Background: The Korean government is implementing policy to reduce medical costs and improve treatment related for human immunodeficiency virus (HIV) patients. The level of cost reduction and the benefits provided vary depending on how individuals with HIV utilize the system. This study aims to determine exact HIV prevalence by analyzing healthcare utilization patterns and examining differences in healthcare usage based on how individuals pay for their medical expenses. Materials and Methods: We analyzed National Health Insurance Service (NHIS) claims data from 2002 to 2021. From a total of 106,675 individuals with at least one HIV-related claim, 22,779 participants were selected for this study. Results: Data from Korea Disease Control and Prevention Agency annual reports indicated that 93% of HIV patients were male, while NHIS data showed 84%. In the analysis of those exempted from registration, it was found that the registration rate for female patients is notably low, with adults between the ages of 20 and 40 making up 80% of the total. The registration rate in Gangwon State was lower than Seoul. The treatment experience rate was much higher in the registered group (93.0%) than the unregistered group (4.9%). Also, there was a big difference in treatment continuity rates: 76.2% for registered individuals and 2.8% for non-registered individuals. Conclusion The exempt calculation system for health insurance improves HIV care. However, those diagnosed anonymously or with reduced medical costs may be less likely to continue HIV treatment, so a new policy is needed to ensure anonymity and treatment continuity.

Background: The Korean government is implementing policy to reduce medical costs and improve treatment related for human immunodeficiency virus (HIV) patients. The level of cost reduction and the benefits provided vary depending on how individuals with HIV utilize the system. This study aims to determine exact HIV prevalence by analyzing healthcare utilization patterns and examining differences in healthcare usage based on how individuals pay for their medical expenses. Materials and Methods: We analyzed National Health Insurance Service (NHIS) claims data from 2002 to 2021. From a total of 106,675 individuals with at least one HIV-related claim, 22,779 participants were selected for this study. Results: Data from Korea Disease Control and Prevention Agency annual reports indicated that 93% of HIV patients were male, while NHIS data showed 84%. In the analysis of those exempted from registration, it was found that the registration rate for female patients is notably low, with adults between the ages of 20 and 40 making up 80% of the total. The registration rate in Gangwon State was lower than Seoul. The treatment experience rate was much higher in the registered group (93.0%) than the unregistered group (4.9%). Also, there was a big difference in treatment continuity rates: 76.2% for registered individuals and 2.8% for non-registered individuals. Conclusion The exempt calculation system for health insurance improves HIV care. However, those diagnosed anonymously or with reduced medical costs may be less likely to continue HIV treatment, so a new policy is needed to ensure anonymity and treatment continuity.

Background: The Korean government is implementing policy to reduce medical costs and improve treatment related for human immunodeficiency virus (HIV) patients. The level of cost reduction and the benefits provided vary depending on how individuals with HIV utilize the system. This study aims to determine exact HIV prevalence by analyzing healthcare utilization patterns and examining differences in healthcare usage based on how individuals pay for their medical expenses. Materials and Methods: We analyzed National Health Insurance Service (NHIS) claims data from 2002 to 2021. From a total of 106,675 individuals with at least one HIV-related claim, 22,779 participants were selected for this study. Results: Data from Korea Disease Control and Prevention Agency annual reports indicated that 93% of HIV patients were male, while NHIS data showed 84%. In the analysis of those exempted from registration, it was found that the registration rate for female patients is notably low, with adults between the ages of 20 and 40 making up 80% of the total. The registration rate in Gangwon State was lower than Seoul. The treatment experience rate was much higher in the registered group (93.0%) than the unregistered group (4.9%). Also, there was a big difference in treatment continuity rates: 76.2% for registered individuals and 2.8% for non-registered individuals. Conclusion The exempt calculation system for health insurance improves HIV care. However, those diagnosed anonymously or with reduced medical costs may be less likely to continue HIV treatment, so a new policy is needed to ensure anonymity and treatment continuity.

