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The effect of public hospital closure on the death of long-term inpatients in Korea
Taeuk Kang, Minsung Sohn, Changwoo Shon
Epidemiol Health. 2024;46:e2024022.   Published online January 17, 2024
DOI: https://doi.org/10.4178/epih.e2024022
  • 1,605 View
  • 73 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study aimed to examine the changes in health outcomes and the patterns of medical institution utilization among patients with long-term stays in public hospitals following the closure of a public medical center. It also sought to present a proposal regarding the role of public hospitals in countries with healthcare systems predominantly driven by private entities, such as Korea.
METHODS
To assess the impact of a public healthcare institution closure on health outcomes in a specific region, we utilized nationally representative health insurance claims data. A retrospective cohort study was conducted for this analysis.
RESULTS
An analysis of the medical utilization patterns of patients after the closure of Jinju Medical Center showed that 67.4% of the total medical usage was redirected to long-term care hospitals. This figure is notably high in comparison to the 20% utilization rate of nursing hospitals observed among patients from other medical facilities. These results indicate that former patients of Jinju Medical Center may have experienced limitations in accessing necessary medical services beyond nursing care. After accounting for relevant mortality factors, the analysis showed that the mortality rate in closed public hospitals was 2.47 (95% confidence interval, 0.85 to 0.96) times higher than in private hospitals.
CONCLUSIONS
The closure of public medical institutions has resulted in unmet healthcare needs, and an observed association was observed with increased mortality rates. It is essential to define the role and objectives of public medical institutions, taking into account the distribution of healthcare resources and the conditions of the population.
Summary
Korean summary
본 연구는 사회보험제도를 기반으로 하고 있는 한국의 상황에서 지방의 공공의료기관 폐쇄가 환자들의 건강에 어떠한 영향을 미쳤는지를 확인하고자 국민건강보험 청구자료를 기반으로 후향적코호트 자료를 구축하여 분석을 시행하였다. 연구결과 장기 입원 환자의 67.4%가 장기요양병원을 의료를 이용하였고, 이는 비교집단의 장기요양 이용비율인 20% 수준보다 3배 가량 높은 수치로, 의료이용에 일부 제약이 발생하였을 가능성을 시사하는 것이다. 폐업 후 1년 이내 사망률을 비교한 결과, 인근지역 내 민간병원 환자와 비교하여 공공의료기관 입원환자의 사망확률은 2.67배였고, 의료급여 수급권자들의 사망확률은 고소득 5분위에 비해 2.24배 높은 것으로 나타났다.
Key Message
Even in Korea's healthcare system with high medical accessibility, adverse health impacts have been observed due to the closure of public healthcare institutions. Systematic policy development is necessary to evaluate essential medical service provision and allocate medical resources comprehensively.
Epidemiological data on nutritional disorders and outcomes in hospitalized Thai children: an analysis of data from the National Health Database 2015-2019
Suchaorn Saengnipanthkul, Jeeraparn Phosuwattanakul, Kaewjai Thepsuthammarat, Nalinee Chongviriyaphan
Epidemiol Health. 2022;44:e2022047.   Published online May 16, 2022
DOI: https://doi.org/10.4178/epih.e2022047
  • 8,002 View
  • 264 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Malnutrition in hospitalized patients is a frequently overlooked health issue. We aimed to assess the prevalence and pattern of nutritional disorders in hospitalized Thai children from the National Health Database.
METHODS
Hospitalized children aged 1 month to 18 years diagnosed with nutritional disorders between 2015 and 2019 were retrospectively reviewed using the National Health Security Office data. Based on the International Classification of Diseases, 10th revision, Clinical Modification, nutritional disorders were classified into 3 major forms of malnutrition: undernutrition (E40-E46), overweight and obesity (E66), and micronutrient deficiencies (D50-D53, E50-E56, E58, E60-E61, and E63).
RESULTS
Out of 5,188,033 hospitalized children, malnutrition was identified in 115,254 (2.2%). Protein-energy malnutrition (PEM), overweight and obesity, and micronutrient deficiencies were prevalent in 0.21%, 0.27%, and 1.81%, respectively. Among those with micronutrient deficiencies, 95.0% had iron deficiency anemia, 2.2% had vitamin D deficiency, and 0.7% had zinc deficiency. Children aged under 5 years mostly had PEM, followed by iron deficiency anemia. Teenagers commonly had obesity and vitamin D deficiency. Patients with PEM who were admitted with common diseases had significantly longer hospital stays and higher hospital costs and mortality rates than those without PEM.
CONCLUSIONS
Hospitalized children had various nutritional disorders, particularly PEM, which was associated with higher morbidity and mortality. Nutritional screening tools should be utilized for the early detection and treatment of malnutrition. Specific International Classification of Diseases codes for nutritional care services and intervention should be available. Additionally, nutritional interventions should be reimbursed, along with nutritional education and empowerment of healthcare providers, to improve hospital care service and improve patient outcomes.
Summary
Key Message
Malnutrition is common among hospitalized Thai children, particularly protein energy malnutrition; it increases mortality, length of hospital stay, and hospital costs as well as exerts long-term effects on growth and development. Prevalence of overweight and obesity is increasing over the past 5 years, the vast majority involved patients 5 – 13 years of age.

