OBJECTIVES: The purpose of this study was to estimate the socioeconomic costs resulting from alcohol drinking among adolescents as of 2006 from a societal perspective. METHODS: The costs were classified into direct costs, indirect costs, and other costs. The direct costs consisted of direct medical costs and direct non-medical costs. The indirect costs were computed by future income losses from premature death, productivity losses from using medical services and reduction of productivity from drinking and hangover. The other costs consisted of property damage, public administrative expenses, and traffic accident compensation. RESULTS: The socioeconomic costs of alcohol drinking among adolescents as of 2006 were estimated to be 387.5 billion won (0.05% of GDP). In the case of the former, the amount included 48.25% for reduction of productivity from drinking and hangover, 39.38% for future income losses from premature death, and 6.71% for hangover costs. CONCLUSIONS: The results showed that the socioeconomic costs of alcohol drinking among adolescents in Korea were a serious as compared with that of the United States. Therefore, the active interventions such as a surveillance system and a prevention program to control adolescents drinking by government and preventive medicine specialist are needed.
Accidents, Traffic/economics ; Adolescent ; Alcohol Drinking/*economics ; Costs and Cost Analysis ; Efficiency ; Health Services/economics/utilization ; Humans ; *Models, Economic ; Republic of Korea ; Socioeconomic Factors

BACKGROUND: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes, but more than half of the adults with diabetes in Korea are improperly controlling their glycemic levels. The purpose of this study is to identify the factors associated with poor glycemic control in type 2 diabetes patients. METHODS: This study analyzed 1,261 subjects ≥30 years old diagnosed with type 2 diabetes who participated in the fifth Korean National Health and Nutrition Examination Survey (2010-2012). Poor glycemic control rates were defined as hemoglobin A1c (HbA1c) level ≥7%. To shed light on the causes of poor glycemic control, socio-demographics, diabetes severity, health status, and health behavior factors were adjusted and logistic regression was done. RESULTS: Of the total 1,261 patients, 53.0% of patients with type 2 diabetes had HbA1c ≥7%. After running a logistic regression model, the odds ratio of poor glycemic control was higher in high school graduates than elementary school graduates; in people living in Chungcheong and Jeolla/Jeju than those living in Seoul; in the group with diabetes for over 5 years had diabetes less than 5 years; in a group with insulin and oral hypoglycemic agent treatment than non-treatment; in a group with hypertriglyceridemia than without hypertriglyceridemia; and in the group with slept less than 6 hours slept 7-8 hours. CONCLUSION: We need a comprehensive public health policy to reduce the poor glycemic control rates in type 2 diabetes patients. We should recognize the education levels, duration of diabetes, diabetes treatment, hypertriglyceridemia, and sleep duration were associated with poor glycemic control.
Adult ; Diabetes Mellitus, Type 2* ; Education ; Health Behavior ; Humans ; Hypertriglyceridemia ; Insulin ; Korea* ; Logistic Models ; Nutrition Surveys* ; Odds Ratio ; Public Health ; Running ; Seoul

BACKGROUND: Family values of a married woman may be related to her own depressive mood. Since depressive mood of a married woman is likely to exert a negative influence, in terms of mental health, on her, her family members, and the whole society's, it may be very important to explore the relationship between family values in married women and their depressive mood. METHODS: In this study, we analyzed nationally representative 5,818 married women aged 20 years or older from the 4th panel data of 2012 Korean Longitudinal Survey of Women and Families. As for variables of interest, we constructed three family values variables: family-oriented view of marriage, individualistic view of marriage, and traditional view of marital roles. Then we employed multivariate logistic regression analyses to explore the relationship between family values and depressive mood, adjusting for family and socio-demographic factors. RESULTS: In total, 804 married women (18.4%) had experienced depressive mood. All of the three family values variables were significant in their relationships with depressive mood. The women categorized as ‘very weak’ in family-oriented view of marriage were more likely to experience depressive mood than the women categorized as ‘very strong’ (odds ratio [OR], 1.98; 95% confidence interval [CI], 1.53–2.55). By contrast, the women categorized as ‘very weak’ in individualistic view of marriage (OR, 0.43; 95% CI, 0.33–0.55) and in traditional view of marital roles (OR, 0.68; 95% CI, 0.51–0.92) were less likely to experience depressive mood than their respective counterpart women categorized as ‘very strong.’ CONCLUSION: In Korea, married women's values towards marriage itself and roles between wives and husbands had significant associations with their depressive mood. This suggests that in order to improve mental health in married women, we need to take social and cultural dimensions into consideration along with public health interventions.
Depression ; Female ; Humans ; Korea ; Logistic Models ; Longitudinal Studies ; Marriage ; Mental Health ; Public Health ; Spouses

