Objectives: Assessing healthcare quality at the national level is essential for evaluating health system performance and identifying areas requiring improvement. This study examined long-term trends in healthcare quality in Korea from 2008 to 2023 using internationally comparable indicators. Methods: We conducted a trend analysis of healthcare quality in Korea using the Organization for Economic Cooperation and Development (OECD) Health Care Quality and Outcomes framework and quality indicators. Indicators across multiple domains, including acute care, primary care, prescribing in primary care, mental healthcare, and patient experiences, were analyzed and compared with OECD averages. Results: Healthcare quality in Korea improved across several domains. Thirty-day mortality for acute myocardial infarction decreased from 14.2% in 2008 to 10.2% in 2023, while mortality for ischemic stroke declined from 8.7% to 5.5%. Avoidable hospitalizations decreased substantially, with hospitalizations for chronic obstructive pulmonary disease declining by 59.7%. The proportion of patients with diabetes receiving cholesterol-lowering treatment increased from 44.1% to 82.5%. However, the proportion of broad-spectrum antibiotic prescriptions remained substantially higher than the OECD average (40.3 vs. 15.5%). In mental healthcare, excess mortality ratios increased from 4.3 in 2010 to 4.9 in 2023 for schizophrenia and from 3.5 to 4.3 for bipolar disorder, while post-discharge suicide rates showed little improvement. Patient experience indicators related to patient-physician communication improved and approached OECD averages. Conclusions Healthcare quality in Korea improved substantially between 2008 and 2023, particularly in acute care outcomes and chronic disease management. However, persistent challenges remain in areas such as antibiotic use, polypharmacy, and mental healthcare. These findings provide internationally comparable evidence to inform future health policy and healthcare quality improvement efforts.

Purpose: The effect of behavior changes in alcohol drinking on gastric cancer (GC) development, and the sex differences in those effects have not yet been fully elucidated. This study investigated the effect of behavior changes in alcohol drinking on the GC risk by sex. Materials and Methods: The cohort consisted of 310,192 Koreans (≥ 40 years) from the National Health Insurance Service–Health Screening Cohort with a median follow-up period of 12 years. Subjects were classified according to alcohol consumption behavior changes (non-drinker, quitter, reducer, sustainer, and increaser). The independent effect of changes in alcohol drinking patterns or concurrent effect of alcohol on GC risk were evaluated using the Cox proportional hazard regression. Results: In males, non-drinkers showed a lower risk of developing GC (hazard ratio [HR], 0.91; 95% confidence interval [CI], 0.84 to 0.98), whereas increasers showed a higher risk of GC than sustainers (HR, 1.11; 95% CI, 1.02 to 1.20). Starting to drink alcohol, even at a mild level, was associated with an increased GC risk, while a decreased GC risk was induced when alcohol consumption dose decreases to a mild from a moderate level among males. However, in females, only substantial change of alcohol consumption dose from non- to heavy-drinking was associated with increased GC risk (HR, 1.97; 95% CI, 0.98 to 3.96). Conclusion These results suggest that alcohol abstinence can reduce the risk of developing GC, particularly among males.

Background and Objectives: This study conducted a comprehensive bibliometric analysis of articles published in the Journal of Rhinology (JR), the official journal of the Korean Rhinologic Society, to examine research trends, thematic evolution, and emerging hotspots in rhinology. Methods: A total of 836 JR articles (1994–2025) were retrieved from PubMed and Research Information Sharing Service (RISS) after duplicate removal. The R bibliometrix package was used to perform keyword trend and thematic evolution analyses. VOSviewer was used to visualize keyword co-occurrence networks and temporal relationships between keywords. Gephi was used to calculate centrality measures, providing insight into the structural characteristics of the research network. Results: From 1994 to 2025, JR published an average of 26.6 articles per year, with publication activity increasing in recent years. Keyword and thematic analyses demonstrated that the research focus gradually shifted from basic disease- and anatomy-related topics and traditional clinical themes in the 2010s to functional conditions, infectious diseases, and increasingly surgical, procedural, and methodological research after 2020, while “rhinitis” and “sleep apnea syndromes” were consistently addressed. Co-occurrence analysis further identified “endoscopy” as a central keyword, highlighting its continued importance in JR research. Conclusion The articles published in JR encompass a broad spectrum of rhinology research, integrating disease pathophysiology, clinical applications, surgical techniques, and evidence-based approaches. These findings highlight evolving research trends and provide guidance for future domestic and international studies in rhinology.

