1.Association of Physical Activity with Dementia Risk in Cancer Survivors: A Korean Nationwide Cohort Study
Su Kyoung LEE ; Minji HAN ; Sangwoo PARK ; Sun Jae PARK ; Jihun SONG ; Hye Jun KIM ; Jaewon KIM ; Hyeokjong LEE ; Hyun-Young SHIN ; Kyae Hyung KIM ; Sang Min PARK
Cancer Research and Treatment 2026;58(1):48-60
Purpose:
This study aimed to investigate the impact of physical activity on dementia risk among cancer survivors in South Korea.
Materials and Methods:
This retrospective, population-based cohort study included 344,152 cancer survivors identified from the National Health Insurance Service database in South Korea. The mean follow-up time was 5.81 years. Different levels of physical activity post-cancer diagnosis, ranging from inactive to highly active, were assessed. The primary outcome was the incidence of overall dementia, Alzheimer’s disease, and vascular dementia. Secondary outcomes included dementia risk stratified by cancer type and treatment (chemotherapy and radiation).
Results:
Of the total participants, 24,363 (7.08%) developed dementia. The risk of overall dementia decreased sequentially across the exercise groups compared to the inactive group: insufficiently active (adjusted hazard ratio [HR], 0.89; 95% confidence interval [CI], 0.86 to 0.92), active (adjusted HR, 0.85; 95% CI, 0.83 to 0.88), and highly active (adjusted HR, 0.79; 95% CI, 0.76 to 0.82). This inverse relationship between exercise and dementia risk was statistically significant across various cancer types and was consistent regardless of age, comorbidities, and whether or not excluding the first 1, 2 years.
Conclusion
Among cancer survivors in South Korea, increased physical activity post-diagnosis was associated with a significantly lower risk of dementia. These findings underscore the importance of promoting physical activity in cancer survivors for cognitive health.
2.Home Healthcare Needs and Characteristics of Patients with Serious Illnesses Who Use Hospital-Affiliated Home-Based Medical Care in Korea
Woohyeon CHO ; Sun Young LEE ; Shin Hye YOO ; Belong CHO ; Kyae Hyung KIM ; In Young HWANG
Yonsei Medical Journal 2026;67(1):62-70
Purpose:
The number of homebound adults with serious illnesses is increasing. This study aimed to examine the healthcare needs and characteristics of patients who use a hospital-affiliated physician-led home-based medical care (HBMC) program and identify factors associated with emergency department (ED) visits in Korea.
Materials and Methods:
This retrospective observational study included patients who used a HBMC program at a tertiary hospital between 2020 and 2023. Patient characteristics and home healthcare needs were analyzed by disease category: cancer, advanced neurologic disease, and others. Multivariable logistic regression analysis was used to identify factors associated with ED visits within 30 days of a physician’s home visit.
Results:
A total of 600 patients were registered and received home visits; 58.5% had cancer and 29.7% had advanced neurologic diseases, e.g., amyotrophic lateral sclerosis. The median age was 72 years [interquartile range (IQR), 62.8–81.0], and 87.0% were dependent in daily activities. The median number of medications per patient was 6 (IQR, 3–10); 66.3% took ≥5 medications and 25.7% took ≥10 (excessive polypharmacy). Physicians provided not only physical examinations (100%) and symptom assessment (90.8%), but also home environment evaluation (86.7%), medical device management (62.0%), advanced care planning (40.7%), and acute health issue management (32.5%). Within 30 days, 19.2% of patients visited the ED. Excessive polypharmacy and cancer diagnosis were associated with increased ED visits.
Conclusion
Most patients who used the hospital-affiliated HBMC program had cancer, advanced neurologic disease, and polypharmacy. Targeted HBMC programs are needed for patients with serious illnesses living at home.