BACKGROUND: This study aimed to explore the associations of social-demographic, health-behavioral, and woman-specific factors with the non-screening status of the cervical cancer screening test in Korean adult women. METHODS: This study was a cross-sectional analysis of 9,698 Korean adult women aged 20 years or more who participated in the Korea National Health and Nutrition Examination Surveys V (2010–2012). Rao-Scott chi-square tests and survey logistic regression analyses were employed respectively to analyze the difference in the non-screening status of the cervical cancer screening test by each characteristic and to explore the factors related to the non-screening status. RESULTS: The rate of the non-screening status of the cervical cancer screening test was 53.5% over the previous 2 years. In the survey logistics regression analysis, age, marital status, educational levels, income levels, residential area, occupation, private health insurance, smoking, alcohol, obesity, menstrual status, pregnancy experience, and hormone replacement therapy were significantly associated with the non-screening status of the cervical cancer screening test. CONCLUSION On the basis of the results of this study, some social-demographic, health-behavioral, and woman-specific characteristics of Korean adult women seem to affect the non-screening status of the cervical cancer screening test. Therefore, appropriate health policies need to be designed, implemented, monitored, and evaluated to reduce the non-screening status of the cervical cancer screening test of them.

Background: Most developed countries are working to improve their universal health coverage systems. This study investigates regional disparities in unmet healthcare needs and their causes in South Korea. Additionally, it compares the unmet healthcare needs rate in South Korea with that of 33 European countries. Methods: The analysis incorporates information from 13,359 adults aged 19 or older, using data from the Korea Health Panel. The dependent variables encompass the experience of unmet healthcare needs and the three causes of occurrence: “burden of medical expenses,” “time constraints,” and “lack of care.” The primary variable of interest is the region of residence, while control variables encompass 14 socio-demographic, health, and functional characteristics. Multivariable binary logistic regression analysis, accounting for the sampling design, is conducted. Results: The rate of unmet healthcare needs in Korea is 11.7% (95% confidence interval [CI], 11.0%–13.3%), which is approximately 30 times higher than that of Austria (0.4%). The causes of unmet healthcare needs, ranked in descending order, are “lack of care,” “time constraints,” and “burden of medical expenses.” Predictive probabilities for experiencing unmet healthcare needs and each cause differ significantly between regions. For instance, the probability of experiencing unmet healthcare needs due to “lack of care” is approximately 10 times higher in Gangwon-do (13.5%; 95% CI, 13.0%–14.1%) than in Busan (1.3%; 95% CI, 1.3%–1.4%). The probability due to “burden of medical expenses” is approximately 14 times higher in Seoul (4.1%; 95% CI, 3.6%–4.6%) compared to Jeollanam-do (0.3%; 95% CI, 0.2%–0.4%). Conclusion Amid rapid sociodemographic transitions, South Korea must make significant efforts to alleviate unmet healthcare needs and the associated regional disparities. To effectively achieve this, it is recommended that South Korea involves the National Assembly in healthcare policy-making, while maintaining a centralized financing model and delegating healthcare planning and implementation to regional authorities for their local residents—similar to the approaches of the United Kingdom and France.

Purpose: The aim of the present study was to investigate the potential utility of the magnetic susceptibility-based assessment of cerebral oxygen metabolism with a dataset from a memory clinic. Materials and Methods: We collected and processed three-dimensional gradient-recalled echo phase data of 290 participants. To analyze oxygen metabolism, quantitative susceptibility mapping was performed for two major veins (superior sagittal sinus and straight sinus), and the venous oxygen saturation was estimated. Results: The estimated venous oxygen saturations of the two major veins were positively correlated with the clinical and volumetric measurements. They did not differ with the clinical diagnosis or clinical dementia rating. The values of the superior sagittal sinus were associated with the presence of the apolipoprotein E type 4 allele, when considering age, sex, and their interactions. Conclusion The results demonstrate that quantitative susceptibility mapping of clinically available three-dimensional susceptibility-weighted imaging sequences in a large-scale clinical dataset can estimate cerebral oxygen metabolism.

Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient’s various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32–0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57– 0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05–1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30–2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34–2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19–2.11); people having diabetes (OR, 1.81; 95% CI, 1.41–2.32);or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28–8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension.Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.

