1.Attributable Costs of Clostridioides difficile Infections in Korea
Rangmi MYUNG ; Eugene LEE ; Jinyeong KIM ; Jieun KIM ; Hyunjoo PAI
Journal of Korean Medical Science 2025;40(4):e22-
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.
2.Attributable Costs of Clostridioides difficile Infections in Korea
Rangmi MYUNG ; Eugene LEE ; Jinyeong KIM ; Jieun KIM ; Hyunjoo PAI
Journal of Korean Medical Science 2025;40(4):e22-
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.
3.Attributable Costs of Clostridioides difficile Infections in Korea
Rangmi MYUNG ; Eugene LEE ; Jinyeong KIM ; Jieun KIM ; Hyunjoo PAI
Journal of Korean Medical Science 2025;40(4):e22-
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.
4.Attributable Costs of Clostridioides difficile Infections in Korea
Rangmi MYUNG ; Eugene LEE ; Jinyeong KIM ; Jieun KIM ; Hyunjoo PAI
Journal of Korean Medical Science 2025;40(4):e22-
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.
5.Injury rates and work-related diseases following workforce reduction among South Korean on-site workers in basic local governments between 2016 and 2018
Dongwhan SUH ; Nahyun KIM ; Han-Na JUNG ; Woo Chul JEONG ; Hyunjoo KIM
Annals of Occupational and Environmental Medicine 2025;37(1):e17-
Background:
South Korean on-site workers in the public sector, fully covered by the Occupational Safety and Health Act, often perform hazardous tasks. However, their status and injury rates remain poorly documented. This study aimed to analyze changes in injury rates and the proportion of work-related diseases (WRDs) among on-site workers in basic local governments (BLGs) following workforce reductions between 2016 and 2018.
Methods:
Data from two sources provided by the Ministry of Employment and Labor were analyzed: organizational data on the number of on-site workers, and cases of injuries, deaths, and diseases among on-site workers in 226 BLGs from 2016 to 2018; and workers’ compensation claims data (individual data) for on-site workers in BLGs during the same period. Injury, mortality, and disease incidence rates were calculated and compared between BLGs with increased and decreased workforce. The proportion of WRDs among all the injuries was also examined.
Results:
The total number of on-site workers in BLGs decreased by 18.1% in 2018 compared with 2016. The injury rate increased from 0.46% in 2016 to 0.62% in 2018. BLGs with workforce reductions showed higher injury rates, particularly in those with fewer than 1,000 on-site workers. The proportion of WRDs among all injuries increased by 1.34 times in 2018 compared with 2016.
Conclusions
Workforce reductions among on-site workers in BLGs are associated with higher injury rates and a great proportion of WRDs. These findings highlight the need for improved occupational safety and health practices within the public sector and serve as an important basis for establishing workforce management and injury prevention policies. However, limitations in the available data made it challenging to identify worker groups particularly vulnerable to WRDs. Further research is needed, as it is critical for the development of effective occupational safety and health policies.
6.Association between urinary polycyclic aromatic hydrocarbon metabolites and the prevalence of respiratory disease in residents living near Pohang Industrial Complex
Minji KIM ; Sangwoo LIM ; Seongrok KIM ; Jea Chul HA ; Hyunjoo KIM ; Insung CHUNG
Annals of Occupational and Environmental Medicine 2025;37(1):e27-
Background:
Polycyclic aromatic hydrocarbons are generated from the incomplete combustion of organic materials such as fossil fuels and wood. These compounds, often inhaled, cause respiratory issues like asthma and chronic obstructive pulmonary disease due to oxidative stress and inflammation. Pohang, South Korea’s iron and steel hub, experiences significant polycyclic aromatic hydrocarbons emissions from extensive industrial activities and heavy truck movements. This study investigates the link between urinary polycyclic aromatic hydrocarbons metabolites and respiratory diseases among Pohang residents, considering their cumulative exposure and duration of residency.
