Epidemiology and Health

Original Articles

Age- and disability-based trends in potentially preventable hospitalizations: evidence from nationwide claims data in Korea: Hyejung Yoon, Boyoung Jeon, Seyune Lee, Daesung Choi, Se-Youn Jung, Dong-Min Son, Yong Joo Rhee, Juhyeon Moon, So Youn Park, In-Hwan Oh, Young-il Jung; Epidemiol Health. 2026;48:e2026012. Published online February 27, 2026; DOI: https://doi.org/10.4178/epih.e2026012

5,217 View
127 Download

Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Individuals with disabilities are at greater risk of hospitalization than the general population. We examined 10-year trends in potentially preventable hospitalizations (PPH) in Korea, comparing individuals with and without disabilities and assessing age-specific patterns.
METHODS
Using National Health Information Database claims data (2010–2019), we established a fixed cohort of newly registered individuals with disabilities and control subjects statistically matched (1:1.5) at baseline. Annual PPH rates among patients with each condition were calculated and age- and sex-standardized according to Organization for Economic Cooperation and Development Health Care Quality Indicators definitions. Trends and annual percent changes (APCs) were analyzed by disability status and age group (non-older: 30–64; older adults: ≥65 years).
RESULTS
Between 2010 and 2019, PPH rates declined significantly in both groups. Among individuals with disabilities, the steepest decline was observed for hypertension (APC, −15.7%; 95% confidence interval [CI], −17.7 to −13.7), whereas congestive heart failure showed the largest reduction among individuals without disabilities (APC, −7.8%; 95% CI, −10.8 to −4.7). Declines were generally greater among non-older adults aged 30–64 years, regardless of disability status. The disparity between disability and non-disability groups narrowed over the decade, primarily due to larger improvements among non-older adults. Older adults with disabilities consistently exhibited the highest PPH rates for most conditions, whereas younger individuals with disabilities had the highest rates for diabetes.
CONCLUSIONS
PPH rates declined over the decade among both individuals with and without disabilities, particularly for hypertension and among non-older adults. However, older adults with disabilities remain at elevated risk, underscoring the need for targeted strategies to improve access to community-based primary care.; Summary

Korean summary
2010–2019년 한국의 예방가능입원(PPH)은 장애인·비장애인 모두에서 감소했으며, 특히 고혈압과 65세 미만에서 가장 두드러졌다. 장애인-비장애인 간 격차는 감소하고 있으나 여전히 존재했고, 특히 당뇨와 고령 장애인에서 두드러졌다. 이러한 격차의 감소에도 불구하고 고령 장애인이 직면한 높은 PPH 위험은 지속되고 있으며, 이는 지역사회 중심의 일차의료 접근성을 강화하기 위한 맞춤형 전략 수립이 시급함을 시사한다.

Key Message
This study examined trends in potentially preventable hospitalizations (PPH) in Korea from 2010 to 2019,comparing individuals with and without disabilities. Overall, PPH rates declined in both groups, with the largest reductions observed for hypertension and among adults aged 30–64 years. Disability-related disparities also narrowed over time; however, they persisted, particularly for diabetes and among older adults with disabilities. Despite narrowing disparities, the persistently high PPH risk among older adults with disabilities underscores the urgent need for targeted strategies to enhance access to community-based primary care.

Multimorbidity patterns by health-related quality of life status in older adults: an association rules and network analysis utilizing the Korea National Health and Nutrition Examination Survey: Thi-Ngoc Tran, Sanghee Lee, Chang-Mo Oh, Hyunsoon Cho; Epidemiol Health. 2022;44:e2022113. Published online November 29, 2022; DOI: https://doi.org/10.4178/epih.e2022113

28,505 View
285 Download
10 Web of Science
10 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Improved life expectancy has increased the prevalence of older adults living with multimorbidity which likely deteriorates their health-related quality of life (HRQoL). However, relatively little is known about patterns and the relationships of multimorbidity by HRQoL status in older adults.

METHODS

Individuals aged 65 or older from the Korea National Health and Nutrition Examination Survey V-VII (2010-2018) were analyzed. HRQoL was assessed by the EuroQoL-5 dimensions questionnaire and categorized as poor, normal, or good. The impact of multimorbidity on HRQoL was evaluated using logistic regression. The patterns and inter-relationships between multimorbidity, stratified by HRQoL groups, were analyzed using the association rules and network analysis approach.

RESULTS

Multimorbidity was significantly associated with poor HRQoL (3 or more diseases vs. none; adjusted odds ratio, 2.70; 95% confidence interval, 2.10 to 3.46). Hypertension, arthritis, hyperlipidemia, and diabetes were the most prevalent diseases across all HRQoL groups. Complex interrelationships of morbidities, higher prevalence, and node strengths in all diseases were observed in the poor HRQoL group, particularly for arthritis, depression, and stroke, compared to other groups (1.5-3.0 times higher, p<0.05 for all). Apart from hypertension, arthritis and hyperlipidemia had a higher prevalence and stronger connections with other diseases in females, whereas this was the case for diabetes and stroke in males with poor HRQoL.