Citations

Citations to this article as recorded by  
  • The Low Sensitivity and Specificity of a Nutrition Screening Tool in Real Circumstances in a Tertiary Care Hospital Setting
    Nithit Semsawat, Oraporn Dumrongwongsiri, Phanphen Phoonlapdacha
    Children.2023; 10(4): 747.     CrossRef
Spatial analysis of tuberculosis treatment outcomes in Shanghai: implications for tuberculosis control
Jing Zhang, Xin Shen, Chongguang Yang, Yue Chen, Juntao Guo, Decheng Wang, Jun Zhang, Henry Lynn, Yi Hu, Qichao Pan, Zhijie Zhang
Epidemiol Health. 2022;44:e2022045.   Published online May 1, 2022
DOI: https://doi.org/10.4178/epih.e2022045
  • 7,902 View
  • 360 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Tuberculosis (TB) treatment outcomes are a key indicator in the assessment of TB control programs. We aimed to identify spatial factors associated with TB treatment outcomes, and to provide additional insights into TB control from a geographical perspective.
METHODS
We collected data from the electronic TB surveillance system in Shanghai, China and included pulmonary TB patients registered from January 1, 2009 to December 31, 2016. We examined the associations of physical accessibility to hospitals, an autoregression term, and random hospital effects with treatment outcomes in logistic regression models after adjusting for demographic, clinical, and treatment factors.
RESULTS
Of the 53,475 pulmonary TB patients, 49,002 (91.6%) had successful treatment outcomes. The success rate increased from 89.3% in 2009 to 94.4% in 2016. The successful treatment outcome rate varied among hospitals from 78.6% to 97.8%, and there were 12 spatial clusters of poor treatment outcomes during the 8-year study period. The best-fit model incorporated spatial factors. Both the random hospital effects and autoregression terms had significant impacts on TB treatment outcomes, ranking 6th and 10th, respectively, in terms of statistical importance among 14 factors. The number of bus stations around the home was the least important variable in the model.
CONCLUSIONS
Spatial autocorrelation and hospital effects were associated with TB treatment outcomes in Shanghai. In highly-integrated cities like Shanghai, physical accessibility was not related to treatment outcomes. Governments need to pay more attention to the mobility of patients and different success rates of treatment among hospitals.
Summary
Key Message
Tuberculosis treatment outcomes, a key indicator in the assessment of TB control programs, were associated with spatial autocorrelation and hospital effects in Shanghai; however, they were not associated with physical accessibility to hospitals.
The impact of COVID-19 on cancer care in a tertiary hospital in Korea: possible collateral damage to emergency care
Shin Hye Yoo, Jin-Ah Sim, Jeongmi Shin, Bhumsuk Keam, Jun-Bean Park, Aesun Shin
Epidemiol Health. 2022;44:e2022044.   Published online May 1, 2022
DOI: https://doi.org/10.4178/epih.e2022044
  • 9,165 View
  • 322 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We investigated the impact of the COVID-19 pandemic on cancer care in a tertiary hospital in Korea without specific lockdown measures.
METHODS
A retrospective cohort of cancer patients from one of the largest tertiary hospitals in Korea was used to compare healthcare utilization in different settings (outpatient cancer clinic, the emergency department [ED], and admissions to the hematology/oncology ward) between January 1 and December 31, 2020 and the same time period in 2019. The percent changes in healthcare utilization between the 2 periods were calculated.
RESULTS
A total of 448,833 cases from the outpatient cohort, 26,781 cases from the ED cohort, and 14,513 cases from the admission cohort were reviewed for 2019 and 2020. The total number of ED visit cases significantly decreased from 2019 to 2020 by 18.04%, whereas the proportion of cancer patients remained stable. The reduction in ED visits was more prominent in patients with symptoms suspicious for COVID-19, high-acuity cases, and those who lived in non-capital city areas. There were no significant changes in the number of total visits, new cases in the outpatient clinic, or the total number of hospitalizations between the 2 periods.
CONCLUSIONS
During the pandemic, the number of ED visits significantly decreased, while the use of the outpatient clinic and hospitalizations were not affected. Cancer patients’ ED visits decreased after the COVID-19 outbreak, suggesting the potential for collateral damage outside the hospital if patients cannot reach the ED in a timely manner.
Summary
Korean summary
코로나19 이전인 2019년에 비해 코로나19 유행 첫 해인 2020년에 암환자의 1개 상급종합병원 응급실 방문이 유의하게 감소하였고, 특히 코로나19 의심 증상이 있거나, 중증도가 높거나, 비수도권 지역에 거주하는 환자에서 응급실 방문의 감소가 뚜렷하였다. 코로나19 이전과 코로나19 유행 시 외래 방문 암환자의 수, 신환 수는 큰 차이가 없었고, 입원한 암환자의 수 역시 유의한 차이가 없었다. 코로나19 대유행 시 암환자의 응급실 방문 감소는 병원 밖에서 적시에 응급실에 방문하지 못하는 부수적 피해의 가능성을 시사하여, 이에 대한 관심이 필요하다.
Key Message
The study identified a significant decrease in the emergency department visits of the cancer patients at a tertiary hospital in Korea during the COVID-19 pandemic. There were no significant changes in the number of total visits, new cases in the outpatient clinic, or the total number of hospitalizations between pre-COVID-19 and during-COVID-19 periods.