Methods:
Utilizing data from the National Environmental Research Institute’s health impact assessment conducted between 2012 and 2015, this study included 1,189 participants from Pohang. Urinary concentrations of polycyclic aromatic hydrocarbons metabolites served as exposure indicators. The study assessed the correlation between these metabolite levels and self-reported respiratory diseases, considering variables such as duration of residence, smoking status, and occupational exposures. Statistical analyses involved logistic regression and fixed-effect meta-analysis.
Results:
The findings indicate a significant association between elevated levels of polycyclic aromatic hydrocarbons metabolites and an increased risk of respiratory diseases, particularly among those in the highest exposure quartile. The study also found a notable dose-response relationship, emphasizing the heightened risk with longer residency durations near the industrial complex. Despite yearly fluctuations, the trend suggests a persistent risk associated with high polycyclic aromatic hydrocarbons exposure.
Conclusions
Elevated exposure to polycyclic aromatic hydrocarbons near industrial areas such as the Pohang Industrial Complex is significantly associated with an increased prevalence of respiratory diseases. The study underscores the importance of implementing public health strategies to reduce polycyclic aromatic hydrocarbons exposure, especially in industrial regions. Future research should broaden the scope of polycyclic aromatic hydrocarbons metabolites analyzed and consider comprehensive exposure histories to better understand the relationship between polycyclic aromatic hydrocarbons exposure and respiratory health outcomes.
7.Factors affecting heat-related illness symptoms among school food service workers: a cross-sectional study in Korea
Nahyun KIM ; Dongwhan SUH ; Jia RYU ; Woo Chul JEONG ; Yun-Keun LEE ; Jinwoo LEE ; Hyunjoo KIM
Annals of Occupational and Environmental Medicine 2025;37(1):e30-
Background:
School food service workers are highly likely to develop heat-related illnesses because of their work environment. However, studies that have examined the risk of heat-related illnesses among them are limited. The purpose of this study was to investigate the status of heat exposure, implementation of heat wave countermeasures, and prevalence of heat-related illness symptoms among school food service workers in Korea, and to explore the relationship between them.
Methods:
A cross-sectional study was conducted through an online survey of school food service workers from May 25 to June 12, 2023, via three labor unions. We analyzed 6,244 valid responses. We assessed general characteristics, heat-related illness symptoms (heat rash, heat cramps, heat edema, heat exhaustion, heat syncope), duration of heat exposure during heat waves, and heat wave preventive measures. Multiple logistic regression analyses were performed, with adjustments for age, occupation, hypertension, diabetes, and school type.
Results:
More than one-third of school food service workers reported heat exposure between May and September exceeding 4 hours daily, and 94.6% experienced at least one heat-related illness symptom during the last year. A dose-response relationship was observed between heat exposure duration and heat-related illness symptoms (p for trend < 0.001). School food service workers who did not have increased rest periods or did not reduce high-heat prepared foods showed significantly higher odds ratios for heat-related illness symptoms.
Conclusions
School food service workers experience substantial heat exposure and a high prevalence of heat-related illness symptoms. The risk of heat-related illness symptoms was associated with extended duration of heat exposure. Increasing rest periods and reducing high-heat food preparation were effective preventive measures. These findings underscore the need for improved heat exposure management and implementation of effective preventive measures to protect the health of school food service workers, with particular attention to appropriate rest periods.
8.Harnessing the Power of Voice: A Deep Neural Network Model for Alzheimer’s Disease Detection
Chan-Young PARK ; Minsoo KIM ; YongSoo SHIM ; Nayoung RYOO ; Hyunjoo CHOI ; Ho Tae JEONG ; Gihyun YUN ; Hunboc LEE ; Hyungryul KIM ; SangYun KIM ; Young Chul YOUN
Dementia and Neurocognitive Disorders 2024;23(1):1-10
Background:
and Purpose: Voice, reflecting cerebral functions, holds potential for analyzing and understanding brain function, especially in the context of cognitive impairment (CI) and Alzheimer’s disease (AD). This study used voice data to distinguish between normal cognition and CI or Alzheimer’s disease dementia (ADD).
Methods:
This study enrolled 3 groups of subjects: 1) 52 subjects with subjective cognitive decline; 2) 110 subjects with mild CI; and 3) 59 subjects with ADD. Voice features were extracted using Mel-frequency cepstral coefficients and Chroma.
