Objective: To evaluate the effectiveness of the National Health Screening Program for Infants and Children (NHSPIC) in the early diagnosis of neurodevelopmental disorders (NDDs) utilizing data from the National Health Insurance Database of South Korea. Methods: We enrolled children born between 2011 and 2018 who completed the first to fourth stages of the NHSPIC. A positive finding was defined as a recommendation for further evaluation during one or more stages. Participants were categorized into the positive and negative finding groups. Following 1:1 propensity score matching, 82,138 participants were assigned to each group. Results: Comparative analysis revealed that participants with positive findings exhibited a higher risk of developing all seven NDDs, particularly for autism spectrum disorder (hazard ratio [HR], 19.70; 95% confidence interval [CI], 17.48–22.20), intellectual disability (HR, 17.11; 95% CI, 14.69–19.93), developmental language disorder (HR, 11.74; 95% CI, 10.73– 12.84), and cerebral palsy (HR, 11.34; 95% CI, 8.67–14.84). The HR for learning disability was 4.31 (95% CI, 2.94–6.34), whereas attention-deficit hyperactivity disorder had an HR of 3.57 (95% CI, 3.37–3.78). Tic disorder had the lowest HR (HR, 1.64; 95% CI, 1.48–1.82). Additionally, HRs were calculated for each NHSPIC stage, demonstrating the utility of specific stages in the early detection of each NDD. Conclusion Developmental screening tests in the NHSPIC contributed to the early diagnosis of NDDs. This study underscores the significance of the NHSPIC and provides foundational evidence to inform and enhance policies related to child health screenings.

Purpose: The aim of this study was to evaluate the episodes of febrile neutropenia (FN) in patients with gastric cancer (GC), colorectal cancer (CRC), lung cancer (LC), and breast cancer (BC); and to identify the incidence and trends of admission rates, as well as factors affecting mortality. Materials and Methods: Using nationwide claims data, all new admissions to hospitals for FN were selected. We evaluated the incidence of FN and mortality-related clinical factors in adult cancer patients who received cytotoxic chemotherapy from January 2004 to December 2013. Results: While the incidence of FN increased, the length of hospitalization decreased in Korea. The incidence of FN was 19.8% in LC patients, 15.5% in GC patients, 13.3% in BC patients, and 9.5% in CRC patients. The overall in-hospital mortality of FN was 12.9% and showed a decreasing trend. Admission rates to intensive care units and in-hospital mortality were the highest for lung cancer (15.2% and 19.3%, respectively). Age and sepsis syndrome were risk factors for in-hospital mortality for all cancer types. Conclusion Careful observation and active prophylaxis should be considered for patients at high risk of FN.

Purpose: The aim of this study was to evaluate the episodes of febrile neutropenia (FN) in patients with gastric cancer (GC), colorectal cancer (CRC), lung cancer (LC), and breast cancer (BC); and to identify the incidence and trends of admission rates, as well as factors affecting mortality. Materials and Methods: Using nationwide claims data, all new admissions to hospitals for FN were selected. We evaluated the incidence of FN and mortality-related clinical factors in adult cancer patients who received cytotoxic chemotherapy from January 2004 to December 2013. Results: While the incidence of FN increased, the length of hospitalization decreased in Korea. The incidence of FN was 19.8% in LC patients, 15.5% in GC patients, 13.3% in BC patients, and 9.5% in CRC patients. The overall in-hospital mortality of FN was 12.9% and showed a decreasing trend. Admission rates to intensive care units and in-hospital mortality were the highest for lung cancer (15.2% and 19.3%, respectively). Age and sepsis syndrome were risk factors for in-hospital mortality for all cancer types. Conclusion Careful observation and active prophylaxis should be considered for patients at high risk of FN.

Background: Except for data in the Korea Hemophilia Foundation Registry, little is known of the epidemiology of congenital bleeding disorders in Korea. Methods: Data were obtained from the Korean Health Insurance Review and Assessment Service (HIRA) database. Results: From 2010 to 2015, there were 2,029 patients with congenital bleeding disorders in the Korean HIRA database: 38% (n = 775) of these patients had hemophilia A (HA), 25% (n = 517) had von Willebrand disease (vWD), 7% (n = 132) had hemophilia B (HB), and 25% (n = 513) had less common factor deficiencies. The estimated age-standardized incidence rate (ASR) of HA and HB was 1.78–3.15/100,000 and 0.31–0.51/100,000, respectively. That of vWD was 1.38–1.95/100,000. The estimated ASR of HA showed increase over time though the number of new patients did not increase. Most patients with congenital bleeding disorders were younger than 19 years old (47.8%), and most were registered in Gyeonggi (22.1%) and Seoul (19.2%). Conclusion This is the first nationwide population-based study of congenital bleeding disorders in Korea. This study provides data that will enable more accurate estimations of patients with vWD. This information will help advance the comprehensive care of congenital bleeding disorders. We need to continue to obtain more detailed information on patients to improve the management of these diseases.