Citations

Citations to this article as recorded by  
  • Government Initiatives for Research Ethics During COVID-19 Pandemic in Korea
    Young Su Park, Ock-Joo Kim
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Impact of coronavirus disease 2019 on cancer care: How the pandemic has changed cancer utilization and expenditures
    Jinah Sim, Jihye Shin, Hyun Jeong Lee, Yeonseung Lee, Young Ae Kim, Chong-Chi Chiu
    PLOS ONE.2024; 19(2): e0296808.     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
  • COVID-19 Outbreak in Daegu City, Korea and Response to COVID-19: How Have We Dealt and What Are the Lessons?
    Shin-Woo Kim
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
Model-based cost-effectiveness analysis of oral antivirals against SARS-CoV-2 in Korea
Youngji Jo, Sun Bean Kim, Munkhzul Radnaabaatar, Kyungmin Huh, Jin-Hong Yoo, Kyong Ran Peck, Hojun Park, Jaehun Jung
Epidemiol Health. 2022;44:e2022034.   Published online March 12, 2022
DOI: https://doi.org/10.4178/epih.e2022034
  • 13,993 View
  • 654 Download
  • 13 Web of Science
  • 14 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Many countries have authorized the emergency use of oral antiviral agents for patients with mild-to-moderate cases of coronavirus disease 2019 (COVID-19). We assessed the cost-effectiveness of these agents for reducing the number of severe COVID-19 cases and the burden on Korea’s medical system.
METHODS
Using an existing model, we estimated the number of people who would require hospital/intensive care unit (ICU) admission in Korea in 2022. The treatment scenarios included (1) all adult patients, (2) elderly patients only, and (3) adult patients with underlying diseases only, compared to standard care. Based on the current health system capacity, we calculated the incremental costs per severe case averted and hospital admission for each scenario.
RESULTS
We estimated that 236,510 COVID-19 patients would require hospital/ICU admission in 2022 with standard care only. Nirmatrelvir/ritonavir (87% efficacy) was predicted to reduce this number by 80%, 24%, and 17% when targeting all adults, adults with underlying diseases, and elderly patients (25, 8, and 4%, respectively, for molnupiravir, with 30% efficacy). Nirmatrelvir/ritonavir use is likely to be cost-effective, with predicted costs of US$8,878, US$8,964, and US$1,454, per severe patient averted for the target groups listed above, respectively, while molnupiravir is likely to be less cost-effective, with costs of US$28,492, US$29,575, and US$7,915, respectively.
CONCLUSIONS
In Korea, oral treatment using nirmatrelvir/ritonavir for symptomatic COVID-19 patients targeting elderly patients would be highly cost-effective and would substantially reduce the demand for hospital admission to below the capacity of the health system if targeted to all adult patients instead of standard care.
Summary
Korean summary
본 연구는 감염병 수리모형을 바탕으로 두가지 항바이러스제의 (nirmatrelvir/ritonavir와 molnupiravir) 비용 효익을 평가하였다. 본 모델에 따르면, 2022년 한국에서, 현재 의료시스템의 수용한계를 넘는 코로나 19 대유행이 발생할 때, nirmatrelvir/ritonavir 를 코로나 감염 및 증상 있는 고령층 환자들을 대상으로 투여할 경우 높은 비용 효익이 기대되고 (중증환자 1명 감소효과에$1,454 비용소요), 성인 환자 대상으로 투여할 경우, (molnupiravir이나 nirmatrelvir/ritonavir를 투여하지 않는) 일반 치료에 비해서 전체 입원 수요를 80% 줄일 것으로 기대된다.
Key Message
Given an expected high epidemic resurgence in 2022 that could exceed South Korea’s current health system capacity, oral treatment using nirmatrelvir/ritonavir for symptomatic COVID-19 patients may be a highly cost-effective solution if targeted to elderly patients ($1,454 per severe case averted) and substantially reduce the demand for hospital admission (80%, 188,478 patients) below the capacity of the health system if targeted to all adult patients compared to standard care.