3.Current Status and Future Directions of Primary Care in the World: Insights from United States (1) —Primary Care and Payment Reform—
Korean Journal of Family Practice 2025;15(1):9-16
The United States has implemented various payment system reforms to strengthen primary care. Since there is no universal healthcare coverage, individuals are enrolled in private insurance or public programs, such as Medicare and Medicaid. Following the enactment of the Affordable Care Act in 2010, the number of uninsured individuals was halved. To reform the payment system, incorporating multiple payers is essential. Fee-for-service alone makes it difficult to provide multidisciplinary care and high-quality, comprehensive primary care, leading to the implementation of various hybrid payment models, such as capitation and performance-based payment systems. Value-based payment is a performance-based incentive that is typically provided as an additional incentive rather than a standalone payment method. Early physician-focused, value-based payment models included the “Physician Value-Based Payment Modifier,” which was later improved with implementation of the “Merit-based Incentive Payment System” and “Alternative Payment Model.” For primary care institutions, performance-based payments are provided based on rating evaluations, with up to 5% in incentive payments. Hybrid payment approaches have proven to be more effective than single-payment methods. Performancebased incentives are particularly effective when tied to specific conditions, such as per patient visit, per medical service, or improvement over previous performance.
4.Telemedicine Experiences of People Living with Amyotrophic Lateral Sclerosis at Home in South Korea
Min Sun KIM ; Shin Hye YOO ; Kyae Hyung KIM ; Belong CHO ; Sun Young LEE
Yonsei Medical Journal 2025;66(6):366-373
Purpose:
Telemedicine is advantageous in providing medical care to patients with mobility difficulties. This single-center study aimed to report on the provision of video televisits to people living with amyotrophic lateral sclerosis (pALS, ALS) who were registered with a home-based medical care (HBMC) team in a tertiary hospital in South Korea.
Materials and Methods:
A retrospective cross-sectional study was conducted for pALS provided with video televisits by the HBMC team between July 2020 and February 2023. The patients’ demographics, disease status, mobility level, and supportive care equipment were investigated. The main issues discussed at televisits were investigated.
Results:
During the 32-month study period, video televisits were provided to 69 (81.2%) of the 85 pALS registered with the HBMC team. Their median (interquartile range) age was 66 (57–71) years, and 66.7% were aged 60 years or older. At the time of the televisits, 71.0% were non-ambulatory and 27.5% were at an assisted ambulatory level. Furthermore, 82.6% were receiving nutritional support with a nasogastric or gastrostomy tube, and 78.3% had received either non-invasive positive pressure ventilation (43.5%) or tracheostomy invasive ventilation (34.8%). Common issues addressed on televisits were disease-related symptoms (100%), management of supportive care equipment (92.8%), acute health issues (52.2%), and advance care planning (ACP) including goal of care discussion (14.5%).
Conclusion
Video telemedicine is feasible for pALS, including older adults with limited mobility due to muscle weakness or reliance on various supportive care equipment. Video televisits allow for a variety of discussions, ranging from acute health issues to ACP.
5.Telemedicine Experiences of People Living with Amyotrophic Lateral Sclerosis at Home in South Korea
Min Sun KIM ; Shin Hye YOO ; Kyae Hyung KIM ; Belong CHO ; Sun Young LEE
Yonsei Medical Journal 2025;66(6):366-373
Purpose:
Telemedicine is advantageous in providing medical care to patients with mobility difficulties. This single-center study aimed to report on the provision of video televisits to people living with amyotrophic lateral sclerosis (pALS, ALS) who were registered with a home-based medical care (HBMC) team in a tertiary hospital in South Korea.
Materials and Methods:
A retrospective cross-sectional study was conducted for pALS provided with video televisits by the HBMC team between July 2020 and February 2023. The patients’ demographics, disease status, mobility level, and supportive care equipment were investigated. The main issues discussed at televisits were investigated.
Results:
During the 32-month study period, video televisits were provided to 69 (81.2%) of the 85 pALS registered with the HBMC team. Their median (interquartile range) age was 66 (57–71) years, and 66.7% were aged 60 years or older. At the time of the televisits, 71.0% were non-ambulatory and 27.5% were at an assisted ambulatory level. Furthermore, 82.6% were receiving nutritional support with a nasogastric or gastrostomy tube, and 78.3% had received either non-invasive positive pressure ventilation (43.5%) or tracheostomy invasive ventilation (34.8%). Common issues addressed on televisits were disease-related symptoms (100%), management of supportive care equipment (92.8%), acute health issues (52.2%), and advance care planning (ACP) including goal of care discussion (14.5%).
