Publications by authors named "Yonsu Kim"

The burden of asthma remains steady with no decline observed in the past few decades. Obesity prevalence has been steadily increasing with a rate of 41.9% in the United States between 2017-2020.

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Background: Falls and extremity fractures often occur in people living with Alzheimer's disease and related disorders (ADRD). In post-fracture care, these patients are cared for either at rehabilitation facilities or their homes. The coronavirus disease 2019 (COVID-19) pandemic limited the utilization of rehabilitation facilities.

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The global prevalence of obesity continues to rise. However, whether obesity affects the degree of intra-abdominal solid organ damage following blunt trauma remains unclear. This study aimed to investigate the correlation between obesity and intra-abdominal solid organ damage.

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Objective: Marginalized racial/ethnic populations showed higher rates of asthma prevalence and high-cost healthcare utilization for asthma. However, few studies investigated the disproportionate financial burden of asthma among the underrepresented racial/ethnic groups. This study aims to estimate the direct cost of asthma by severity and race/ethnicity and examine the moderating effects of race/ethnicity on the relationship between asthma severity and the cost.

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To people living with Alzheimer's Disease-Related Disorders (ADRD), timely and coordinated communication is essential between their informal caregivers and healthcare providers. In provider shortage areas, for example, the state of Nevada, telehealth can be an effective primary care delivery alternative to in-person visits. To evaluate the cost-effectiveness of telehealth visits for people living with ADRD in the state of Nevada, a decision-analytic Markov model was developed from healthcare system perspectives with a 10-year horizon/1-year cycle.

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Article Synopsis
  • There has been a decline in post-acute care (PAC) utilization in skilled nursing facilities for older adults with extremity fractures in Nevada from 2018 to 2021, dropping from 55.1% to 49.7%.
  • Simultaneously, the use of home services for PAC has increased, rising from 18.8% to 24.5% during the same period.
  • Factors influencing PAC utilization include older age, gender, fracture type, and insurance coverage, while racial minorities and other specific circumstances like the COVID-19 pandemic negatively impact this utilization, highlighting the need for improved caregiver training and workforce development.
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Telehealth has emerged as a vital alternative to traditional healthcare delivery, particularly for rural and underserved populations. While efforts to enhance telehealth accessibility have primarily focused on technological solutions, the effectiveness of its telehealth and the role of physician training in bridging racial and ethnic disparities in telehealth usage remains underexplored. This study evaluates the impact of a trained-physician-delivered, age-friendly telehealth model on healthcare accessibility and outcomes.

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Background: The burden of asthma remains steady with no decline observed in the past few decades. Obesity prevalence has been steadily increasing with a rate of 41.9% in the United States between 2017-2020.

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Article Synopsis
  • Emergency department visits in Nevada have surged since the legalization of cannabis for medical and recreational use, particularly cases of cannabinoid hyperemesis syndrome among chronic cannabis users.
  • A study analyzing Nevada's emergency department databases from 2013 to 2021 found that visits for cannabinoid hyperemesis syndrome doubled from 1.07 to 2.22 per 100,000 people after the commercialization of recreational cannabis in late 2017.
  • The findings noted that patients with cannabinoid hyperemesis syndrome were generally younger and included fewer males compared to those visiting for other reasons, highlighting the need for further research on the factors driving this increase.
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Background: The COVID-19 pandemic has resulted in an increase in the number of individuals with respiratory conditions that require hospitalization, posing new challenges for the healthcare system. Recent respiratory condition studies have been focused on the COVID-19 period, with no comparison of respiratory conditions before and during the pandemic. This study aimed to examine hospital-setting respiratory conditions regarding potential changes in length of stay (LOS), mortality, and total charge, as well as socioeconomic disparities before and during the pandemic.

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The causal effects of chondroitin, glucosamine, and vitamin/mineral supplement intake on kidney function remain unknown, despite being commonly used. We conducted a two-sample summary-level Mendelian randomization (MR) analysis to test for causal associations between regular dietary supplement intake and kidney function. Genetic instruments for chondroitin, glucosamine, and vitamin/mineral supplement intake were obtained from a genome-wide association study of European ancestry.

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Telehealth has been widely accepted as an alternative to in-person primary care. This study examines whether the quality of primary care delivered via telehealth is equitable for older adults across racial and ethnic boundaries in provider-shortage urban settings. The study analyzed documentation of the 4Ms components (What Matters, Mobility, Medication, and Mentation) in relation to self-reported racial and ethnic backgrounds of 254 Medicare Advantage enrollees who used telehealth as their primary care modality in Southern Nevada from July 2021 through June 2022.

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Healthcare organisations in the USA rank significantly lower in quality of care compared with other developed nations. Research shows US performance emphasises expensive treatment over effective prevention programmes. This study demonstrates how a comprehensive quality improvement programme can improve health outcomes in a large county-based Medicaid health plan.