Citations

Citations to this article as recorded by  
  • Cost-Utility Model of Nirmatrelvir/Ritonavir in Brazil: Analysis of a Vaccinated Population
    Ricardo R.A. Fernandes, Bruno M. Barros, Milene R. da Costa, Carlos A.S. Magliano, Bernardo R. Tura, Quenia Cristina D. Morais, Marisa Santos
    Value in Health Regional Issues.2024; 40: 74.     CrossRef
  • Cost-effectiveness of nirmatrelvir/ritonavir for high-risk adult outpatients with COVID-19 in Japan
    Takahito Mizuno, Yu Kondo, Mikiyasu Sakai, Kenichi Saneyasu, Ryota Kojima, Yoshio Miyake
    Journal of Infection and Chemotherapy.2024;[Epub]     CrossRef
  • Lessons Learned from Model-based Economic Evaluations of COVID-19 Drug Treatments Under Pandemic Circumstances: Results from a Systematic Review
    Clazinus Veijer, Marinus H. van Hulst, Benjamin Friedrichson, Maarten J. Postma, Antoinette D.I. van Asselt
    PharmacoEconomics.2024; 42(6): 633.     CrossRef
  • Economic Evaluation of Nirmatrelvir/Ritonavir Among Adults Against Hospitalization During the Omicron Dominated Period in Malaysia: A Real-World Evidence Perspective
    Ee Vien Low, Hoon Shien Teh, Nicholas Yee Liang Hing, Suresh Kumar Chidambaram, Mohan Dass Pathmanathan, Wee Ric Kim, Wei Jia Lee, Zhi Wei Teh, Maheshwara Rao Appannan, Shahanizan Mohd Zin, Faizah Muhamad Zin, Samha Bashirah Mohamed Amin, Mastura Ismail,
    Drugs - Real World Outcomes.2024;[Epub]     CrossRef
  • Impact of the Use of Oral Antiviral Agents on the Risk of Hospitalization in Community Coronavirus Disease 2019 Patients (COVID-19)
    Terry Cheuk-Fung Yip, Grace Chung-Yan Lui, Mandy Sze-Man Lai, Vincent Wai-Sun Wong, Yee-Kit Tse, Bosco Hon-Ming Ma, Elsie Hui, Maria K W Leung, Henry Lik-Yuen Chan, David Shu-Cheong Hui, Grace Lai-Hung Wong
    Clinical Infectious Diseases.2023; 76(3): e26.     CrossRef
  • Nirmatrelvir plus ritonavir in COVID-19: a profile of its use
    Hannah A. Blair
    Drugs & Therapy Perspectives.2023; 39(2): 41.     CrossRef
  • Cost-effectiveness analysis of ritonavir boosted nirmatrelvir for adult outpatients with mild to moderate COVID-19 in a European health system
    Philip Wikman-Jorgensen, José María Ibarra, Carlos Devesa, Jorge Peris, Jara Llenas-García
    European Journal of Internal Medicine.2023; 118: 133.     CrossRef
  • Assessing the cost-effectiveness of annual COVID-19 booster vaccination in South Korea using a transmission dynamic model
    Wongyeong Choi, Eunha Shim
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Multi-Faceted Analysis of COVID-19 Epidemic in Korea Considering Omicron Variant: Mathematical Modeling-Based Study
    Youngsuk Ko, Victoria May Mendoza, Renier Mendoza, Yubin Seo, Jacob Lee, Jonggul Lee, Donghyok Kwon, Eunok Jung
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Adjusting non-pharmaceutical interventions based on hospital bed capacity using a multi-operator differential evolution
    Victoria May P. Mendoza, Renier Mendoza, Jongmin Lee, Eunok Jung
    AIMS Mathematics.2022; 7(11): 19922.     CrossRef
  • The Possible Impact of Nationwide Vaccination on Outcomes of the COVID-19 Epidemic in North Korea: A Modelling Study
    Sung-mok Jung, Jaehun Jung
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Medications for early treatment of COVID ‐19 in Australia
    Adam Polkinghorne, James M Branley
    Medical Journal of Australia.2022;[Epub]     CrossRef
  • Comparative effectiveness of sotrovimab and molnupiravir for prevention of severe covid-19 outcomes in patients in the community: observational cohort study with the OpenSAFELY platform
    Bang Zheng, Amelia C A Green, John Tazare, Helen J Curtis, Louis Fisher, Linda Nab, Anna Schultze, Viyaasan Mahalingasivam, Edward P K Parker, William J Hulme, Sebastian C J Bacon, Nicholas J DeVito, Christopher Bates, David Evans, Peter Inglesby, Henry D
    BMJ.2022; : e071932.     CrossRef
  • Treatment Options for Patients With Mild-to-Moderate Coronavirus Disease 2019 in Korea
    Jaehyun Jeon, BumSik Chin
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
COVID-19: Epidemiologic Investigation
Experience of a COVID-19 outbreak response in a general hospital in Gyeonggi Province, Korea
Chanhee Kim, Gawon Choi, Shin Young Park, Jieun Kim, Young Joon Park, Kyungnam Kim
Epidemiol Health. 2021;43:e2021083.   Published online October 18, 2021
DOI: https://doi.org/10.4178/epih.e2021083
  • 8,176 View
  • 138 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Coronavirus disease 2019 (COVID-19) outbreaks in general hospitals are particularly risky because they not only overburden the regional healthcare delivery system, but also increase the possibility of community transmission. This study shares an experience of a COVID-19 outbreak response in a general hospital in Gyeonggi Province, Korea.
METHODS
Since the first COVID-19 confirmed case was recognized in Hospital A on March 29, 2020, the Immediate Response Team of Gyeonggi Province and Korea Disease Control and Prevention Agency devised a plan to conduct an epidemiological investigation and minimize the paralysis of hospital functions. Apart from the epidemiological investigation, a risk assessment of the hospital and management of contacts, including patients and workers, were also undertaken.
RESULTS
In total, 72 confirmed cases were identified, including 26 hospitalized patients, 16 healthcare personnel, 7 visitors, and 22 cases identified externally. The majority of the confirmed cases were exposed in Ward B or were contacts of people exposed in Ward A (58.3% of 72 cases). Among healthcare personnel, caregivers were found to be the most vulnerable to COVID-19 in this outbreak.
CONCLUSIONS
Preparation for all possible situations in medical facilities is important because it is difficult to find alternative resources. The findings of this study provide information on controlling the further transmission of COVID-19 and furnish evidence of the importance of ordinary management skills to be prepared for COVID-19.
Summary
Korean summary
본 연구에서는 2020년 경기도 소재 한 종합병원에서 발생한 코로나19 유행 대응 사례 경험을 공유한다. 병원 외 지역사회 전파 사례를 포함하여 총 72명의 확진자가 이 유행에서 확인되었다. 종합병원은 지역 의료전달체계에서 중요한 역할을 하고 있기 때문에 코로나19로 인해 그 기능이 마비되지 않도록 예방하는 것이 가장 바람직하며, 이를 위해서는 평상 시에 적절한 대비 체계를 갖추어 두어야 한다.
Key Message
This study shares the experience of responding to the COVID-19 outbreak at a general hospital in Gyeonggi-do, 2020. A total of 72 confirmed cases were identified, including cases of community based transmission outside the hospital. Since general hospitals play an important role in the medical delivery system, it is most desirable to prevent the function from being paralyzed by COVID-19 situation, and for this, and appropriate preparedness should be established.