Background: Hematologic malignancies have a relatively lower prevalence than major solid cancers, although the incidence of hematologic malignancies has significantly increased in recent years. However, understanding the current status of hematologic malignancy is significantly challenging because basic data regarding this malignancy are insufficient in the Korean population. Methods: From 2005 to 2015, the status of seven codes of hematologic malignancy, containing 24 subcodes defined using a classification defined by the Korean Classification of Disease-6, was analyzed. The number of new patients, crude incidence rate, prevalence rate, and age-standardized incidence rate were also investigated. Results were analyzed based on National Health Insurance Service (NHIS) data. Results: The number of new patients showed an overall increase over time and a rate of increase up to 56.7% for 10 years. The number of male patients was higher than that of female patients, with the majority of patients aged greater than 60 years. The incidence and prevalence rates have increased steadily. Conclusions Consistent with the previous studies, this study might be useful to understand the current status of hematologic malignancy and might contribute to the improvement of national public healthcare.

PURPOSE: The volume of thyroid cancer screening and subsequent thyroid fine-needle aspiration (FNA) have rapidly increased in South Korea. We analyzed the thyroid cancer diagnoses/thyroid FNA ratio according to the annual number of FNA to evaluate changes in the diagnosticefficiency of FNA. MATERIALS AND METHODS: This was a nationwide population-based retrospective cohort study. The overall thyroid cancer diagnoses/thyroid FNA ratio and annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratio were indirectly calculated using data obtained from the Korea Central Cancer Registry database and the Korean National Health Insurance Service claims database from 2004 to 2012. Pearson correlation analyses were performed to evaluate the strength of linear associations between variables. RESULTS: The number of thyroid FNA increased from 28,596 to 177,805 (6.2-fold increase) from 2004 to 2012. The overall thyroid cancer diagnoses/thyroid FNA ratio decreased from 36.5% in 2004 to 25.1% in 2012 and was negatively correlated to the number of FNA (R=‒0.977, p < 0.001). The annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratios (range, 15.3% to 30.7%) were always lower than the overall thyroid cancer diagnoses/thyroid FNA ratio in each year and also worsened according to the increase in the number of FNA (R=‒0.853, p=0.007). CONCLUSION: The diagnostic performance of both overall and annual incremental thyroid FNA worsened, whereas the number of thyroid FNA procedures increased. More sophisticated indications for FNA are required to improve its diagnostic efficiency, considering the increased burden of screening-detected thyroid nodules.
Biopsy, Fine-Needle ; Cohort Studies ; Korea ; Mass Screening ; National Health Programs ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule

BACKGROUND: The aim of this study was to investigate the current state of the assistive devices and appliances provision system for cerebral palsy patients registered with brain disability. METHODS: From 2003 to 2013, we analyzed the records of cerebral palsy patients who had assistive devices and appliances provisioned at least once in their lives based on National Health Information Database. Patients with cerebral palsy were divided into three groups: infants and toddlers, school age and adolescence, and adults. RESULTS: Data on short leg plastic orthoses, ankle joint orthoses, and wheelchair were mainly analyzed. The types of ankle joint orthoses divided into three categories: limited, 90° limited, and Klenzac. Limited ankle joint orthoses was most frequently supported of the three in all age groups. Powered wheelchair and scooter were most supported to adult patients. When the re-supply duration was evaluated, the duration was suitable to the duration on guideline of regulation of re-supplement according to the related laws in adult patients but not in infants/toddlers and school age/adolescence as the actual re-supplement duration was much shorter than the reference value. CONCLUSION: This study confirmed the pattern of assistive devices and appliances supply differed depending on the age of cerebral palsy patients.
Adolescent ; Adult ; Ankle Joint ; Brain ; Cerebral Palsy ; Foot Orthoses ; Humans ; Infant ; Jurisprudence ; Korea ; Leg ; Orthotic Devices ; Plastics ; Reference Values ; Self-Help Devices ; Wheelchairs

No abstract available.
Acinetobacter baumannii* ; Acinetobacter* ; Hospitals, General* ; Imipenem* ; Korea*

No abstract available.
Pseudomonas aeruginosa* ; Pseudomonas*

PURPOSE: Cerebral palsy (CP) is a neurodevelopmental disorder that causes serious disability. Prematurity and low birth weight (LBW) are known to be the strongest risk factors of CP. While socioeconomic status (SES) has been found to influence the occurrence of CP, prematurity, and LBW, no studies have investigated this effect in Korea. The aim of this study was to evaluate the incidence of CP, prematurity, and LBW in Korea, as well as the effect of SES thereon. MATERIALS AND METHODS: Data were obtained from the National Health Information Database from 2007 to 2013; persons with a history of CP, prematurity, and LBW were investigated by year. SES was defined in accordance with income quintiles, birth regions, and coverage classification. RESULTS: The incidence of CP decreased over the last five years, despite increased rates of prematurity and LBW. CP incidence was significantly lower in affluent groups than in the most deprived group, although this difference disappeared after controlling for confounders. The incidence of CP was significantly higher in medical aid beneficiaries, even after controlling for confounders. CONCLUSION: CP incidence in Korea has decreased over the last five years, despite an increase in high-risk deliveries. Income level had no effect in CP incidence. These results may aid CP management and prevention policies.
Cerebral Palsy* ; Classification ; Humans ; Incidence* ; Infant, Low Birth Weight ; Infant, Newborn ; Korea* ; Neurodevelopmental Disorders ; Parturition ; Premature Birth ; Risk Factors ; Social Class* ; Socioeconomic Factors