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Telehealth has been adopted as an alternative to in-person primary care visits. With multiple participants able to join remotely, telehealth can facilitate the discussion and documentation of advance care planning (ACP) for those with Alzheimer's disease-related disorders (ADRDs). We measured hospitalization-associated utilization outcomes, instances of hospitalization and 90-day re-hospitalizations from payors' administrative databases and verified the data via electronic health records.

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A growing number of studies reported the association between social mobility and health. However, few studies investigated whether the association varies by age group. Drawing on the economic environment that facilitated social mobility in South Korea, we postulate each age group had a different extent of social mobility, which would vary with the extent of economic growth and affect the association between social mobility and health.

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Background: Studies found heterogeneity of asthma prevalence among Hispanic subgroups using survey data but addressed under-diagnosis issues due to limited access to health care and diagnosis bias.

Objectives: To examine heterogeneity by language in health care utilization for asthma among Hispanic subgroups.

Research Design: A retrospective, longitudinal cohort study of Medi-Cal claims data (2018-2019) using logistic regression to estimate the odds ratio of health care utilization for asthma.

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Introduction: Higher rates of ED visits and hospitalizations for asthma among African American and Hispanic children may indicate suboptimal management of asthma, leading to a greater financial burden of healthcare. It is not well known if an association of race/ethnicity with controller medication and hospital-based care utilization exists.

Objective: This study examines whether the Asthma Medication Ratio (AMR) predicts healthcare utilization for asthma by race/ethnicity.

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Transglutaminase 2 (TG2) is a calcium-dependent transamidating acyltransferase enzyme of the protein-glutamine γ-glutamyltransferase family implicated in kidney injury. In this study, we identified associations between TG2 and chronic kidney disease (CKD) identified by visualizing TG2 in kidney biopsy samples derived from CKD patients using immunohistochemistry and measuring the plasma TG2 concentrations. Our study revealed a connection between TG2 and the pathological markers of kidney disease.

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Kruppel-like factor 2 (KLF2) regulates endothelial cell metabolism; endothelial dysfunction is associated with hypertension and is a predictor of atherosclerosis development and cardiovascular events. Here, we investigated the role of KLF2 in hypertensive nephropathy by regulating KLF2 expression in human primary glomerular endothelial cells (hPGECs) and evaluating this expression in the kidney tissues of a 5/6 nephrectomy mouse model as well as patients with hypertension. Hypertension-mimicking devices and KLF2 siRNA were used to downregulate KLF2 expression, while the expression of KLF2 was upregulated by administering simvastatin.

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Article Synopsis
  • Kidney fibrosis is a frequent result of chronic kidney disease (CKD), and this study explored the role of the chemokine CCL8 in relation to kidney fibrosis in CKD patients.
  • Serum levels and tissue expression of CCL8 were found to rise significantly with the progression of CKD, correlating with increased protein levels and kidney damage.
  • Blockading CCL8 reduced fibrosis and apoptosis in cell cultures, suggesting that targeting the CCL8 pathway could help mitigate kidney fibrosis in CKD.
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The US spends two times more than the OECD average in health expenditure but has a much smaller portion of public health spending to total health expenditure than other OECD countries. While it has been suggested that public health and social services spending is crucial to promoting health outcomes, less is known about what drives variations in public health expenditure across regions. This study aims to examine whether political fragmentation in local governance is associated with variations in public health and social services expenditures.

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Background: Generalizing an 'optimal' blood pressure (BP) level for individuals with hypertension remains controversial due to the implementation of different medical guidelines. This study investigated the association of BP with major adverse cardiovascular and cerebrovascular events (MACCE) and determined the optimal BP for patients with hypertension.

Method: A total of 934 179 individuals who received antihypertensive medications were selected from the National Health Insurance Service Examination Database between 2003 and 2011 in Korea.

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Objective: We sought to identify racial/ethnic patterns of health care utilization for asthma among asthmatic children (ages 0-18) and address unequal access to optimal asthma management as a determinant of asthma disparities.

Methods: We used children Medi-Cal (California's Medicaid program) enrollees, including African American, Asian, Hispanic, and White children in Los Angeles and retrieved individual hospital utilization records of 69,118 asthmatic children (2013-2018). We applied Hierarchical Generalized Linear Models (HGMLs) to identify the patterns of health care utilization at the individual level, controlling for demographic and neighborhood characteristics.

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We aimed to investigate the causal effects of n-3 and n-6 polyunsaturated fatty acids (PUFAs) on the risk of coronary artery disease (CAD) through Mendelian randomization (MR) analysis. This MR study utilized a genetic instrument developed from previous genome-wide association studies for various serum n-3 and n-6 PUFA levels. First, we calculated the allele scores for genetic predisposition of PUFAs in individuals of European ancestry in the UK Biobank data ( = 337,129).

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