Citations

Citations to this article as recorded by  
  • Vaccine effectiveness and the epidemiological characteristics of a COVID-19 outbreak in a tertiary hospital in Republic of Korea
    Seonhee Ahn, Tae Jong Son, Yoonsuk Jang, Jihyun Choi, Young Joon Park, Jiseon Seong, Hyun Hee Kwon, Muk Ju Kim, Donghyok Kwon
    Osong Public Health and Research Perspectives.2023; 14(3): 188.     CrossRef
  • Effect of changes in the hearing aid subsidy on the prevalence of hearing loss in South Korea
    Chul Young Yoon, Junhun Lee, Tae Hoon Kong, Young Joon Seo
    Frontiers in Neurology.2023;[Epub]     CrossRef
Data Profile
Data resource profile: the Korea National Hospital Discharge In-depth Injury Survey
Yeon-Kyeng Lee, Sung Ok Hong, Soo-Jung Park, Mijin Park, Kyunghae Wang, Mini Jo, Jeongah Oh, Sin Ae Lee, Hyeon Ju Lee, Jungeun Oh, Dosang Lim, Sanghui Kweon, Youngtaek Kim
Epidemiol Health. 2021;43:e2021052.   Published online August 17, 2021
DOI: https://doi.org/10.4178/epih.e2021052
  • 9,110 View
  • 111 Download
  • 6 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
The Korea National Hospital Discharge In-depth Injury Survey (KNHDIS), which was started in 2005, is a national probability survey of general hospitals in Korea with 100 or more beds conducted by the Korea Disease Control and Prevention Agency (KDCA). The KNHDIS captures approximately 9% of discharged cases from sampled hospitals using a 2-stage stratified cluster sampling scheme, among which 13% are injury related cases, defined as S00-T98 (injury, poisoning, and certain other consequences of external causes) using International Classification of Diseases, 10th revision codes. The KNHDIS collects information on characteristics of injury-related discharges in order to understand the scale of injuries, identify risk factors, and provide data supporting prevention policies and intervention strategies. The types of data captured include the hospitals’ information, detailed clinical information, and injury-related codes such as the mechanism, activities undertaken when injured (sports, leisure activities, work, treatment, and education), external causes of the injury, and location of the occurrence of the injury based on the International Classification of External Causes of Injuries. Furthermore, the means of transportation, risk factors for suicide, and toxic substances are recoreded. Annual reports of the KNHDIS are publicly accessible to browse via the KDCA website (http://www.kdca.go.kr) and microdata are available free of charge upon request via email (kcdcinjury@korea.kr).
Summary
Korean summary
퇴원손상심층조사는 손상발생 규모 및 손상 퇴원환자의 발생 추이를 파악하고자 2005년 도입된국가 단위 통계를 산출하는 표본 조사 사업이다. 본 연구는 퇴원손상심층조사의 표본설계, 조사방법, 조사항목과 함께 그간의 조사결과의 활용도 등 성과에 대해 살펴보았다. 조사결과는 국가 손상예방관리를 위한 기초자료로 활용되고 있으며, 조사 원자료는 공개하고 있다.
Key Message
The Korea National Hospital Discharge In-depth Injury Survey (KNHDIS), started in 2005, is a national probability survey of general hospitals in Korea with 100 or more beds conducted by the Korea Disease Control and Prevention Agency. The KNHDIS collects information on characteristics of injury-related discharges to understand the scale of injuries, identify risk factors, and provide data supporting prevention policies. The data captured including the hospitals’ information, and injury-related codes based on the International Classification of External Causes of Injuries. Annual reports of the KNHDIS are publicly accessible from KDCA website and microdata are available upon request via email.