Conclusion
Video telemedicine is feasible for pALS, including older adults with limited mobility due to muscle weakness or reliance on various supportive care equipment. Video televisits allow for a variety of discussions, ranging from acute health issues to ACP.
6.Telemedicine Experiences of People Living with Amyotrophic Lateral Sclerosis at Home in South Korea
Min Sun KIM ; Shin Hye YOO ; Kyae Hyung KIM ; Belong CHO ; Sun Young LEE
Yonsei Medical Journal 2025;66(6):366-373
Purpose:
Telemedicine is advantageous in providing medical care to patients with mobility difficulties. This single-center study aimed to report on the provision of video televisits to people living with amyotrophic lateral sclerosis (pALS, ALS) who were registered with a home-based medical care (HBMC) team in a tertiary hospital in South Korea.
Materials and Methods:
A retrospective cross-sectional study was conducted for pALS provided with video televisits by the HBMC team between July 2020 and February 2023. The patients’ demographics, disease status, mobility level, and supportive care equipment were investigated. The main issues discussed at televisits were investigated.
Results:
During the 32-month study period, video televisits were provided to 69 (81.2%) of the 85 pALS registered with the HBMC team. Their median (interquartile range) age was 66 (57–71) years, and 66.7% were aged 60 years or older. At the time of the televisits, 71.0% were non-ambulatory and 27.5% were at an assisted ambulatory level. Furthermore, 82.6% were receiving nutritional support with a nasogastric or gastrostomy tube, and 78.3% had received either non-invasive positive pressure ventilation (43.5%) or tracheostomy invasive ventilation (34.8%). Common issues addressed on televisits were disease-related symptoms (100%), management of supportive care equipment (92.8%), acute health issues (52.2%), and advance care planning (ACP) including goal of care discussion (14.5%).
Conclusion
Video telemedicine is feasible for pALS, including older adults with limited mobility due to muscle weakness or reliance on various supportive care equipment. Video televisits allow for a variety of discussions, ranging from acute health issues to ACP.
7.Current Status and Future Directions of Primary Care in the World: Insights from United States (1) —Primary Care and Payment Reform—
Korean Journal of Family Practice 2025;15(1):9-16
The United States has implemented various payment system reforms to strengthen primary care. Since there is no universal healthcare coverage, individuals are enrolled in private insurance or public programs, such as Medicare and Medicaid. Following the enactment of the Affordable Care Act in 2010, the number of uninsured individuals was halved. To reform the payment system, incorporating multiple payers is essential. Fee-for-service alone makes it difficult to provide multidisciplinary care and high-quality, comprehensive primary care, leading to the implementation of various hybrid payment models, such as capitation and performance-based payment systems. Value-based payment is a performance-based incentive that is typically provided as an additional incentive rather than a standalone payment method. Early physician-focused, value-based payment models included the “Physician Value-Based Payment Modifier,” which was later improved with implementation of the “Merit-based Incentive Payment System” and “Alternative Payment Model.” For primary care institutions, performance-based payments are provided based on rating evaluations, with up to 5% in incentive payments. Hybrid payment approaches have proven to be more effective than single-payment methods. Performancebased incentives are particularly effective when tied to specific conditions, such as per patient visit, per medical service, or improvement over previous performance.
8.Current Status and Future Directions of Primary Care in the World: Insights from United States (1) —Primary Care and Payment Reform—
Korean Journal of Family Practice 2025;15(1):9-16
The United States has implemented various payment system reforms to strengthen primary care. Since there is no universal healthcare coverage, individuals are enrolled in private insurance or public programs, such as Medicare and Medicaid. Following the enactment of the Affordable Care Act in 2010, the number of uninsured individuals was halved. To reform the payment system, incorporating multiple payers is essential. Fee-for-service alone makes it difficult to provide multidisciplinary care and high-quality, comprehensive primary care, leading to the implementation of various hybrid payment models, such as capitation and performance-based payment systems. Value-based payment is a performance-based incentive that is typically provided as an additional incentive rather than a standalone payment method. Early physician-focused, value-based payment models included the “Physician Value-Based Payment Modifier,” which was later improved with implementation of the “Merit-based Incentive Payment System” and “Alternative Payment Model.” For primary care institutions, performance-based payments are provided based on rating evaluations, with up to 5% in incentive payments. Hybrid payment approaches have proven to be more effective than single-payment methods. Performancebased incentives are particularly effective when tied to specific conditions, such as per patient visit, per medical service, or improvement over previous performance.
