled and disabled groups showed similar negative values. When the standardized mortality ratio was calculated for the top 10 causes of death, deaths from Alzheimer’s disease and septicemia increased, whereas those from diabetes mellitus and cerebrovascular disease decreased. The decrease in mortality was primarily concentrated in older adults, while the mortality of young females increased due to increased intentional self-harm.
CONCLUSIONS
This study adds essential evidence regarding the overall performance of Korea. The observed inequalities according to various socioeconomic variables indicate that the results of strict measures to control coronavirus disease 2019 were not distributed equitably. Efforts should be made to properly evaluate the current and future problems related to the pandemic.
Summary

Citations

Citations to this article as recorded by  
  • Did the socioeconomic inequalities in avoidable and unavoidable mortality worsen during the first year of the COVID-19 pandemic in Korea?
    Rora Oh, Myoung-Hee Kim, Juyeon Lee, Rangkyoung Ha, Jungwook Kim
    Epidemiology and Health.2023; 45: e2023072.     CrossRef
Physical activity level in Korean adults: the Korea National Health and Nutrition Examination Survey 2017
Ki-Yong An
Epidemiol Health. 2019;41:e2019047.   Published online November 9, 2019
DOI: https://doi.org/10.4178/epih.e2019047
  • 34,891 View
  • 254 Download
  • 21 Web of Science
  • 20 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study investigated physical activity (PA) participation based on demographic, physical, and psychological variables in Korean adults.
METHODS
Participants were divided into four groups (combined, aerobic only, resistance only, and neither) based on meeting the PA guidelines using moderate and vigorous PA time and resistance exercise frequency from the Korea National Health and Nutrition Examination Survey 2017. The association between meeting the PA guidelines and demographic, medical, fitness, lifestyle, and psychological variables were analyzed using complex samples crosstabs and a general linear model.
RESULTS
Of the 5,820 Korean adults, 66.0% did not meet any of the guidelines. Among demographic factors, sex, age, marital status, income, education level, occupation, and employment status were associated with meeting the PA guidelines. Chronic disease prevalence, weight, waist circumference, body mass index, diastolic blood pressure, glucose, high-density lipoprotein and triglyceride levels, hand-grip strength, resting heart rate, and family history of chronic disease in the medical and fitness variables; frequency of drinking and eating breakfast, total calorie, water, protein, and fat intake in the lifestyle variables; and perceived stress, depression, suicidal thoughts, and quality of life in the psychological variables were associated with meeting PA guidelines.
CONCLUSIONS
Most Korean adults participate in insufficient PA. Moreover, individuals who are socially underprivileged, have low-income or poor physical and mental health conditions participated in relatively less PA. Our findings suggest that government and individual efforts are required to increase PA and resolve health inequality in Korean adults.
Summary
Korean summary
2017년 국민건강영양조사 자료를 분석한 결과, 한국 성인들의 신체활동 실천율은 매우 낮았으며, 특히, 사회적 약자나 저소득층, 신체적, 정신적 건강 위험요인이 높은 사람들에게 더 낮게 나타났다. 신체활동은 건강증진을 위한 가장 경제적이며 효율적인 방법으로써, 신체활동 참여를 늘리고 건강불평등을 해소하기 위한 정부, 의료기관, 교육기관은 물론 국민 개개인의 신체활동에 대한 인식개선과 적극적인 노력이 필요하다.

Citations

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  • Physical activity and psychological adjustment among retirees: a systematic review
    Mehdi Sharifi, Davud Nodehi, Behzad Bazgir
    BMC Public Health.2023;[Epub]     CrossRef
  • 포토보이스를 활용한 베이비붐 세대 여성의 신체활동 참여 제약요인 탐색: 사회생태학적 모델을 기반으로＊
    우진 안, 채희 박
    The Korean Journal of Physical Education.2023; 62(1): 191.     CrossRef
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    Thi Phuong Thao Tran, Ngoc Minh Luu, Thi Tra Bui, Minji Han, Min Kyung Lim, Jin-Kyoung Oh
    European Review of Aging and Physical Activity.2023;[Epub]     CrossRef
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    Eun‐Jeong Kim, Do‐Hee Kim, Ra‐Gyeom Yu, Ye‐Jin Lee, Ye‐Jin Lee, Do‐Gyeong Im, Hye‐Ju Lee
    Gerodontology.2023;[Epub]     CrossRef
  • Effect of Short Bouts of Vigorous Stair Climbing on Cardiorespiratory Fitness in Women with Overweight and Obesity: A Pilot Feasibility Study
    Jeong Eun Yun, Xiaolin Wen, Minsub Han, Serim Cho, Jennifer L. Kuk, SoJung Lee
    Journal of Obesity & Metabolic Syndrome.2023; 32(4): 346.     CrossRef
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    Ze Liang, Wanzhou Wang, Chao Yang, Yueyao Wang, Jiashu Shen, Pengfei Li, Lin Ma, Feili Wei, Rui Chen, Chenyu Liang, Shuangcheng Li, Luxia Zhang
    Science of The Total Environment.2022; 806: 150628.     CrossRef
  • Continuing regular physical activity and maintaining body weight have a synergistic interaction in improving survival: a population-based cohort study including 6.5 million people
    Chang-Hoon Lee, Kyung-Do Han, Da Hye Kim, Min-Sun Kwak
    European Journal of Preventive Cardiology.2022; 29(3): 547.     CrossRef
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    Sang-Jun Lee, Sung-Soo Yoon, Myeong-Hoon Lee, Hye-Jun Kim, Yohwan Lim, Hyewon Park, Sun Jae Park, Seogsong Jeong, Hyun-Wook Han
    Journal of Clinical Medicine.2022; 11(11): 3181.     CrossRef
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    Takae Shinto, Saneyuki Makino, Yu Tahara, Lyie Nitta, Mai Kuwahara, Ayako Tada, Nanako Abe, Mikiko Michie, Shigenobu Shibata
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    Journal of Personalized Medicine.2022; 12(8): 1217.     CrossRef
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Pros and cons of the health transformation program in Iran: evidence from financial outcomes at the household level
Enayatollah Homaie Rad, Vahid Yazdi-Feyzabad, Shahrokh Yousefzadeh-Chabok, Abolhasan Afkar, Ahmad Naghibzadeh
Epidemiol Health. 2017;39:e2017029.   Published online July 18, 2017
DOI: https://doi.org/10.4178/epih.e2017029
  • 18,202 View
  • 202 Download
  • 28 Web of Science
  • 18 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The health transformation program was a recent reform in the health system of Iran that was implemented in early 2014. Some of the program’s important goals were to improve the equity of payments and to reduce out-of-pocket (OOP) payments and catastrophic health expenditures (CHE). In this study, these goals were evaluated using a before-and-after analysis.
METHODS
Data on household income and expenditures in Guilan Province were gathered for the years 2013 and 2015. OOP payments for outpatient, inpatient, and drug services were calculated, and the results were compared using the propensity score matching technique after adjusting for confounding variables. Concentration indices and curves were added to quantify changes in inequity before and after the reform. The incidence of catastrophic expenditures was then calculated.
RESULTS
Overall and outpatient service OOP payments increased by approximately 10 dollars, while for other types of services, no significant changes were found. Inequity and utilization of services did not change after the reform. However, a significant reduction was observed in CHE incidence (5.75 to 3.82%).
CONCLUSIONS
The reform was successful in decreasing the incidence of CHE, but not in reducing the monetary amount of OOP payments or affecting the frequency of health service utilization.
Summary

Citations

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