Background: With growing elderly populations, management of patients with acute stroke is increasingly important. In South Korea, the Acute Stroke Quality Assessment Program (ASQAP) has contributed to improving the quality of stroke care and practice behavior in healthcare institutions. While the mortality of hemorrhagic stroke remains high, there are only a few assessment indices associated with hemorrhagic stroke. Considering the need to develop assessment indices to improve the actual quality of care in the field of acute stroke treatment, this study aims to investigate the current status of human resources and practices related to the treatment of patients with acute stroke through a nationwide survey. Methods: For the healthcare institutions included in the Ninth ASQAP of the Health Insurance Review and Assessment Service (HIRA), data from January 2022 to December 2022 were collected through a survey on the current status and practice of healthcare providers related to the treatment of patients with acute stroke. The questionnaire consisted of 19 items, including six items on healthcare providers involved in stroke care and 10 items on the care of patients with acute stroke. Results: In the treatment of patients with hemorrhagic stroke among patients with acute stroke, neurosurgeons were the most common providers. The contribution of neurosurgeons in the treatment of ischemic stroke has also been found to be equivalent to that of neurologists. However, a number of institutions were found to be devoid of healthcare providers who perform definitive treatments, such as intra-arterial thrombectomy for patients with ischemic stroke or cerebral aneurysm clipping for subarachnoid hemorrhage. The intensity of the workload of healthcare providers involved in the care of patients with acute stroke, especially those involved in definitive treatment, was also found to be quite high. Conclusion Currently, there are almost no assessment indices specific to hemorrhagic stroke in the ASQAP for acute stroke. Furthermore, it does not reflect the reality of the healthcare providers and practices that provide definitive treatment for acute stroke. The findings of this study suggest the need for the development of appropriate assessment indices that reflect the realities of acute stroke care.

Background: There are few long-term large-scale epidemiologic studies on hypertrophic cardiomyopathy (HCM; 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes: I42.1, I42.2). This analysis used the Korean National Health Insurance Service (KNHIS) data between 2006 and 2017 to evaluate the natural history of HCM over a decade. Methods: KNHIS data and death statistics were evaluated according to age, sex, socioeconomic position, and comorbidities. Survival rates (SRs) and adjusted hazard ratio (HR) were compared with death data of the Korean population from 2006 through 2018. Results: The mean age was 47.3 ± 14.9 years in males and 57.5 ± 15.4 years in females (P < 0.001).The male proportion was 58.9%. The most common cause of death was diseases of the circulatory system. The 10-year SR of HCM was higher in males (75.9% vs. 62.5%, P < 0.001).The adjusted HR for different age groups was significantly high in most age group: 3.67 (95% confidence interval [CI], 2.65–5.10) for 0–9 years, and it gradually increased from the 30s to the 80s group (1.39 [95% CI, 1.05–1.83] for 30–39 years and 48.2 [95% CI, 37.0–62.7] for those older than 80 years). The adjusted HR was 1.12 (95% CI, 1.07–1.17) for males, 1.40 (95% CI, 1.33–1.48) for the lower income level, and 1.18 (95% CI, 1.12–1.25) for the medium income level. In patients with comorbidities, the adjusted HRs were 1.23 (95% CI, 1.16–1.30) for diabetes, 1.45 (95% CI, 1.30–1.62) for myocardial infarction, 1.63 (95% CI, 1.52–1.76) for atrial fibrillation, 1.83 (95% CI, 1.68–1.99) for ischemic stroke, 1.66 (95% CI, 1.31–2.10) for hemorrhagic stroke, 2.42 (95% CI, 2.16–2.70) for chronic kidney disease, and 3.18 (95% CI, 2.87–3.52) for malignant neoplasm. Conclusion HCM in Korea showed a higher prevalence and incidence in males. The 10-year SR of HCM was approximately 70% and lower in females than that in males. The risk of death from HCM increased with age and was significantly higher in males, individuals with low income levels, and patients with various comorbidities. These findings should be considered for the long-term management and allocation of healthcare resources for patients with HCM.