Citations

Citations to this article as recorded by  
  • Temporal trends and the association between self-rated oral health and falls in community-dwelling older adults in South Korea: a secondary analysis of survey data
    Hyun-Ju Seo, Soon-Ki Ahn, Min-Jung Choi
    BMJ Open.2024; 14(4): e081549.     CrossRef
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    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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Original Article
Main results of the Korea National Hospital Discharge In-depth Injury Survey, 2004-2016
Sung Ok Hong, Boae Kim, Joongho Jo, Yunhyung Kwon, Yeon-Kyeng Lee, Youngtaek Kim
Epidemiol Health. 2020;42:e2020044.   Published online June 20, 2020
DOI: https://doi.org/10.4178/epih.e2020044
  • 11,217 View
  • 152 Download
  • 7 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The purpose of this study was to estimate the incidence of injuries and to identify their causes by classifying injuries according to various categories including age, sex, mechanism of injury, body parts injured, and place of injury.
METHODS
This study used data from the Korea National Hospital Discharge In-depth Injury Survey (KNHDIS) from 2004 to 2016. The KNHDIS is conducted annually by the Korea Centers for Disease Control and Prevention, and its survey population includes all hospitalized patients discharged from medical institutions that have 100 or more beds, such as hospitals, general hospitals, and secondary community health centers. The number of injured cases is weighted and estimated using the mid-year estimated population of each year.
RESULTS
The injury discharge rate steadily increased since 2004 (1,505 per 100,000 population in 2004, 2,007 per 100,000 population in 2016) and most injuries were unintentional (annual average of 94.7%). On average, during the 13-year study period, the injury rate for males was 1.5 times as high as for females. The 2 main causes of injury were consistently traffic accidents and falls. Notably, the rate of injuries resulting from falls rose by 1.7-fold from 463 to 792 per 100,000 people, and exceeded the rate of traffic accidents in 2016.
CONCLUSIONS
The incidence of injuries steadily increased after the survey was first conducted, whereas mortality resulting from injuries mostly remained unchanged. This suggests that effective strategies and interventions should be reinforced to reduce unintentional injuries.
Summary
Korean summary
질병관리본부가 2005년부터 구축하여 운영 중에 있는 퇴원손상심층조사의 연도별 조사자료를 분석한 결과 10만명당 손상발생규모는 2004년 1,505명에서 2016년 2,007명으로 지속적으로 증가하였다. 이러한 꾸준한 증가 추세는, 손상으로 인한 사망률은 감소하였을지라도 손상 예방을 위한 효과적인 정책과 전략, 지속적인 모니터링이 필요성을 제시한다.

Citations

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  • The Impact of the Association between Cancer and Diabetes Mellitus on Mortality
    Sung-Soo Kim, Hun-Sung Kim
    Journal of Personalized Medicine.2022; 12(7): 1099.     CrossRef
  • Comparison of Prediction Models for Mortality Related to Injuries from Road Traffic Accidents after Correcting for Undersampling
    Yookyung Boo, Youngjin Choi
    International Journal of Environmental Research and Public Health.2021; 18(11): 5604.     CrossRef
Systematic Review
Medication errors among Iranian emergency nurses: A systematic review
Zohreh Hosseini Marznaki, Somaye Pouy, Waliu Jawula Salisu, Amir Emami Zeydi
Epidemiol Health. 2020;42:e2020030.   Published online May 13, 2020
DOI: https://doi.org/10.4178/epih.e2020030
  • 14,486 View
  • 340 Download
  • 11 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Medication errors (MEs) made by nurses are the most common errors in emergency departments (EDs). Identifying the factors responsible for MEs is crucial in designing optimal strategies for reducing such occurrences. The present study aimed to review the literature describing the prevalence and factors affecting MEs among emergency ward nurses in Iran.
METHODS
We searched electronic databases, including the Scientific Information Database, PubMed, Cochrane Library, Web of Science, Scopus, and Google Scholar, for scientific studies conducted among emergency ward nurses in Iran. The studies were restricted to full-text, peer-reviewed studies published from inception to December 2019, in the Persian and English languages, that evaluated MEs among emergency ward nurses in Iran.
RESULTS
Eight studies met the inclusion criteria. Most of the nurses (58.9%) had committed MEs only once. The overall mean rate of MEs was 46.2%, and errors made during drug administration accounted for 41.7% of MEs. The most common type of administration error was drug omission (17.8%), followed by administering drugs at the wrong time (17.5%) and at an incorrect dosage (10.6%). The lack of an adequate nursing workforce during shifts and improper nurse-patient ratios were the most critical factors affecting the occurrence of MEs by nurses.
CONCLUSIONS
Despite the increased attention on patient safety in Iran, MEs by nurses remain a significant concern in EDs. Therefore, nurse managers and policy-makers must take adequate measures to reduce the incidence of MEs and their potential negative consequences.
Summary