OBJECTIVES: To estimate time-variant reproductive number (Rt) of coronavirus disease 19 based on either number of daily confirmed cases or their onset date to monitor effectiveness of quarantine policies. METHODS: Using number of daily confirmed cases from January 23, 2020 to March 22, 2020 and their symptom onset date from the official website of the Seoul Metropolitan Government and the district office, we calculated Rt using program R’s package “EpiEstim”. For asymptomatic cases, their symptom onset date was considered as -2, -1, 0, +1, and +2 days of confirmed date. RESULTS: Based on the information of 313 confirmed cases, the epidemic curve was shaped like ‘propagated epidemic curve’. The daily Rt based on Rt_c peaked to 2.6 on February 20, 2020, then showed decreased trend and became <1.0 from March 3, 2020. Comparing both Rt from Rt_c and from the number of daily onset cases, we found that the pattern of changes was similar, although the variation of Rt was greater when using Rt_c. When we changed assumed onset date for asymptotic cases (-2 days to +2 days of the confirmed date), the results were comparable. CONCLUSIONS Rt can be estimated based on Rt_c which is available from daily report of the Korea Centers for Disease Control and Prevention. Estimation of Rt would be useful to continuously monitor the effectiveness of the quarantine policy at the city and province levels.

OBJECTIVES: To estimate time-variant reproductive number (Rt) of coronavirus disease 19 based on either number of daily confirmed cases or their onset date to monitor effectiveness of quarantine policies. METHODS: Using number of daily confirmed cases from January 23, 2020 to March 22, 2020 and their symptom onset date from the official website of the Seoul Metropolitan Government and the district office, we calculated Rt using program R’s package “EpiEstim”. For asymptomatic cases, their symptom onset date was considered as -2, -1, 0, +1, and +2 days of confirmed date. RESULTS: Based on the information of 313 confirmed cases, the epidemic curve was shaped like ‘propagated epidemic curve’. The daily Rt based on Rt_c peaked to 2.6 on February 20, 2020, then showed decreased trend and became <1.0 from March 3, 2020. Comparing both Rt from Rt_c and from the number of daily onset cases, we found that the pattern of changes was similar, although the variation of Rt was greater when using Rt_c. When we changed assumed onset date for asymptotic cases (-2 days to +2 days of the confirmed date), the results were comparable. CONCLUSIONS Rt can be estimated based on Rt_c which is available from daily report of the Korea Centers for Disease Control and Prevention. Estimation of Rt would be useful to continuously monitor the effectiveness of the quarantine policy at the city and province levels.

PURPOSE: We aimed to compare the detection of breast cancer using full-field digital mammography (FFDM), FFDM with computer-aided detection (FFDM+CAD), ultrasound (US), and FFDM+CAD plus US (FFDM+CAD+US), and to investigate the factors affecting cancer detection. METHODS: In this retrospective study conducted from 2008 to 2012, 48,251 women underwent FFDM and US for cancer screening. One hundred seventy-one breast cancers were detected: 115 invasive cancers and 56 carcinomas in situ. Two radiologists evaluated the imaging findings of FFDM, FFDM+CAD, and US, based on the Breast Imaging Reporting and Data System lexicon of the American College of Radiology by consensus. We reviewed the clinical and the pathological data to investigate factors affecting cancer detection. We statistically used generalized estimation equations with a logit link to compare the cancer detectability of different imaging modalities. To compare the various factors affecting detection versus nondetection, we used Wilcoxon rank sum, chi-square, or Fisher exact test. RESULTS: The detectability of breast cancer by US (96.5%) or FFDM+CAD+US (100%) was superior to that of FFDM (87.1%) (p=0.019 or p<0.001, respectively) or FFDM+ CAD (88.3%) (p=0.050 or p<0.001, respectively). However, cancer detectability was not significantly different between FFDM versus FFDM+CAD (p=1.000) and US alone versus FFDM+CAD+US (p=0.126). The tumor size influenced cancer detectability by all imaging modalities (p<0.050). In FFDM and FFDM+CAD, the nondetecting group consisted of younger patients and patients with a denser breast composition (p<0.050). In breast US, carcinoma in situ was more frequent in the nondetecting group (p=0.014). CONCLUSION: For breast cancer screening, breast US alone is satisfactory for all age groups, although FFDM+ CAD+US is the perfect screening method. Patient age, breast composition, and pathological tumor size and type may influence cancer detection during screening.
Breast Neoplasms* ; Breast* ; Carcinoma in Situ ; Consensus ; Diagnosis, Computer-Assisted ; Early Detection of Cancer ; Female ; Humans ; Information Systems ; Mammography* ; Mass Screening* ; Methods ; Retrospective Studies ; Ultrasonography* ; Ultrasonography, Mammary