COVID-19: Original Article
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Worsening of health disparities across COVID-19 pandemic stages in Korea
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Hyejin Lee, Hyunwoo Nam, Jae-ryun Lee, Hyemin Jung, Jin Yong Lee
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Epidemiol Health. 2024;46:e2024038. Published online March 13, 2024
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DOI: https://doi.org/10.4178/epih.e2024038
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Abstract
Summary
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Abstract
OBJECTIVES
With the end of the coronavirus disease 2019 (COVID-19) pandemic, the health outcomes of this disease in Korea must be examined. We aimed to investigate health outcomes and disparities linked to socioeconomic status during the COVID-19 pandemic in Korea and to identify risk factors for hospitalization and mortality.
METHODS
This nationwide retrospective study incorporated an analysis of individuals with and without COVID-19 in Korea between January 1, 2020 and December 31, 2022. The study period was divided into 4 stages. Prevalence, hospitalization, mortality, and case-fatality rates were calculated per 100,000 population. Multivariate logistic regression was performed to identify risk factors for COVID-19 hospitalization and mortality.
RESULTS
Overall, the incidence rate was 40,601 per 100,000 population, the mortality rate was 105 per 100,000 population, and the case-fatality rate was 259 per 100,000 cases. A total of 12,577,367 new cases (24.5%) were recorded in stage 3 and 8,979,635 cases (17.5%) in stage 4. Medical Aid recipients displayed the lowest 3-year cumulative incidence rate (32,737 per 100,000) but the highest hospitalization (5,663 cases per 100,000), mortality (498 per 100,000), and case-fatality (1,521 per 100,000) rates. Male sex, older age, lower economic status, non-metropolitan area of residence, high Charlson comorbidity index, and disability were associated with higher risk of hospitalization and death. Vaccination was found to reduce mortality risk.
CONCLUSIONS
As the pandemic progressed, surges were observed in incidence, hospitalization, and mortality, exacerbating disparities associated with economic status and disability. Nevertheless, Korea has maintained a low case-fatality rate across all economic groups.
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Summary
Korean summary
국민건강보험공단 자료를 이용하여 2020-2022년 후향적 코호트를 구축하여 시기별 코로나19 유병률, 입원률, 사망률, 치명률과 장애, 소득에 따른 건강격차를 확인하였을 때, 코로나19 대유행이 진행됨에 따라 발병률, 입원률, 사망률이 급증하고 건강 격차가 확대되었다. 그러나 이러한 격차에도 불구하고 한국은 다른 국가들과 비교하여 모든 소득수준에서 낮은 치명률을 유지하였다.
Key Message
Using data from the National Health Insurance Service, a retrospective cohort for the years 2020-2022 was established. By examining the COVID-19 prevalence rate, hospitalisation rate, mortality rate, and case-fatality rate, along with health disparities based on disability and economic status, as the pandemic progressed, there was a surge in incidence, hospitalisation, and mortality, widening disparities related to economic status and disability. Despite these disparities, Korea has maintained a low case-fatality rate across all economic groups.
Original Articles
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An epidemic of cataract surgery in Korea: the effects of private health insurance on the National Health Insurance Service
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Hyejin Lee, Soo-Hee Hwang, Choon-Seon Park, Seol-Hee Chung, Catherine L. Chen, Jin Yong Lee, Jin Soo Lee
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Epidemiol Health. 2024;46:e2024015. Published online January 6, 2024
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DOI: https://doi.org/10.4178/epih.e2024015
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3,560
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Abstract
Summary
PDFSupplementary Material
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Abstract
OBJECTIVES
In Korea, the National Health Insurance Service (NHIS) covers essential healthcare expenses, including cataract surgery. To address concerns that private health insurance (PHI) might have inflated the need for such procedures, we investigated the extent of the PHI-attributable increase in cataract surgery and its impact on NHIS-reimbursed expenses.
METHODS
This retrospective, observational study uses nationwide claims data for cataract surgery from 2016 to 2020. We examined trends in utilization and cost, and we estimated the excess numbers of (1) cataract operations attributable to PHI and (2) types of intraocular lenses used for cataract surgery in 2020.
RESULTS
Between 2016 and 2020, a 36.8% increase occurred in the number of cataract operations, with increases of 63.5% and 731.8% in the total healthcare costs reimbursed by NHIS and PHI, respectively. Over a 5-year period, the surgical rate per 100,000 people doubled for patients aged <65 years (from 328 in 2016 to 664 in 2020). Among the 619,771 cases in 2020 of cataract surgery reimbursed by the Korean diagnosis-related group system, more non-NHIS-covered intraocular lenses were used for patients aged <65 years than ≥65 years (68.1 vs. 14.2%). In 2020 alone, an estimated 129,311 excess operations occurred, accounting for an excess cost of US$115 million.
CONCLUSIONS
A dramatic increase in the number and cost of cataract operations has occurred over the last 5 years. The PHI-related increase in operations resulted in increased costs to NHIS. Measures to curtail the non-indicated use of cataract surgery should be implemented regarding PHI.