CONCLUSIONS

Multimorbidity patterns formed complicatedly inter-correlated disease networks in the poor HRQoL group with differences according to sex. These findings enhance the understanding of multimorbidity connections and provide information on the healthcare needs of older adults, especially those with poor HRQoL.

Summary

Korean summary
기대 수명의 증가에 따라 고령인구에서 건강관련 삶의 질을 저하시킬 수 있는 복합질환의 유병률도 함께 증가하고 있다. 본 연구에서는 국민건강영양조사 자료를 이용하여 65세 이상 우리나라 고령인구에서 건강관련 삶의 질 (HRQoL)에 따른 복합만성질환 패턴을 분석하였다. 복합만성질환은 건강관련 삶의 질 저하와 통계적으로 유의하게 연관되어 있으며, 연관성 및 네크워크 분석 결과 건강관련 삶의 질이 낮을수록 복합질환의 패턴이 복잡한 것으로 나타났다. 전체적으로 고혈압, 관절염, 고지혈증, 당뇨병이 가장 높은 발생률을 보였다. 건강관련 삶의 질이 낮은 그룹에서는 관절염, 우울증, 뇌졸중 등의 질병이 높은 발생률과 상호관련성을 보였으며, 이는 성별에 따라 차이가 있었다. 연구 결과는 고령자, 특히 건강관련 삶의 질이 낮은 노인의 의료 서비스 요구에 대해 정보를 제공해 줄 수 있을 것이다,

Key Message
Network analysis of older adults (65 or older) in Korea showed that hypertension, arthritis, hyperlipidemia, and diabetes were the most common multimorbidity regardless of HRQoL status. However, as HRQoL deteriorated, multimorbidity patterns formed complicatedly inter-correlated disease networks; the prevalence and the node strength of arthritis, depression, and stroke increased considerably and be diversified by sex.

Citations

Citations to this article as recorded by

Trends in mortality rates of female breast cancer in China, 2004 to 2021
Huali Xiong, Fengxun Ma
Medicine.2026; 105(3): e46805. CrossRef
Multimorbidity and health related quality of life in U.S. adults: A population-based study
Monira Alwhaibi, Bander Balkhi
Journal of Multimorbidity and Comorbidity.2026;[Epub] CrossRef
Patterns of Vulnerability: Frailty, Multimorbidity, and Physical Health-Related Quality of Life in Institutionalised Older Adults
Noelia Durán-Gómez, Miguel Ángel Martín-Parrilla, Jesús Montanero-Fernández, Casimiro Fermín López-Jurado, Lydia Rodríguez-Rivero, Macarena C. Cáceres
Healthcare.2026; 14(11): 1491. CrossRef
Prediction of Multimorbidity Network Evolution in Middle-Aged and Elderly Population Based on CE-GCN
Yushi Che, Yiqiao Wang
Interdisciplinary Sciences: Computational Life Sciences.2025; 17(2): 424. CrossRef
Exploring Multimorbidity Patterns in older hospitalized Norwegian patients using Network Analysis modularity
Mohsen Askar, Beate Hennie Garcia, Kristian Svendsen
International Journal of Medical Informatics.2025; 201: 105954. CrossRef
Investigation of multimorbidity patterns and association rules in patients with type 2 diabetes mellitus using association rules mining algorithm
Lianhua Liu, Xiaodan Wang, Mei Gui, Feng Ju, Li Cao, Bo Bi
Scientific Reports.2025;[Epub] CrossRef
Prevalence, patterns of multimorbidity, and its correlations with health-related quality of life in rural southwest China: a cross-sectional study
Na Xie, Huali Xiong, Xin Jiang
Frontiers in Medicine.2025;[Epub] CrossRef
Chronic Disease Patterns and Their Relationship With Health-Related Quality of Life in South Korean Older Adults With the 2021 Korean National Health and Nutrition Examination Survey: Latent Class Analysis
Mi-Sun Lee, Hooyeon Lee
JMIR Public Health and Surveillance.2024; 10: e49433. CrossRef
Impact of intensive hypertension criteria on multimorbidity prevalence and patterns in a multi-ethnic Chinese population
Yezhou Liu, Baibing Mi, Leilei Pei, Shaonong Dang, Hong Yan, Chao Li
Frontiers in Public Health.2024;[Epub] CrossRef
Health-promoting behavior to enhance perceived meaning and control of life in chronic disease patients with role limitations and depressive symptoms: a network approach
Je-Yeon Yun, Young Ho Yun
Scientific Reports.2023;[Epub] CrossRef

Relationship between smoking status and muscle strength in the United States older adults: R. Constance Wiener, Patricia A. Findley, Chan Shen, Nilanjana Dwibedi, Usha Sambamoorthi; Epidemiol Health. 2020;42:e2020055. Published online July 28, 2020; DOI: https://doi.org/10.4178/epih.e2020055

29,192 View
190 Download
11 Web of Science
10 Crossref

Abstract PDF

Abstract

OBJECTIVES
Muscle strength in older adults is associated with greater physical ability. Identifying interventions to maintain muscle strength can therefore improve quality of life. The purpose of this study was to evaluate whether current or former smoking status is associated with a decrease in muscle strength in older adults.

