Differences in Fracture Incidence According to Caregiver Type in Stroke Survivors.

Background: To assess whether the type of primary caregiver is a risk factor of the incidence of fracture among older adults who have survived a stroke.

Methods: Data from 4282 stroke survivors in the National Health Insurance Service-Senior Cohort (2002-2013) were used in this study. We categorized type of primary caregiver as none, spouse/family caregiver, and formal caregiver.

Oral health and later coronary heart disease: Cohort study of one million people.

Aims Systematic reviews report an association between poorer oral health and an increased risk of coronary heart disease. This contentious relationship may not be causal but existing studies have been insufficiently well powered comprehensively to examine the role of confounding, particularly by cigarette smoking. Accordingly, we sought to examine the role of smoking in generating the relationship between oral health and coronary heart disease in life-long non-smokers.

The J-curve between Diastolic Blood Pressure and Risk of All-cause and Cardiovascular Death.

Background And Objectives: The J-curve phenomenon between diastolic blood pressure (DBP) and mortality has been reported repeatedly in treated patients. However, the baseline risk of low DBP has not been fully explored. This study was to examine the relationship between DBP and risk of mortality from all-cause, atherosclerotic vascular diseases (ASCVD), and ischemic heart disease (IHD) using a prospective cohort of general population.

Sex-specific role of education on the associations of socioeconomic status indicators with obesity risk: A population-based study in South Korea.

Background: No study of obesity risk for people in developed countries has conducted a multi-dimensional analysis of the association of socioeconomic status with obesity. In this paper, we investigated if education functions as either a confounder or an effect modifier in the association of another socioeconomic status indicator with obesity.

Methods: This cross-sectional study analyzed data of an adult population sample (10,905 men and 14,580 women) from the Korea National Health and Nutrition Examination Survey (2010-2014).

Gender-specific interactions between education and income in relation to obesity: a cross-sectional analysis of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V).

Objectives: To identify gender-specific associations between education and income in relation to obesity in developed countries by considering both the interaction-effect terms of the independent variables and their main-effect terms.

Design: A cross-sectional study. Education and income levels were chosen as socioeconomic status indicators.

Serum persistent organic pollutants levels and stroke risk.

Knowledge of environmental risk factors for stroke and their role are limited. We performed a case-cohort study to evaluate the association between serum persistent organic pollutants (POPs) level and stroke risk. 526 subcohort members and 111 stroke incidence cases were identified from the Korean Cancer Prevention Study-II.

Prevalence and survival prognosis of prostate cancer in patients with end-stage renal disease: a retrospective study based on the Korea national database (2003-2010).

Objective: The study was aimed to evaluate the prevalence and prognosis of prostate cancer (PC) and end-stage renal disease (ESRD), determine the risk factors for overall survival (OS) and PC-specific survival (CSS), and evaluate differences in PC-related clinical therapeutic patterns between patients with and without PC-ESRD.

Methods: This observational population study, performed at the National Cancer Center and Cancer Research Institute in Korea, included patients with PC and ESRD from the nationwide Korean Health Insurance System and Korean Central Cancer Registry data. Five-year overall and cancer-specific survival.

Analyzing the Historical Development and Transition of the Korean Health Care System.

Objectives: Many economically advanced countries have attempted to minimize public expenditures and pursue privatization based on the principles of neo-liberalism. However, Korea has moved contrary to this global trend. This study examines why and how the Korean health care system was formed, developed, and transformed into an integrated, single-insurer, National Health Insurance (NHI) system.

Kidney Function, Proteinuria, and Cancer Incidence: The Korean Heart Study.

Background: Reported associations of estimated glomerular filtration rate (eGFR) with cancer risk are inconsistent, and data for the proteinuria-cancer relationship are sparse. We sought to quantify the associations of cancer incidence with eGFR and with proteinuria in a large population-based cohort.

Study Design: A prospective cohort study.

Trends in socioeconomic costs of morbid obesity among Korean adults, 2009-2013: Data from National Health Insurance Service.

As the prevalence of morbid obesity increased in Korea, the estimation of the accurate socioeconomic costs by morbid obesity was required; we analysed national medical costs through the big data. From 2009 year to 2013 year, Direct Costs (DC) for medical costs, transit costs and nursing costs and Indirect Costs (IC) for Future Income Loss (FIL) and Productivity Loss (PL) of morbid obesity (BMI≥30) were calculated, and socioeconomic costs were estimated by applying Population Attributable Risk (PAR) proportion according to obesity related diseases. From 10 year follow up research, Relative risk (RR) for morbid obesity related disease was analysed in comparison with control group.

The Impact of In-Home Services Utilization on the Institutionalization of Older People in Korea.

As a result of aging populations, institutionalization of older people is creating an increasing financial burden in many countries. The purpose of the present study was to explore the impact of in-home service utilization on institutionalization. The subjects were newly certified as eligible for long-term care insurance between January and February 2009 in Korea.

Eliciting preferences for medical devices in South Korea: A discrete choice experiment.

This study aims to identify the attributes that contribute to the value of medical devices and quantify the relative importance of them using a discrete choice experiment. Based on a literature review and expert consultation, seven attributes and their levels were identified-severity of disease (2), availability of substitutes (2), improvement in procedure (3), improvement in clinical outcomes (2), increase in survival (2), improvement in quality of life (3), and cost (4). Among 576 hypothetical profiles, optimal choice sets with 20 choices were developed and experts experienced in health technology assessment and reimbursement decision making in South Korea were surveyed.

Modifying effects of education on the association between lifestyle behaviors and the risk of obesity: evidence from South Korea.