Purpose: Radical cystectomy (RC) is associated with substantial postoperative morbidity, and unplanned readmission remains common despite advances in perioperative management. However, the association between postoperative readmission due to complications and oncologic outcomes after RC for bladder cancer has not been clearly defined. We evaluated the impact of postoperative readmission on overall survival (OS) and cancer-specific survival (CSS) after RC for bladder cancer. Materials and Methods: We retrospectively analyzed 3,972 patients who underwent RC for bladder cancer in a multicenter cohort. Postoperative readmission was defined as unplanned hospitalization within 90 days postsurgery due to surgery-related complications. Survival outcomes were assessed using the Kaplan-Meier method and compared using the log-rank test. Univariable and multivariable Cox proportional hazards regression analyses were performed to identify independent predictors of OS and CSS. Results: Among the study population, 916 patients (23.1%) experienced postoperative readmission. Baseline and perioperative characteristics were generally comparable between patients with and without readmission. Kaplan-Meier analyses demonstrated significantly worse OS and CSS among patients who experienced postoperative readmission (both log-rank p<0.001). In multivariable analyses adjusting for clinicopathological factors, postoperative readmission remained independently associated with worse OS (hazard ratio [HR], 1.654; 95% confidence interval [CI], 1.464–1.868; p<0.001) and CSS (HR, 1.761; 95% CI, 1.509–2.055; p<0.001). Conclusion Postoperative readmission within 90 days after RC was independently associated with inferior long-term oncologic outcomes. These findings suggest the importance of strategies aimed at preventing postoperative complications and subsequent readmission.

Objectives: We mapped trends in studies on dietary behaviors, nutritional status, and nutrition-related education among individuals with developmental disabilities in Korea over the past decade to identify research gaps and inform future research and policy development. Methods: A scoping review was conducted using three major Korean academic databases (RISS, KISS, and DBpia). Studies published between 2015 and September 2025 were identified using combinations of keywords related to developmental disabilities, dietary behavior, nutrition, and health-related interventions. Eligible studies included empirical studies and secondary research (e.g., systematic or scoping reviews) conducted in Korea that focused on dietary behaviors, nutrition, health promotion, or nutrition-related education for individuals with developmental disabilities. Thirty-six studies met our inclusion criteria and were analyzed based on study design, study population, disability type, research topic, and publication period. Results: Observational quantitative, qualitative, intervention-based experimental, and evidence synthesis accounted for 27.8%, 13.9%, 22.2%, and 36.1% of all included studies, respectively. Children and adolescents (27.8%) and adults (25.0%) were the most frequently studied populations, with limited studies focusing on professionals or teachers. Most studies targeted individuals with developmental disabilities as a combined group (61.1%), followed by those specifically targeting autism spectrum disorder. Research topics included dietary behaviors and nutritional status, nutrition-related education and interventions, health promotion, and medical or clinical issues, with many small-scale and shortterm intervention studies. Conclusion Although research on dietary and nutrition-related issues among individuals with developmental disabilities in Korea has expanded in scope and methodology, significant limitations remain. Future research should adopt longitudinal and community-based approaches, incorporate diverse populations, and strengthen policy-oriented nutrition support systems to promote sustainable health and quality of life for individuals with developmental disabilities.

Background: Vascular smooth muscle cells (VSMCs) play a crucial role in the development of occlusive vascular diseases through abnormal proliferation and migration. This pathological behavior is closely associated with mitochondrial reactive oxygen species (ROS)-mediated mitochondrial DNA (mtDNA) damage. The mitochondrial carrier protein solute carrier family 25 member 33 (SLC25A33), essential for nucleoside transport, is integral to mtDNA production. This study aimed to investigate the effects of SLC25A33 inhibition on the proliferation and migration of VSMCs, as well as its impact on neointima formation. Methods: VSMCs were isolated from the thoracic aorta of 4-week-old Sprague-Dawley rats. The effects of small interfering RNAinduced silencing of SLC25A33 mRNA on platelet-derived growth factor (PDGF)-induced proliferation and migration of VSMCs were analyzed. The in vivo effects of targeting the SLC25A33 gene on neointima formation were evaluated using a murine carotid artery ligation model by perivascularly applying Lenti-shSLC25A33 with Pluronic F-127 gel. Results: First, we observed an upregulation of the SLC25A33 protein in the carotid artery ligation-induced neointima in mice. Silencing of SLC25A33 suppressed the PDGF-stimulated proliferation and migration of VSMCs and cell cycle progression. Knockdown of SLC25A33 inhibited PDGF-induced production of mtDNA and ROS, consequently inactivating the cyclic GMP-AMP synthesis (cGAS)-stimulator of interferon genes (STING)-TANK-binding kinase 1 (TBK1)-nuclear factor kappa B (NF-κB) pathway. Furthermore, the downregulation of SLC25A33 reduced carotid artery ligation-induced neointima in mice. Conclusion This study suggests that targeting SLC25A33 in VSMCs could be a novel therapeutic strategy to prevent occlusive vascular diseases.