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Summary
Korean summary
백내장 수술에서 실손보험으로 인한 의료비 증가 수준을 확인하고 건강보험급여 비용에 미치는 영향을 조사했을 때 2016년과 2020년 사이에 백내장 수술 건수는 36.8% 증가했으며, 건강보험과 실손보험에서 지급한 총 의료 비용은 각각 63.5%와 731.8% 증가했다. 백내장 수술은 65세 미만에서 주로 증가하였으며, 이 연령층은 공단에서 급여하지 않는 고가의 인공수정체를 더 많이 사용하였다. 추정 초과 수술 건수는 2020년에만 129,311건으로 1억 1,500만 달러의 초과 비용이 발생했다.
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Citations
Citations to this article as recorded by
- Global prevalence of cataract surgery
Hassan Hashemi, Faezeh Fayaz, Alireza Hashemi, Mehdi Khabazkhoob
Current Opinion in Ophthalmology.2024;[Epub] CrossRef
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The general public’s perspectives on telemedicine during the COVID-19 pandemic in Korea: analysis of a nationwide survey
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EunKyo Kang, Hyejin Lee, Ki Jeong Hong, Jieun Yun, Jin Yong Lee, Yun-Chul Hong
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Epidemiol Health. 2022;44:e2022020. Published online February 4, 2022
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DOI: https://doi.org/10.4178/epih.e2022020
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12,053
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Abstract
Summary
PDFSupplementary Material
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Abstract
OBJECTIVES
We investigated the awareness, experience, approval, intention to use, and the desired type of telemedicine among Korean general public.
METHODS
From November to December 2020, we conducted an online self-reported survey on awareness, experience, approval, and intent to use telemedicine services among Korean residents aged 20 years or older. A total of 2,097 participants completed the survey.
RESULTS
Of the 2,097 participants, 1,558 (74.3%) were aware of, 1,198 (57.1%) approved of, and 1,474 (70.3%) had the intention to use telemedicine. Participants from regions other than the Seoul metropolitan area and Daegu–Gyeongbuk Province (adjusted odds ratio [aOR], 1.29; 95% confidence interval [CI], 1.02 to 1.63), households with a monthly household income of US$6,000 or more (aOR, 1.44; 95% CI, 1.01 to 2.08), participants who had a college/university or associate’s degree (aOR, 1.35. 95% CI, 1.04 to 1.75) or a master’s degree or above (aOR, 1.73; 95% CI, 1.20 to 2.50), and housewives (aOR, 1.30; 95% CI, 1.03 to 1.64) had higher odds of approval. Elderly participants, those with a chronic disease (aOR, 1.26; 95% CI, 1.04 to 1.54), those who had experienced delays of healthcare services (aOR, 1.94; 95% CI, 1.27 to 2.96), and those who had experience with telemedicine (aOR, 4.28; 95% CI, 1.69 to 10.82) were more likely to intend to use telemedicine services. Regarding types of telemedicine, teleconsultation between doctors showed the highest approval rate (73.1%).
CONCLUSIONS
In the context of the coronavirus disease 2019 pandemic, more than 70% of participants had already used or intended to use telemedicine at some point. Groups with a substantial need for telemedicine were more in favor of telemedicine.
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Summary
Korean summary
대표성 있는 대상자에 대해 설문조사를 시행하였을 때, 74.3%가 원격의료에 대해 알고 있었다. 코로나19 유행지역, 소득이 높은 군, 대졸자 혹은 그 이상, 주부는 원격의료에 찬성할 가능성이 높았으며만성질환이 있는 고령자, 의료이용에 지연을 겪었던 사람, 원격의료를 이용해 본 사람은 원격의료 사용 의향이 더 높았다.
Key Message
We conducted an online self-reported survey on awareness, experience, approval, and intent to use telemedicine services among Korean residents aged 20 years or older. In the context of the coronavirus disease 2019 pandemic, more than 70% of participants had already used or intended to use telemedicine at some point.
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Citations
Citations to this article as recorded by
- A comparison of the characteristics of adult medicine patients seeking telemedicine consultations versus in-person consultations in a Philippine public hospital
Fatima Ericka S. Vista, Diana R. Tamondong-Lachica
Baylor University Medical Center Proceedings.2024; 37(1): 80. CrossRef - Selected Acute Safety Events Following the Use of Nirmatrelvir/Ritonavir or Molnupiravir for COVID‐19: A Nationwide Cohort Study in South Korea
Ju Hwan Kim, Ahhyung Choi, Gihwan Bae, Eun‐Jeong Joo, Min Joo Choi, Kyungmin Huh, Hyungmin Lee, Jungyeon Kim, Dong‐Hwi Kim, Min‐Gyu Yoo, Il Uk Jo, Poong Hoon Lee, Geun Woo Lee, Hee Sun Jung, Jaehun Jung, Ju‐Young Shin
Clinical Pharmacology & Therapeutics.2024;[Epub] CrossRef - Satisfaction Survey of Medical Staff for Telemedicine after the COVID-19 Pandemic: A Comparison Between the COVID-Pandemic and Post-COVID Pandemic Periods
Seung Eun Jung, Young-Mi Kwon, Soon-Yong Kwon, Young-Hoon Kim, Hyung-Youl Park
Telemedicine and e-Health.2024;[Epub] CrossRef - Factors Influencing the Behavioral Intentions and Use Behaviors of Telemedicine in Patients With Diabetes: Web-Based Survey Study
Huige Shao, Chaoyuan Liu, Li Tang, Bian Wang, Hebin Xie, Yiyu Zhang
JMIR Human Factors.2023; 10: e46624. CrossRef