METHODS

Data from the Health and Retirement Study from 2012-2014 were analyzed with regard to maximum dominant hand grip strength, maximum overall hand grip strength, and smoking status (current, former, or never). Unadjusted linear regression was conducted. Other factors known to be related to strength were included in the adjusted linear regression analyses.

RESULTS

For maximum grip strength, the regression coefficient was 4.91 for current smoking (standard error [SE], 0.58; p<0.001), 3.58 for former smoking (SE, 0.43; p<0.001), and 28.12 for never smoking (SE, 0.34). Fully adjusted linear regression on the relationship between dominant hand grip strength and smoking did not yield a significant result. The factors significantly associated with dominant hand grip strength were male sex, younger age, a race/ethnicity of non-Hispanic White or non-Hispanic Black, higher income, morbidity of ≤1 condition, no pain, and moderate or vigorous exercise more than once a week.

CONCLUSIONS

Muscle strength in older adults was not associated with smoking status in the adjusted analysis.

Summary

Citations

Citations to this article as recorded by

A meta-analysis of smoking and fracture risk to update the FRAX® tool
Marian Schini, Helena Johansson, Nicholas C. Harvey, Mattias Lorentzon, Enwu Liu, Liesbeth Vandenput, William D. Leslie, Kristina E. Åkesson, Fred A. Anderson, Rafael Azagra-Ledesma, Cecilie L. Bager, Charlotte Beaudart, Heike A. Bischoff-Ferrari, Emmanue
Osteoporosis International.2026; 37(4): 839. CrossRef
Glycaemic Control, Blood Pressure and Lifestyle Behaviours in Relation to Sarcopenia Among Older Adults in Korea: A Population‐Based Cross‐Sectional Study
Kyeongmin Jang
Australasian Journal on Ageing.2026;[Epub] CrossRef
Contribution of Sport Type to the Association Between Handgrip Strength and Morbidity/Mortality: Future Follow-up Study and Possible Mechanisms
Takashi Abe, Jeremy P. Loenneke, Koya Suzuki, Yoshimitsu Kohmura, Akemi Abe, Shuichi Machida, Hisashi Naito
Sports Medicine - Open.2026;[Epub] CrossRef
Glycated Hemoglobin, Lifestyle, and Sarcopenia in Rural Older Adults: A Cross‐Sectional Analysis
Kyeongmin Jang
Nursing & Health Sciences.2026;[Epub] CrossRef
Cumulative handgrip strength and longitudinal changes in cognitive function and daily functioning among people aged 50 years and older: evidence from two longitudinal cohort studies
Bin Han, Ziqian Zeng, Ying Wen, Chu Chen, Daomei Cheng, Yachao Li, Ning Huang, Jia Ruan, Dan Zhao, Qingping Xue
Archives of Public Health.2025;[Epub] CrossRef
Association of smoking cessation with dynapenia among older lifetime smokers in Korea
Keunjoong Yoo, Yong Soon Park, Hye Jin Kim, Jeong Hyeon Kim
Tobacco Induced Diseases.2024; 22(August): 1. CrossRef
Association between smoking status and handgrip strength in Korean male adults: based on Korea National Health and Nutrition Examination Survey 2016–2019
Eunbyul Cho, Hi Sun Soh, Jae-Ryun Lee, Jieun Yun, Woo Kyung Bae, Hyejin Lee
Frontiers in Medicine.2023;[Epub] CrossRef
Handgrip strength, dynapenia, and related factors in postmenopausal women
Pascual García-Alfaro, Sandra García, Ignacio Rodríguez, Faustino R. Pérez-López
Menopause.2022; 29(1): 16. CrossRef
Lower body muscle strength, dynapenic obesity and risk of type 2 diabetes –longitudinal results on the chair-stand test from the Survey of Health, Ageing and Retirement in Europe (SHARE)
Bernd Kowall
BMC Geriatrics.2022;[Epub] CrossRef
Relationship between Smoking History and Diaphragm Thickness and Muscle Strength in Young Men
Nan-Soo Kim, Young-Su Park
Archives of Orthopedic and Sports Physical Therapy.2020; 16(2): 65. CrossRef

First
Prev
Page of 1
Next
Last

Search