Purpose: Physical activity (PA) is considered a potentially effective factor in the primary prevention of gastric cancer (GC). As body mass index (BMI) and waist circumference (WC) differ by sex, particularly with age, this study aimed to investigate the impact of PA on GC development, considering BMI and WC variations by sex. Materials and Methods: We analyzed the impact of PA on GC development using Cox proportional hazard regression in a cohort of 314,525 Korean individuals from the National Health Insurance Service–Health Screening database, using data from 2009–2019.Additionally, subgroup analyses were conducted based on BMI and WC. The models were adjusted for age, sex, smoking status, alcohol consumption, BMI, and comorbidities. Results: The effect of PA on the prevention of GC development was relatively evident in males. The high PA group (metabolic equivalents of task, METs/week of 500–999) showed a lower risk of GC compared to the group with METs/week of 0 (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.79–0.98). Especially in males with WC <90 cm and BMI <23 kg/m2 , a lower risk of GC was observed in the group with METs/week of 1–499 compared to the group with METs/week of 0 (HR, 0.80; 95% CI, 0.67–0.96). In contrast, no consistent association was observed between PA levels and risk of GC in females. Conclusions Moderate PA had a preventive effect on GC development in males, particularly in those with low BMI and WC. However, this effect was not observed in females.

Purpose: This study aimed to establish a basis for minimizing readmission of patients with heart failure by comparing their demographic, clinical, psychosocial, and behavioral characteristics based on the presence or absence of readmission. Methods: This retrospective descriptive study included 160 elderly patients with heart failure aged 60 years and older, who regularly visited the cardiovascular outpatient clinic in K hospital in Daegu.Data were collected from April to December 2021 using self-report questionnaires including the Lubben Social Network Scale, the Scale of Positive and Negative Experience, and European Heart Failure Self-care Behaviour 9-Item Tools, which were translated in the Korean context. IBM SPSS Statistics 25 was used for analysis, and descriptive statistics, χ2 test, Fisher’s exact test, t-test, and logistic regression analysis were conducted. Results: The factors that significantly affected the readmission of elderly patients with heart failure were social network and the type of medications taken. The total explanatory power of the regression model was 22.7%. Social network (OR=0.93, p=.037) and the type of medication taken were 4~5 (OR=4.80, p=.014) and more than 6 medications (OR=7.84, p=.037) had a significant impact on readmission. Conclusion Social network was the most influential factor for readmission. Further studies are needed to minimize readmission by analyzing additional factors that show significant differences.

Background: Clostridioides difficile infection (CDI) is one of the most common hospitalacquired infections, with its incidence and disease burden increasing markedly worldwide over the past decade. Methods: To assess the attributable costs of CDI in Korea, the expenses related to hospital management of CDI cases were computed. This analysis used data from the National Health Insurance Service–National Sample Cohort spanning a decade (2010–2019). The annual national burden of CDI was determined by combining the attributable cost per CDI case with the number of patients with CDI obtained from the Health Insurance Review and Assessment Service data. Results: The attributable costs of CDI were determined based on variations in the length of hospital stay and medical costs between patients with CDI and control patients. The mean length of hospital stay was significantly longer for patients with CDI than that for control patients: 43.06 vs. 14.76 days (a difference of 28.30 days, P < 0.001). The adjusted medical costs (2019 = 100) for cases of CDI and controls were 11,162 USD and 3,318 USD, respectively, with a significant difference of 7,843 USD (P < 0.001). The cost of CDI per case exhibited a noticeable annual increase from 2010 to 2019, despite an annual decreasing trend in length of hospital stay. The estimated national cost attributed to CDI was $28.9 million in 2010; however, it increased gradually each year, reaching $205.6 million in 2019 (a 600% increase over 10 years). Conclusion CDI is associated with substantial healthcare costs in Korea. The economic burden of CDI has gradually increased in South Korea.

Background: Diarrheal disease accounts for a large proportion of childhood deaths in North Korea, however, information regarding its management in North Korean clinical settings is limited. The absence of a reliable diarrheal disease database hinders efforts to determine priorities for support. Methods: Articles published in three major North Korean medical journals between 2012 and 2019 were analyzed to determine the clinical aspects of diagnosing and treating diarrhea. A total of 43 articles were identified during the screening process. Original articles and case reports focusing on the clinical features of diarrheal disease in the pediatric population were included. Results: The clinical features and markers of several types of diarrheal diseases, including infectious diarrhea (20.9%) and diarrhea due to indigestion or malabsorption (18.6%), were assessed. Healthcare providers used multiple treatment modalities, including rehydration solutions, antibiotics, probiotics, and vitamin supplementation. Therapeutic trials on North Korean Oriental medicine were also conducted in more than half of the studies (55.8%). Conclusion This review provides insights into understanding the types of diarrhea and unmet needs in clinical settings in North Korea. Follow-up studies are required to interpret the situation in detail.