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: Dementia is an important health issue in Korea due to its associated medical costs. Our study aimed to estimate the prevalence of dementia in Korea by analyzing hospital utilization rates. Materials and Methods: We examined National Health Insurance data from 2008 to 2016 and identified all dementia cases. Crude and age- and sex-standardized prevalence were calculated. A generalized linear mixed model was used to estimate prevalence ratios. Results: We identified 176746 and 530269 dementia cases in 2008 and 2016, respectively. Alzheimer’s disease was the most common dementia subtype (65.4% and 86.1% in 2008 and 2016, respectively). Across all age groups, the prevalence of dementia increased consistently: the increase was prominent among patients ≥85 years of age. Among patients ≥65 years of age, crude prevalence was estimated at 31.3 and 72.2 per 1000 population in 2008 and 2016, respectively. Age- and sex-standardized prevalence increased from 31.3 to 62.0 per 1000 population between 2008 and 2016, respectively. The prevalence ratio for dementia in 2016 was 2.02 times (95% confidence interval, 2.01–2.03) higher than that in 2008. When adjusted for age, dementia was more prevalent among females. The most common comorbidity was hypertension, followed by diabetes and stroke. Conclusion Our results demonstrated that hospital utilization for dementia increased significantly from 2008 to 2016, reflecting a proportional increase in the prevalence of dementia. Korean healthcare policy must prioritize dementia treatment.

Purpose: Dementia is an important health issue in Korea due to its associated medical costs. Our study aimed to estimate the prevalence of dementia in Korea by analyzing hospital utilization rates. Materials and Methods: We examined National Health Insurance data from 2008 to 2016 and identified all dementia cases. Crude and age- and sex-standardized prevalence were calculated. A generalized linear mixed model was used to estimate prevalence ratios. Results: We identified 176746 and 530269 dementia cases in 2008 and 2016, respectively. Alzheimer’s disease was the most common dementia subtype (65.4% and 86.1% in 2008 and 2016, respectively). Across all age groups, the prevalence of dementia increased consistently: the increase was prominent among patients ≥85 years of age. Among patients ≥65 years of age, crude prevalence was estimated at 31.3 and 72.2 per 1000 population in 2008 and 2016, respectively. Age- and sex-standardized prevalence increased from 31.3 to 62.0 per 1000 population between 2008 and 2016, respectively. The prevalence ratio for dementia in 2016 was 2.02 times (95% confidence interval, 2.01–2.03) higher than that in 2008. When adjusted for age, dementia was more prevalent among females. The most common comorbidity was hypertension, followed by diabetes and stroke. Conclusion Our results demonstrated that hospital utilization for dementia increased significantly from 2008 to 2016, reflecting a proportional increase in the prevalence of dementia. Korean healthcare policy must prioritize dementia treatment.

BACKGROUND/AIMS: Mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach is an uncommon disease. Bone marrow involvement is reported even in patients with only a mucosal lesion. We evaluated the prevalence and risk factors of marrow involvement and its implications for diagnosis and treatment. METHODS: In total, 132 patients who were diagnosed with gastric MALT lymphoma at the National Cancer Center in Korea between January 2001 and December 2016 were enrolled in the study. The patient data were collected and analyzed retrospectively. RESULTS: Of the 132 patients, 47 (35.6%) were male, with a median age of 52 years (range, 17 to 81 years). The median follow-up duration was 48.8 months (range, 0.5 to 169.9 months). Helicobacter pylori infection was detected in 82 patients (62.1%). Most patients (80.3%) had stage IE1 according to the modified Ann Arbor staging system. Ninety-two patients underwent bone marrow evaluation, and four patients (4.3%) had marrow involvement. Of these patients, one presented with abdominal lymph node involvement, while the other three had stage IE1 disease if marrow involvement was disregarded. All three patients had no significant symptoms and were monitored after local treatment without evidence of disease aggravation. CONCLUSIONS: Bone marrow involvement was found in 4.3% of the patients with gastric MALT lymphoma. Bone marrow examination may be deferred because marrow involvement does not change the treatment options or outcome in gastric MALT lymphoma confined to the stomach wall.
Bone Marrow Examination ; Bone Marrow* ; Diagnosis ; Follow-Up Studies ; Helicobacter pylori ; Humans ; Korea ; Lymph Nodes ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Male ; Prevalence* ; Prognosis ; Retrospective Studies ; Risk Factors ; Stomach