Background: With growing elderly populations, management of patients with acute stroke is increasingly important. In South Korea, the Acute Stroke Quality Assessment Program (ASQAP) has contributed to improving the quality of stroke care and practice behavior in healthcare institutions. While the mortality of hemorrhagic stroke remains high, there are only a few assessment indices associated with hemorrhagic stroke. Considering the need to develop assessment indices to improve the actual quality of care in the field of acute stroke treatment, this study aims to investigate the current status of human resources and practices related to the treatment of patients with acute stroke through a nationwide survey. Methods: For the healthcare institutions included in the Ninth ASQAP of the Health Insurance Review and Assessment Service (HIRA), data from January 2022 to December 2022 were collected through a survey on the current status and practice of healthcare providers related to the treatment of patients with acute stroke. The questionnaire consisted of 19 items, including six items on healthcare providers involved in stroke care and 10 items on the care of patients with acute stroke. Results: In the treatment of patients with hemorrhagic stroke among patients with acute stroke, neurosurgeons were the most common providers. The contribution of neurosurgeons in the treatment of ischemic stroke has also been found to be equivalent to that of neurologists. However, a number of institutions were found to be devoid of healthcare providers who perform definitive treatments, such as intra-arterial thrombectomy for patients with ischemic stroke or cerebral aneurysm clipping for subarachnoid hemorrhage. The intensity of the workload of healthcare providers involved in the care of patients with acute stroke, especially those involved in definitive treatment, was also found to be quite high. Conclusion Currently, there are almost no assessment indices specific to hemorrhagic stroke in the ASQAP for acute stroke. Furthermore, it does not reflect the reality of the healthcare providers and practices that provide definitive treatment for acute stroke. The findings of this study suggest the need for the development of appropriate assessment indices that reflect the realities of acute stroke care.

Background: There are few long-term large-scale epidemiologic studies on hypertrophic cardiomyopathy (HCM; 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes: I42.1, I42.2). This analysis used the Korean National Health Insurance Service (KNHIS) data between 2006 and 2017 to evaluate the natural history of HCM over a decade. Methods: KNHIS data and death statistics were evaluated according to age, sex, socioeconomic position, and comorbidities. Survival rates (SRs) and adjusted hazard ratio (HR) were compared with death data of the Korean population from 2006 through 2018. Results: The mean age was 47.3 ± 14.9 years in males and 57.5 ± 15.4 years in females (P < 0.001).The male proportion was 58.9%. The most common cause of death was diseases of the circulatory system. The 10-year SR of HCM was higher in males (75.9% vs. 62.5%, P < 0.001).The adjusted HR for different age groups was significantly high in most age group: 3.67 (95% confidence interval [CI], 2.65–5.10) for 0–9 years, and it gradually increased from the 30s to the 80s group (1.39 [95% CI, 1.05–1.83] for 30–39 years and 48.2 [95% CI, 37.0–62.7] for those older than 80 years). The adjusted HR was 1.12 (95% CI, 1.07–1.17) for males, 1.40 (95% CI, 1.33–1.48) for the lower income level, and 1.18 (95% CI, 1.12–1.25) for the medium income level. In patients with comorbidities, the adjusted HRs were 1.23 (95% CI, 1.16–1.30) for diabetes, 1.45 (95% CI, 1.30–1.62) for myocardial infarction, 1.63 (95% CI, 1.52–1.76) for atrial fibrillation, 1.83 (95% CI, 1.68–1.99) for ischemic stroke, 1.66 (95% CI, 1.31–2.10) for hemorrhagic stroke, 2.42 (95% CI, 2.16–2.70) for chronic kidney disease, and 3.18 (95% CI, 2.87–3.52) for malignant neoplasm. Conclusion HCM in Korea showed a higher prevalence and incidence in males. The 10-year SR of HCM was approximately 70% and lower in females than that in males. The risk of death from HCM increased with age and was significantly higher in males, individuals with low income levels, and patients with various comorbidities. These findings should be considered for the long-term management and allocation of healthcare resources for patients with HCM.