Background: No previous study has explored the interactions between education and lifestyle in relation to obesity. This study hypothesized that education may be obesogenic through its interplay with lifestyle behaviors.

Methods: Data for a nationally representative sample (6937 men and 9333 women) from the Korea National Health and Nutrition Examination Survey (2010-2012) were analyzed.

Eight-year experience of using HTA in drug reimbursement: South Korea.

This study describes the process and results of drug reimbursement decision-making in South Korea and evaluates its performance from the perspectives of the various stakeholders involved. Data were retrieved from the evaluation report posted on the Health Insurance Review and Assessment Service (HIRA) website. As of 2014, 253 new drugs had been submitted to the HIRA for appraisal.

The association between the utilization of long-term care services and mortality in elderly Koreans.

It is necessary to confirm the effect of long-term care insurance (LTCI) by identifying changes in mortality, whether benefits are used or not, as well as the effects of in-home and institutional services on mortality. The goal of this study was to identify the association between service use and the mortality rate in elderly Koreans. We used Cox proportional hazard regression models and the Kaplan-Meier survival curve method to estimate the hazard ratio and survival probability for death while adjusting for covariates.

Cost Effectiveness of Colorectal Cancer Screening Interventions with Their Effects on Health Disparity Being Considered.

Purpose: The purpose of this study was to evaluate the cost effectiveness of colorectal cancer screening interventions with their effects on health disparity being considered.

Materials And Methods: Markov cohort simulation was conducted with the cycle/duration of 1/40 year(s). Data came from the results of randomized trials and others.

Hazard Ratio of Smoking on Lung Cancer in Korea According to Histological Type and Gender.

Purpose: Using nationwide cancer incidence data, we examined whether the strength of the association of cigarette smoking with lung cancer risk differs according to major histological type and gender, taking account of other risk factors in the Korean population.

Methods: The study population derived from government employees and teachers aged 20 years and over who participated in a national health examination program in 1998 or 1999. Total study subjects were 1,357,447.

Prescription Drug Use Among Adults With Chronic Conditions in South Korea: Dual Burden of Health Care Needs and Socioeconomic Vulnerability.

The aim of this study is to identify the social determinants of prescription drug use among adults with chronic diseases by examining the associations between socioeconomic position and prescription medicine use and perceived burden for pharmaceutical expenditure, using a sample of the Korean population from the 2008 Korea Health Panel, with 4 analytic models. Controlled with health status and the type of health insurance, the probability of using prescription drugs and overall spending on drugs significantly increased with rising income level, while perceived burden for out-of-pocket payment significantly decreased. These results imply that the poor are likely to underuse prescription drugs compared with their wealthier counterparts with the same need for health care, probably due to economic barriers.

Applicability and potential clinical effects of 2013 cholesterol guidelines on major cardiovascular events.

Background: The applicability to different race/ethnic groups and effects on cardiovascular disease (CVD) outcomes of the 2013 American College of Cardiology and American Heart Association (ACC/AHA) guidelines for cholesterol management remain to be determined. We estimated the proportion of Korean adults who would be affected by the 2013 cholesterol guidelines and to determine the related effects on cardiovascular events.

Methods: Using data from the Korean National Health and Nutrition Examination Survey of 2008 to 2012 (n = 18,573), we compared the estimated number of statin candidates under the 2013 ACC/AHA and the Third Adult Treatment Panel (ATP-III) guidelines and extrapolated the results to 19.

Differential effects of white matter hyperintensity on geriatric depressive symptoms according to APOE-ε4 status.

Background: We aimed to examine differential effects of WMH on progression of depressive symptoms according to APOE ε4 status in the elderly.

Methods: We obtained data from elderly Korean subjects (n=707) aged 60 years or older at baseline from the CREDOS study from November 2005 to July 2014. A linear mixed model stratified according to APOE genotype (APOE ε4 carrier vs.

The ACC/AHA 2013 pooled cohort equations compared to a Korean Risk Prediction Model for atherosclerotic cardiovascular disease.

Background And Aims: To evaluate the performance of the American College of Cardiology/American Heart Association (ACC/AHA) 2013 Pooled Cohort Equations in the Korean Heart Study (KHS) population and to develop a Korean Risk Prediction Model (KRPM) for atherosclerotic cardiovascular disease (ASCVD) events.

Methods: The KHS cohort included 200,010 Korean adults aged 40-79 years who were free from ASCVD at baseline. Discrimination, calibration, and recalibration of the ACC/AHA Equations in predicting 10-year ASCVD risk in the KHS cohort were evaluated.

Population Aging and Healthcare Expenditure in Korea.

Korea's rapid population aging has been considered as a major factor in increase of healthcare expenditure (HCE). However, there were no clear empirical evidences in Korea that show if population aging has a significant impact on HCE. To examine the 'red herring' argument, this study used Heckman, two-part, and augmented model with Korean National Health Insurance claim data for the deceased and survivors of aged 20 years and over verified by Korean National Health Insurance Service between January 1 and December 31, 2010.

Effect of Psychotropic Drugs on Development of Diabetes Mellitus in Patients With Alzheimer's Disease.

We aimed to examine risk of diabetes mellitus (DM) among older adults with Alzheimer's disease receiving 3 types of psychotropic drugs, that is, antipsychotics, antidepressants, and sedative anxiolytics. We retrospectively analyzed data from a hospital-based Clinical Research Center for Dementia of South Korea (CREDOS) study conducted between January 1, 2008 and December 31, 2012. Participants (n = 3042) with Alzheimer's disease were aged 65 or older and had no preexisting history of DM.