9.Telemedicine Experiences of People Living with Amyotrophic Lateral Sclerosis at Home in South Korea
Min Sun KIM ; Shin Hye YOO ; Kyae Hyung KIM ; Belong CHO ; Sun Young LEE
Yonsei Medical Journal 2025;66(6):366-373
Purpose:
Telemedicine is advantageous in providing medical care to patients with mobility difficulties. This single-center study aimed to report on the provision of video televisits to people living with amyotrophic lateral sclerosis (pALS, ALS) who were registered with a home-based medical care (HBMC) team in a tertiary hospital in South Korea.
Materials and Methods:
A retrospective cross-sectional study was conducted for pALS provided with video televisits by the HBMC team between July 2020 and February 2023. The patients’ demographics, disease status, mobility level, and supportive care equipment were investigated. The main issues discussed at televisits were investigated.
Results:
During the 32-month study period, video televisits were provided to 69 (81.2%) of the 85 pALS registered with the HBMC team. Their median (interquartile range) age was 66 (57–71) years, and 66.7% were aged 60 years or older. At the time of the televisits, 71.0% were non-ambulatory and 27.5% were at an assisted ambulatory level. Furthermore, 82.6% were receiving nutritional support with a nasogastric or gastrostomy tube, and 78.3% had received either non-invasive positive pressure ventilation (43.5%) or tracheostomy invasive ventilation (34.8%). Common issues addressed on televisits were disease-related symptoms (100%), management of supportive care equipment (92.8%), acute health issues (52.2%), and advance care planning (ACP) including goal of care discussion (14.5%).
Conclusion
Video telemedicine is feasible for pALS, including older adults with limited mobility due to muscle weakness or reliance on various supportive care equipment. Video televisits allow for a variety of discussions, ranging from acute health issues to ACP.
10.Telemedicine Experiences of People Living with Amyotrophic Lateral Sclerosis at Home in South Korea
Min Sun KIM ; Shin Hye YOO ; Kyae Hyung KIM ; Belong CHO ; Sun Young LEE
Yonsei Medical Journal 2025;66(6):366-373
Purpose:
Telemedicine is advantageous in providing medical care to patients with mobility difficulties. This single-center study aimed to report on the provision of video televisits to people living with amyotrophic lateral sclerosis (pALS, ALS) who were registered with a home-based medical care (HBMC) team in a tertiary hospital in South Korea.
Materials and Methods:
A retrospective cross-sectional study was conducted for pALS provided with video televisits by the HBMC team between July 2020 and February 2023. The patients’ demographics, disease status, mobility level, and supportive care equipment were investigated. The main issues discussed at televisits were investigated.
Results:
During the 32-month study period, video televisits were provided to 69 (81.2%) of the 85 pALS registered with the HBMC team. Their median (interquartile range) age was 66 (57–71) years, and 66.7% were aged 60 years or older. At the time of the televisits, 71.0% were non-ambulatory and 27.5% were at an assisted ambulatory level. Furthermore, 82.6% were receiving nutritional support with a nasogastric or gastrostomy tube, and 78.3% had received either non-invasive positive pressure ventilation (43.5%) or tracheostomy invasive ventilation (34.8%). Common issues addressed on televisits were disease-related symptoms (100%), management of supportive care equipment (92.8%), acute health issues (52.2%), and advance care planning (ACP) including goal of care discussion (14.5%).
Conclusion
Video telemedicine is feasible for pALS, including older adults with limited mobility due to muscle weakness or reliance on various supportive care equipment. Video televisits allow for a variety of discussions, ranging from acute health issues to ACP.

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