Background: With growing elderly populations, management of patients with acute stroke is increasingly important. In South Korea, the Acute Stroke Quality Assessment Program (ASQAP) has contributed to improving the quality of stroke care and practice behavior in healthcare institutions. While the mortality of hemorrhagic stroke remains high, there are only a few assessment indices associated with hemorrhagic stroke. Considering the need to develop assessment indices to improve the actual quality of care in the field of acute stroke treatment, this study aims to investigate the current status of human resources and practices related to the treatment of patients with acute stroke through a nationwide survey. Methods: For the healthcare institutions included in the Ninth ASQAP of the Health Insurance Review and Assessment Service (HIRA), data from January 2022 to December 2022 were collected through a survey on the current status and practice of healthcare providers related to the treatment of patients with acute stroke. The questionnaire consisted of 19 items, including six items on healthcare providers involved in stroke care and 10 items on the care of patients with acute stroke. Results: In the treatment of patients with hemorrhagic stroke among patients with acute stroke, neurosurgeons were the most common providers. The contribution of neurosurgeons in the treatment of ischemic stroke has also been found to be equivalent to that of neurologists. However, a number of institutions were found to be devoid of healthcare providers who perform definitive treatments, such as intra-arterial thrombectomy for patients with ischemic stroke or cerebral aneurysm clipping for subarachnoid hemorrhage. The intensity of the workload of healthcare providers involved in the care of patients with acute stroke, especially those involved in definitive treatment, was also found to be quite high. Conclusion Currently, there are almost no assessment indices specific to hemorrhagic stroke in the ASQAP for acute stroke. Furthermore, it does not reflect the reality of the healthcare providers and practices that provide definitive treatment for acute stroke. The findings of this study suggest the need for the development of appropriate assessment indices that reflect the realities of acute stroke care.

Background: There are few long-term large-scale epidemiologic studies on hypertrophic cardiomyopathy (HCM; 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes: I42.1, I42.2). This analysis used the Korean National Health Insurance Service (KNHIS) data between 2006 and 2017 to evaluate the natural history of HCM over a decade. Methods: KNHIS data and death statistics were evaluated according to age, sex, socioeconomic position, and comorbidities. Survival rates (SRs) and adjusted hazard ratio (HR) were compared with death data of the Korean population from 2006 through 2018. Results: The mean age was 47.3 ± 14.9 years in males and 57.5 ± 15.4 years in females (P < 0.001).The male proportion was 58.9%. The most common cause of death was diseases of the circulatory system. The 10-year SR of HCM was higher in males (75.9% vs. 62.5%, P < 0.001).The adjusted HR for different age groups was significantly high in most age group: 3.67 (95% confidence interval [CI], 2.65–5.10) for 0–9 years, and it gradually increased from the 30s to the 80s group (1.39 [95% CI, 1.05–1.83] for 30–39 years and 48.2 [95% CI, 37.0–62.7] for those older than 80 years). The adjusted HR was 1.12 (95% CI, 1.07–1.17) for males, 1.40 (95% CI, 1.33–1.48) for the lower income level, and 1.18 (95% CI, 1.12–1.25) for the medium income level. In patients with comorbidities, the adjusted HRs were 1.23 (95% CI, 1.16–1.30) for diabetes, 1.45 (95% CI, 1.30–1.62) for myocardial infarction, 1.63 (95% CI, 1.52–1.76) for atrial fibrillation, 1.83 (95% CI, 1.68–1.99) for ischemic stroke, 1.66 (95% CI, 1.31–2.10) for hemorrhagic stroke, 2.42 (95% CI, 2.16–2.70) for chronic kidney disease, and 3.18 (95% CI, 2.87–3.52) for malignant neoplasm. Conclusion HCM in Korea showed a higher prevalence and incidence in males. The 10-year SR of HCM was approximately 70% and lower in females than that in males. The risk of death from HCM increased with age and was significantly higher in males, individuals with low income levels, and patients with various comorbidities. These findings should be considered for the long-term management and allocation of healthcare resources for patients with HCM.