BACKGROUND/OBJECTIVES: The accumulation of amyloid-β (Aβ) in the brain is a hallmark of Alzheimer's disease (AD) and plays a key role in cognitive dysfunction. Perilla frutescens var. japonica extract (PFE) and its major compound, rosmarinic acid (RA), have shown antioxidant and anti-inflammatory activities. We investigated whether administration of PFE and RA contributes to cognitive improvement in an Aβ25-35-injected mouse model. MATERIALS/METHODS: Male ICR mice were intracerebroventricularly injected with aggregated Aβ25-35 to induce AD. Aβ25-35-injected mice were fed PFE (50 mg/kg/day) or RA (0.25 mg/kg/day) for 14 days and examined for learning and memory ability through the T-maze, object recognition, and Morris water maze test. RESULTS: Our present study demonstrated that PFE and RA administration significantly enhanced cognition function and object discrimination, which were impaired by Aβ25-35, in the T-maze and object recognition tests, respectively. In addition, oral administration of PFE and RA decreased the time to reach the platform and increased the number of crossings over the removed platform when compared with the Aβ25-35-induced control group in the Morris water maze test. Furthermore, PFE and RA significantly decreased the levels of nitric oxide (NO) and malondialdehyde (MDA) in the brain, kidney, and liver. In particular, PFE markedly attenuated oxidative stress by inhibiting production of NO and MDA in the Aβ25-35-injected mouse brain. CONCLUSIONS: These results suggest that PFE and its active compound RA have beneficial effects on cognitive improvement and may help prevent AD induced by Aβ.
Administration, Oral ; Alzheimer Disease ; Animals ; Brain ; Cognition* ; Discrimination (Psychology) ; Humans ; Kidney ; Learning ; Liver ; Male ; Malondialdehyde ; Memory* ; Mice ; Mice, Inbred ICR ; Nitric Oxide ; Oxidative Stress ; Perilla frutescens* ; Perilla* ; Water

BACKGROUND/OBJECTIVES: The accumulation of amyloid-β (Aβ) in the brain is a hallmark of Alzheimer's disease (AD) and plays a key role in cognitive dysfunction. Perilla frutescens var. japonica extract (PFE) and its major compound, rosmarinic acid (RA), have shown antioxidant and anti-inflammatory activities. We investigated whether administration of PFE and RA contributes to cognitive improvement in an Aβ25-35-injected mouse model. MATERIALS/METHODS: Male ICR mice were intracerebroventricularly injected with aggregated Aβ25-35 to induce AD. Aβ25-35-injected mice were fed PFE (50 mg/kg/day) or RA (0.25 mg/kg/day) for 14 days and examined for learning and memory ability through the T-maze, object recognition, and Morris water maze test. RESULTS: Our present study demonstrated that PFE and RA administration significantly enhanced cognition function and object discrimination, which were impaired by Aβ25-35, in the T-maze and object recognition tests, respectively. In addition, oral administration of PFE and RA decreased the time to reach the platform and increased the number of crossings over the removed platform when compared with the Aβ25-35-induced control group in the Morris water maze test. Furthermore, PFE and RA significantly decreased the levels of nitric oxide (NO) and malondialdehyde (MDA) in the brain, kidney, and liver. In particular, PFE markedly attenuated oxidative stress by inhibiting production of NO and MDA in the Aβ25-35-injected mouse brain. CONCLUSIONS: These results suggest that PFE and its active compound RA have beneficial effects on cognitive improvement and may help prevent AD induced by Aβ.
Administration, Oral ; Alzheimer Disease ; Animals ; Brain ; Cognition* ; Discrimination (Psychology) ; Humans ; Kidney ; Learning ; Liver ; Male ; Malondialdehyde ; Memory* ; Mice ; Mice, Inbred ICR ; Nitric Oxide ; Oxidative Stress ; Perilla frutescens* ; Perilla* ; Water

Neurodegenerative diseases are often associated with oxidative damage in neuronal cells. This study was conducted to investigate the neuro-protective effect of methanolic (MeOH) extract of Perilla frutescens var. japonica and its one of the major compounds, rosmarinic acid, under oxidative stress induced by hydrogen peroxide (H2O2) in C6 glial cells. Exposure of C6 glial cells to H2O2 enhanced oxidative damage as measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and thiobarbituric acid-reactive substance assays. The MeOH extract and rosmarinic acid prevented oxidative stress by increasing cell viability and inhibiting cellular lipid peroxidation. In addition, the MeOH extract and rosmarinic acid reduced H2O2-induced expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) at the transcriptional level. Moreover, iNOS and COX-2 protein expression was down-regulated in H2O2-indcued C6 glial cells treated with the MeOH extract and rosmarinic acid. These findings suggest that P. frutescens var. japonica and rosmarinic acid could prevent the progression of neurodegenerative diseases through attenuation of neuronal oxidative stress.
Cell Survival ; Cyclooxygenase 2 ; Hydrogen Peroxide ; Lipid Peroxidation ; Methanol* ; Neurodegenerative Diseases ; Neuroglia* ; Neurons ; Nitric Oxide Synthase Type II ; Oxidative Stress* ; Perilla frutescens* ; Perilla*