Results:
A deep neural network (DNN) model showed promising performance, with an accuracy of roughly 81% in 10 trials in predicting ADD, which increased to an average value of about 82.0%±1.6% when evaluated against unseen test dataset.
Conclusions
Although results did not demonstrate the level of accuracy necessary for a definitive clinical tool, they provided a compelling proof-of-concept for the potential use of voice data in cognitive status assessment. DNN algorithms using voice offer a promising approach to early detection of AD. They could improve the accuracy and accessibility of diagnosis, ultimately leading to better outcomes for patients.
9.Incidence of Clostridioides difficile Infections in Republic of Korea:A Prospective Study With Active Surveillance vs. National Data From Health Insurance Review & Assessment Service
Jieun KIM ; Rangmi MYUNG ; Bongyoung KIM ; Jinyeong KIM ; Tark KIM ; Mi Suk LEE ; Uh Jin KIM ; Dae Won PARK ; Yeon-Sook KIM ; Chang-Seop LEE ; Eu Suk KIM ; Sun Hee LEE ; Hyun-Ha CHANG ; Seung Soon LEE ; Se Yoon PARK ; Hee Jung CHOI ; Hye In KIM ; Young Eun HA ; Yu Mi WI ; Sungim CHOI ; So Youn SHIN ; Hyunjoo PAI
Journal of Korean Medical Science 2024;39(12):e118-
Background:
Since the emergence of hypervirulent strains of Clostridioides difficile, the incidence of C. difficile infections (CDI) has increased significantly.
Methods:
To assess the incidence of CDI in Korea, we conducted a prospective multicentre observational study from October 2020 to October 2021. Additionally, we calculated the incidence of CDI from mass data obtained from the Health Insurance Review and Assessment Service (HIRA) from 2008 to 2020.
Results:
In the prospective study with active surveillance, 30,212 patients had diarrhoea and 907 patients were diagnosed with CDI over 1,288,571 patient-days and 193,264 admissions in 18 participating hospitals during 3 months of study period; the CDI per 10,000 patientdays was 7.04 and the CDI per 1,000 admission was 4.69. The incidence of CDI was higher in general hospitals than in tertiary hospitals: 6.38 per 10,000 patient-days (range: 3.25–12.05) and 4.18 per 1,000 admissions (range: 1.92–8.59) in 11 tertiary hospitals, vs. 9.45 per 10,000 patient-days (range: 5.68–13.90) and 6.73 per 1,000 admissions (range: 3.18–15.85) in seven general hospitals. With regard to HIRA data, the incidence of CDI in all hospitals has been increasing over the 13-year-period: from 0.3 to 1.8 per 10,000 patient-days, 0.3 to 1.6 per 1,000 admissions, and 6.9 to 56.9 per 100,000 population, respectively.
Conclusion
The incidence of CDI in Korea has been gradually increasing, and its recent value is as high as that in the United State and Europe. CDI is underestimated, particularly in general hospitals in Korea.
10.Targeted Therapy of Advanced Non-Small Cell Lung Cancer
Yun-Gyoo LEE ; Hyun-Il GIL ; Soo Jeong KIM ; Hyunjoo LEE ; Heerim NAM ; Soo-Youn HAM ; Du-Young KANG
Korean Journal of Medicine 2024;99(2):96-103
Lung cancer is the leading cause of cancer death in Republic of Korea. After their initial diagnosis, only 10-20% of patients with advanced non-small cell lung cancer (NSCLC) survive for 5 years of longer. Given enormous advances in therapeutics such as novel targeted therapies and immunotherapies, survival rates are improving for advanced patients with NSCLC; 5-year survival rates range from 15% to 50%, contingent upon the biomarker. Detection of the specific molecular alteration as biomarker is thus crucial for identifying subgroups of NSCLC that contain therpapeutically targetable oncogenic drivers. This review examines the process of diagnosing lung adenocarcinoma with dominant biomarkers in order to customize treatment with appropriate targeted therapy.

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