Background: With growing elderly populations, management of patients with acute stroke is increasingly important. In South Korea, the Acute Stroke Quality Assessment Program (ASQAP) has contributed to improving the quality of stroke care and practice behavior in healthcare institutions. While the mortality of hemorrhagic stroke remains high, there are only a few assessment indices associated with hemorrhagic stroke. Considering the need to develop assessment indices to improve the actual quality of care in the field of acute stroke treatment, this study aims to investigate the current status of human resources and practices related to the treatment of patients with acute stroke through a nationwide survey. Methods: For the healthcare institutions included in the Ninth ASQAP of the Health Insurance Review and Assessment Service (HIRA), data from January 2022 to December 2022 were collected through a survey on the current status and practice of healthcare providers related to the treatment of patients with acute stroke. The questionnaire consisted of 19 items, including six items on healthcare providers involved in stroke care and 10 items on the care of patients with acute stroke. Results: In the treatment of patients with hemorrhagic stroke among patients with acute stroke, neurosurgeons were the most common providers. The contribution of neurosurgeons in the treatment of ischemic stroke has also been found to be equivalent to that of neurologists. However, a number of institutions were found to be devoid of healthcare providers who perform definitive treatments, such as intra-arterial thrombectomy for patients with ischemic stroke or cerebral aneurysm clipping for subarachnoid hemorrhage. The intensity of the workload of healthcare providers involved in the care of patients with acute stroke, especially those involved in definitive treatment, was also found to be quite high. Conclusion Currently, there are almost no assessment indices specific to hemorrhagic stroke in the ASQAP for acute stroke. Furthermore, it does not reflect the reality of the healthcare providers and practices that provide definitive treatment for acute stroke. The findings of this study suggest the need for the development of appropriate assessment indices that reflect the realities of acute stroke care.

Background: There are few long-term large-scale epidemiologic studies on hypertrophic cardiomyopathy (HCM; 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes: I42.1, I42.2). This analysis used the Korean National Health Insurance Service (KNHIS) data between 2006 and 2017 to evaluate the natural history of HCM over a decade. Methods: KNHIS data and death statistics were evaluated according to age, sex, socioeconomic position, and comorbidities. Survival rates (SRs) and adjusted hazard ratio (HR) were compared with death data of the Korean population from 2006 through 2018. Results: The mean age was 47.3 ± 14.9 years in males and 57.5 ± 15.4 years in females (P < 0.001).The male proportion was 58.9%. The most common cause of death was diseases of the circulatory system. The 10-year SR of HCM was higher in males (75.9% vs. 62.5%, P < 0.001).The adjusted HR for different age groups was significantly high in most age group: 3.67 (95% confidence interval [CI], 2.65–5.10) for 0–9 years, and it gradually increased from the 30s to the 80s group (1.39 [95% CI, 1.05–1.83] for 30–39 years and 48.2 [95% CI, 37.0–62.7] for those older than 80 years). The adjusted HR was 1.12 (95% CI, 1.07–1.17) for males, 1.40 (95% CI, 1.33–1.48) for the lower income level, and 1.18 (95% CI, 1.12–1.25) for the medium income level. In patients with comorbidities, the adjusted HRs were 1.23 (95% CI, 1.16–1.30) for diabetes, 1.45 (95% CI, 1.30–1.62) for myocardial infarction, 1.63 (95% CI, 1.52–1.76) for atrial fibrillation, 1.83 (95% CI, 1.68–1.99) for ischemic stroke, 1.66 (95% CI, 1.31–2.10) for hemorrhagic stroke, 2.42 (95% CI, 2.16–2.70) for chronic kidney disease, and 3.18 (95% CI, 2.87–3.52) for malignant neoplasm. Conclusion HCM in Korea showed a higher prevalence and incidence in males. The 10-year SR of HCM was approximately 70% and lower in females than that in males. The risk of death from HCM increased with age and was significantly higher in males, individuals with low income levels, and patients with various comorbidities. These findings should be considered for the long-term management and allocation of healthcare resources for patients with HCM.