Background: There have been many studies on the associations between body mass index (BMI) and cognitive function. However, no study has ever compared the associations across the methods of categorizing BMI. In this study, we aimed to fill the gap in the previous studies and examine whether the obesity paradox is valid in the risk of cognitive function. Methods: Of the 10,254 people aged 45 and older from the Korean Longitudinal Study of Ageing from 2006 to 2016, 8,970 people were finalized as the study population. The dependent variable was whether a person has a normal cognitive function or not, and the independent variables of interest were BMI categorized by the World Health Organization Western Pacific Regional Office (WHO-WPRO) method, the WHO method, and a 10-group method. Covariates included sociodemographic factors, health behavior factors, and health status factors. A generalized linear mixed model analysis with a logit link was used. Results: In the adjusted model with all covariates, first, in the case of BMI categories of the WHO-WPRO method, underweight (odds ratio [OR], 1.16; 95% confidence interval [CI], 1.15–1.17), overweight (OR, 1.36; 95% CI, 1.35–1.36), and obese (OR, 1.34; 95% CI, 1.33–1.34) groups were more likely to have a normal cognitive function than a normal-weight group. Next, in the case of BMI categories of the WHO method, compared to a normal-weight group, underweight (OR, 1.15; 95% CI, 1.14–1.16) and overweight (OR, 1.06; 95% CI, 1.06–1.07) groups were more likely to have a normal cognitive function; however, obese (OR, 0.62; 95% CI, 0.61–0.63) group was less likely to have it. Lastly, in the case of the 10-group method, as BMI increased, the likelihood to have a normal cognitive function changed like a wave, reaching a global top at group-7 (26.5 kg/㎡ ≤ BMI <28.0 kg/㎡ ). Conclusion The associations between BMI and cognitive function differed according to how BMI was categorized among people aged 45 and older in Korea, which suggests that cognitive function may be positively associated with BMI in some categories of BMI but negatively in its other categories. Health policies to reduce cognitive impairment need to consider this association between BMI and cognitive function.

Background: As the population is aging, chronic diseases and depression are becoming the main problems in a country’s healthcare system. In this study, we aimed to explore the associations between chronic diseases and depression among the elderly in South Korea. Methods: We analyzed 9,975 (men, 4,147; women, 5,828) respondents obtained from the 2014 National Survey of Living Conditions and Welfare Needs of Korean Older Persons. Our dependent variable was either 1 or 0 according to whether a respondent had depression or not, where depression was defined when the Short Form of Geriatric Depression Scale score was 8 or more points. Variables of interest were 24 types of chronic diseases and covariates included various socio-demographic and health behavior characteristics. We performed Rao-Scott chi-square tests and hierarchal logistic regression analyses by gender, reflecting the characteristics of the survey. Results: A significant difference was found in the proportion of having depression between genders (men 18.9% vs. women 23.4%). According to fully adjusted, multivariable analyses, for elderly men, relative to those without any chronic disease, the odds ratio of depression was 1.56 (95% confidence interval [CI], 1.10–2.22) in the stroke patients group and 1.82 (95% CI, 1.01–3.25) in the osteoporosis patients group. For elderly women, the odds ratio was 1.96 (95% CI, 1.28–3.00) in the fracture/dislocation and aftereffects patients group and 1.30 (95% CI, 1.03–1.64) in the group of patients with other diseases. Conclusion Even after being adjusted for diverse characteristics, some chronic diseases were significantly associated with depression in the elderly and the association differed between genders. Therefore, public health and medical interventions are needed to manage such chronic diseases together with curing depression symptoms.

Background: Korea has gradually expanded the coverage of medical care services in its national health insurance system. On April 1, 2018, it implemented a policy that expanded the coverage for an ultrasonography in the upper abdomen. In this study, we aimed to investigate the effect of the policy on the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals. Methods: Using the dataset of the Health Insurance Review and Assessment Service, we explored changes in the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals from July 1, 2017 to November 30, 2018 through the difference-in-difference (DID) mixed-effects-model method. Facility factor, equipment factor and personnel factors, type of hospital, the total amount of medical care expenses, and geographic region were considered as control variables. Results: On average, the utilization of the ultrasonography in the upper abdomen increased by 228% after the coverage expansion policy. However, the results of DID mixed-effects-model method analysis showed that the utilization increased by 73%. As for the number of beds, the utilization was higher with a group of 844–930, 931–1,217, and 1,218 or greater compared with a group of 843 or fewer, while the utilization of the number of ultrasonic devices was lower with a group of 45–49 compared with a group of 44 or fewer. The utilization decreased with the number of interns and the number of nurse assistants. Besides, relative to Seoul, the utilization was lower in the other metro-cities and provinces. Conclusion The coverage expansion policy in the national health insurance system increased service utilization among people. Future research needs to investigate the degree to which such coverage expansion policy reduces the unmet medical care needs among the deprived in Korea.