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    Fateme Mohammadi, Sanaz Rustaee, Mostafa Bijani
    Nursing Open.2024;[Epub]     CrossRef
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Original Article
The burden of infectious and cardiovascular diseases in India from 2004 to 2014
Kajori Banerjee, Laxmi Kant Dwivedi
Epidemiol Health. 2016;38:e2016057.   Published online December 14, 2016
DOI: https://doi.org/10.4178/epih.e2016057
  • 15,552 View
  • 259 Download
  • 6 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
In India, both communicable and non-communicable diseases have been argued to disproportionately affect certain socioeconomic strata of the population. Using the 60th (2004) and 71st (2014) rounds of the National Sample Survey, this study assessed the balance between infectious diseases and cardiovascular diseases (CVD) from 2004 to 2014, as well as changes in the disease burden in various socioeconomic and demographic subpopulations.
METHODS
Prevalence rates, hospitalization rates, case fatality rates, and share of in-patients deaths were estimated to compare the disease burdens at these time points. Logistic regression and multivariate decomposition were used to evaluate changes in disease burden across various socio-demographic and socioeconomic groups.
RESULTS
Evidence of stagnation in the infectious disease burden and rapid increase in the CVD burden was observed. Along with the drastic increase in case fatality rate, share of in-patients deaths became more skewed towards CVD from 2004 to 2014. Logistic regression analysis demonstrated a significant shift of the chance of succumbing to CVD from the privileged class, comprising non-Scheduled Castes and Tribes, more highly educated individuals, and households with higher monthly expenditures, towards the underprivileged population. Decomposition indicated that a change in the probability of suffering from CVD among the subcategories of age, social groups, educational status, and monthly household expenditures contributed to the increase in CVD prevalence more than compositional changes of the population from 2004 to 2014.
CONCLUSIONS
This study provides evidence of the ongoing tendency of CVD to occur in older population segments, and also confirms the theory of diffusion, according to which an increased probability of suffering from CVD has trickled down the socioeconomic gradient.
Summary

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MERS-Editorial
2015 MERS outbreak in Korea: hospital-to-hospital transmission
Moran Ki
Epidemiol Health. 2015;37:e2015033.   Published online July 21, 2015
DOI: https://doi.org/10.4178/epih/e2015033
  • 39,923 View
  • 411 Download
  • 42 Web of Science
  • 152 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The distinct characteristic of the Middle East Respiratory Syndrome (MERS) outbreak in South Korea is that it not only involves intra-hospital transmission, but it also involves hospital-to-hospital transmission. It has been the largest MERS outbreak outside the Middle East, with 186 confirmed cases and, among them, 36 fatal cases as of July 26, 2015. All confirmed cases are suspected to be hospital-acquired infections except one case of household transmission and two cases still undergoing examination. The Korean health care system has been the major factor shaping the unique characteristics of the outbreak. Taking this as an opportunity, the Korean government should carefully assess the fundamental problems of the vulnerability to hospital infection and make short- as well as long-term plans for countermeasures. In addition, it is hoped that this journal, <i>Epidemiology and Health</i>, becomes a place where various topics regarding MERS can be discussed and shared.
Summary
Korean summary
한국의 메르스 유행은 병원내 감염뿐 아니라 병원에서 병원으로 전파되는 양상을 보인 것이 특징이다. 사우디아라비아 다음으로 가장 많은 환자가 발생하였는데 전체 확진자는 186명이고, 이중에 사망자는 36명이다. 확진자 대부분이 병원에서 감염된 것으로 추정된다. 가족간 감염이 의심되는 경우는 1명정도이며, 2명은 경로를 조사중인데 이중에 한명은 지역사회 감염이 의심된다. 한국의 의료체계 특성이 이번 유행에 중요한 요인이 되었다. 이 기회에 한국은 병원감염관리에 취약한 우리의 근본적인 문제점을 살펴서 장단기적인 대책을 마련하여야 할 것이다. 또한 역학회지가 메르스와 관련된 다양한 주제가 논의되는 장이 되기를 바란다.

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Original Articles
Admission route and use of invasive procedures during hospitalization for acute myocardial infarction: analysis of 2007-2011 National Health Insurance database
Hyungseon Yeom, Dae Ryong Kang, Seong Kyung Cho, Seung Won Lee, Dong-Ho Shin, Hyeon Chang Kim
Epidemiol Health. 2015;37:e2015022.   Published online May 1, 2015
DOI: https://doi.org/10.4178/epih/e2015022
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The goal of this study was to investigate trends in admission to the emergency department and the use of invasive or surgical procedures during hospitalization for acute myocardial infarction (AMI) in Korea.
METHODS
The National Health Insurance (NHI) claims database between 2007 and 2011 was used. We identified all admission claims that included codes from the tenth revision of the International Classification of Diseases beginning with I21 as the primary or secondary diagnosis. Information about the admission route, admission date, discharge date, and whether coronary artery angiography, angioplasty, or bypass surgery was performed was also obtained from the NHI database.
RESULTS
Of the 513,886 relevant admission claims over the five years encompassed by this study, 295,001 discrete episodes of admission for AMI were identified by analyzing the date and length of each admission and the interval between admissions. The number of AMI admissions gradually decreased from 66,883 in 2007 to 47,656 in 2011. The number and proportion of admissions through the emergency department also decreased from 38,118 (57.0%) in 2007 to 24,001 (50.4%) in 2011. However, during the same period, admissions in which invasive or surgical procedures were performed increased from 15,342 (22.9%) to 17,505 (36.7%).
CONCLUSIONS
The reported numbers of emergency department visits and admissions for AMI decreased from 2007 to 2011. However, only a small portion of the patients underwent invasive or surgical procedures during hospitalization, although the number of admissions involving invasive or surgical procedures has increased. These findings suggest that simply counting the number of admission claims cannot provide valid information on trends in AMI occurrence.
Summary
Korean summary
급성심근경색 환자의 급성기 의료이용행태를 조사하기 위해 2007년부터 2011년까지 급성심근경색증 진단명(ICD-10 코드 I21.x)을 포함하는 입원 청구자료 513,886건을 분석하였다. 총 295,001건의 독립된 입원 에피소드를 추출하여 분석한 결과, 5년동안 전체 입원건수와 응급실 경유 입원건수는 감소한 반면, 진단 또는 치료 목적의 침습적 시술을 동반한 입원은 증가하였다. 건강보험청구자료를 이용하여 급성심근경색증 발생 규모를 파악할 때, 진단명만으로는 정확한 추계가 어려우며 관련 시술 등의 의료이용 정보를 추가하는 것이 필요할 것이다.