Background: As the prevalence of hypertension increases with age and the proportion of the older population is also on the rise, research on the characteristics of older hypertensive patients and the importance of frailty is necessary. This study aimed to identify clinical characteristics of older hypertension in Korea and to investigate these characteristics based on frailty status. Methods: The HOW to Optimize eLDerly systolic BP (HOWOLD-BP) is a prospective, multicenter, open-label, randomized clinical trial that aims to compare intensive (target systolic blood pressure [SBP] ≤ 130 mmHg) with standard (target SBP ≤ 140 mmHg) treatment to reduce cardiovascular events in older hypertensive Korean patients aged ≥ 65 years. Data were analyzed through a screening assessment of 2,085 patients recruited from 11 university hospitals. Demographic, functional (physical and cognitive), medical history, laboratory data, quality of life, and medication history of antihypertensive drugs were assessed. Results: The mean age was 73.2 years (standard deviation ± 5.60), and 48.0% (n = 1,001) were male. Prevalent conditions included dyslipidemia (66.5%), obesity (body mass index ≥ 25 kg/m 2 , 53.6%), and diabetes (28.9%). Dizziness and orthostatic hypotension were self-reported by 1.6% (n = 33) and 1.2% (n = 24), respectively. The majority of patients were on two antihypertensive drugs (48.4%), while 27.5% (n = 574) and 20.8% (n = 433) were on 1 and 3 antihypertensive medications, respectively. Frail to pre-frail patients were older and also tended to have dependent instrumental activities of daily living, slower gait speed, weaker grip strength, lower quality of life, and lower cognitive function. The frail to pre-frail group reported more dizziness (2.6% vs. 1.2%, P < 0.001) and had concerning clinical factors, including lower glomerular filtration rate, more comorbidities such as diabetes, stroke, and a history of admission. Frail to pre-frail older hypertensive patients used slightly more antihypertensive medications than robust older hypertensive patients (1.95 vs. 2.06, P = 0.003). Pre-frail to frail patients often chose beta-blockers as a third medication over diuretics. Conclusion This study described the general clinical characteristics of older hypertensive patients in Korea. Frail hypertensive patients face challenges in achieving positive clinical outcomes because of multifactorial causes: they are older, have more morbidities, decreased function, lower quality of life and cognitive function, and take more antihypertensive medications. Therefore, it is essential to comprehensively evaluate and monitor diseaserelated or drug-related adverse events more frequently during regular check-ups, which is necessary for pre-frail to frail older patients with hypertension.

Purpose: This study aimed to assess the survival rate (SR) and death risk for associated pulmonary arterial hypertension (aPAH; 10th revision of the International Statistical Classification of Diseases [ICD-10], I27.2) in Koreans. Methods: The data were collected from the Korean National Health Insurance Service from 2006 through 2017 (n= 15,448). We analyzed the SR using the Kaplan-Meier method and carried out Cox proportional hazards analyses. Results: Patients’ mean age upon aPAH diagnosis was 60.1±24.0 years, and 60.7% of the patients were female. The 10-year SR of aPAH was 46.3% (95% confidence interval, 45.0 to 47.6). The factors associated with an increase in the adjusted death risk included age of 0 to 9 years, advancing age, male sex, lower income level, and comorbidities including diabetes mellitus, myocardial infarction, heart failure, hemorrhagic stroke, chronic kidney disease, malignant neoplasm, hereditary hemorrhagic telangiectasia, and systemic lupus erythematosus. Conclusion The 10-year SR of aPAH was over 46%. The risk of death from aPAH was significantly higher with advancing age, sex, lower income level, and comorbidities.