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Measles Outbreak among Institutional Infants after Hospital Infection.
Hyung Cheol Park, Eun Young Park, Sun Hee Cho, Young Jun Choi, Hyun Kyun Ki, Young Hwa Jung, Kyung Rye Moon, So Yeon Ryu, Ki Soon Kim
Korean J Epidemiol. 2001;23(1):50-58.
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AbstractAbstract PDF
Abstract
PURPOSE
S: This study was to investigate the source of infection, mode of transmission and incidence of a measles outbreak among infants living in a Gwangju welfare institution in July 2000.
METHODS
The information about 63 children was collected through the nurses interview and blood sampling and laryngopharyngeal swab were conducted to the children. In addition, an epidemiologic survey was performed to confirm the infection dissemination route.
RESULTS
Before the outbreak, two children living at the institution were admitted to a university hospital for other health problems. These children shared a room with a 5 year old diagnosed with meningitis who was later diagnosed as having measles after rashes appeared. The two children developed measles after returning to their institution and the infection spread to other children in the institution. Among 63 children observed, 14 children(22.2%) developed measles, secondary attack rate of measles due to index cases was 19.7%. And 78.6% of the patients were between 4 and 8 months old. The room where the index case lived showed an attack rate of 81.8%, which is a much higher rate compared to other rooms. The attack rate among boys(26.0%) was higher than that of girls(12.5%), but it was not statistically significant.
CONCLUSIONS
This outbreak was considered to be a nosocomial infection, where the index cases were admitted to a hospital, infected and the infection spread to children. Further studies are necessary to find out the maternal antibody levels of infants of post-vaccinated mothers and the optimal age for measles vaccination.
Summary
A study on epidemiologic characteristics and factors associated with excess hospitalization of the patients injured by traffic accident.
Mi Woon Kim, Joung Soon Kim, Min Kyung Lim
Korean J Epidemiol. 1998;20(2):279-287.
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AbstractAbstract PDF
Abstract
The occurrence of injuries and death caused by traffic accidents have been increasing during last few decades in Korea, which resulted in enormous personal, social and economic loss in terms of death, disability, labour days and medical costs incurred for treatment. Generally, it is well known and even became an hot sociopolitical issue that the duration of hospital stay for traffic accident patients are much longer than that of other patients with the similar condition. The objective of the study is to find out epidemiologic characreristics and management pattern of traffic accident patients in a general hospital of medium-sized, industrialized town. This study was carried out on 177 cases injured by motor vehicle accidents, who were admitted and treated in a general hospital from Feb. 1, 1997 to Sept. 30, 1997. The results obtained are as followings: The most of the patients(44%) were 20-30 years old age group although the occurrence of injuries was more frequent among older ages, 50's for male and 60's for female being 2.1 times more frequent among male. The traffic accidents occurred most frequently(14.1%) in the morning(06:00-08:00) and afternoon(14:00-16:00), and on Saturdays(20.3%); the (14.1% traffic accidents were frequent during weekends for passengers whereas it was more frequent during weekdays for pedestrian. Old and child pedestrians were most vulnerable subjects to traffic accidents. The most common site injured was head(19.9%) and the injury types were fracture of lower extremity(9.3%), skull fracture(8.6%) and rib fracture(8.6%) for both sexes; rib fractures/thoracic spine fractures(12.0%) for female and tibia/ fibula fractures(11.6%) for male. Mean days of hospital stay presumptively judged by the doctor who examined, made diagnosis and admitted the patient was 43.8 days compare to 38.4 days of actual mean days of hospitalixation. On the other hand, the optimal mean days of hospital stay for the patients determined by two doctors independently was estimated to be 26.6 days. Thus the difference between actual days of hospitalization and optimal days of hospitalization was 11.7 days, which can be regarded as excess hospitalization days. It consists 30.5% of actual hospitalization days, an enormous waste of resources. The only factor associated with this excess hospitalization was payment responsibility for the hospital cost; when the hospitalization expenses are to be paid by the person inflicted the injury there were always excess days of hospitalization regardless of insurance status.
Summary

Epidemiol Health : Epidemiology and Health