• Health Policy and Management
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• v.28 no.1
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• pp.53-69
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• 2018

Background: This study investigates association modified category medical specialization (CMS) and hospital charge, length of stay (LOS), and mortality among lumbar spine disease inpatients. Methods: This study used National Health Insurance Service-cohort sample database from 2002 to 2013, using stratified representative sampling released by the National Health Insurance Service. A total of 56,622 samples were analyzed. The primary analysis was based on generalized estimating equation model accounting for correlation among individuals within each hospital. Results: Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had a shorter LOS (estimate, -1.700; 95% confidence interval [CI], -1.886 to -1.514; p<0.0001). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had a lower mortality rate (odds ratio, 0.635; 95% CI, 0.521 to 0.775; p<0.0001). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had higher hospital cost per case (estimate, 192,658 Korean won; 95% CI, 125,701 to 259,614; p<0.0001). However, inpatients admitted with lumbar spine surgery patients at hospitals with higher modified CMS had lower hospital cost per case (estimate, -152,060 Korean won; 95% CI, -287,236 to -16,884; p=0.028). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had higher hospital cost per diem (estimate, 55,694 Korean won; 95% CI, 46,205 to 65,183; p<0.0001). Conclusion: Our results showed that increase in hospital specialization had a substantial effect on decrease in hospital cost per case, LOS, and mortality, and on increase in hospital cost per diem among lumbar spine disease surgery patients.

• Korean Journal of Head & Neck Oncology
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• v.37 no.1
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• pp.11-16
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• 2021

Background/Objectives: To analyze changes in the incidence of thyroid cancer for Korean population using big data from the National Health Insurance Service. Materials & Methods: Sample cohort database between January 2004 and December 2013 with 1,000,000 cases for each year was enrolled in this study. Thyroid cancer incidence was analyzed by sex, age and by region. Public health insurance payment was used to reflect socioeconomic status. Results: The incidence of thyroid cancer in Korea increased for 10 years annually. There are 3 times increasing in the incidence rate of thyroid cancer from 2004, 0.03% to 2013, 0.09%. The sex ratio in the incidence rate of thyroid cancer was male : female = 1:7.2 in 2004 and male : female = 1:3.6 in 2013 that suggest decreased gap between the sex ratio. Between 2004 and 2010, the incidence rates of those in their 40s were found to be the highest, whereas the incidence rates for those in their 50s were found to be highest from 2011 and thereafter. Every year the high socioeconomic status group showed a higher incidence of thyroid cancer than low socioeconomic status group. Some specific region showed continuous high incidence of thyroid cancer, not all city and state. Conclusion: The incidence rate of thyroid cancer for 10 years had special feature by sex, age, socioeconomic status and especially by region. This results will be a barometer for further epidemiologic study about the incidence of thyroid cancer for Korean population

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.1
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• pp.56-62
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• 2023

Backgrounds/Aims: Endoscopic retrograde cholangiopancreatography-guided gallbladder drainage (ERGD) is an alternative to percutaneous cholecystostomy (PTC) for hospitalized acute cholecystitis (AC) patients. Methods: We retrospectively analyzed propensity score matched (PSM) AC hospitalizations using the National Inpatient Sample database between 2016 and 2019 to compare the outcomes of ERGD and PTC. Results: After PSM, there were 3,360 AC hospitalizations, with 48.8% undergoing PTC and 51.2% undergoing ERGD. There was no difference in median length of stay between the PTC and ERGD cohorts (p = 0.110). There was a higher median hospitalization cost in the ERGD cohort, $62,562 (interquartile range [IQR] $40,707-97,978) compared to PTC, $40,413 (IQR $25,244-65,608; p < 0.001). The 30-day inpatient mortality was significantly lower in hospitalizations with ERGD compared to PTC (adjusted hazard ratio 0.16, 95% confidence interval [CI]: 0.1-0.41; p < 0.001). There was no difference in association with blood transfusions, acute renal failure, ileus, small bowel obstruction, and open cholecystectomy conversion (p > 0.05) between hospitalizations with ERGD and PTC. There was lower association of acute hypoxic respiratory failure (adjusted ratio [AOR] 0.46, 95% CI: 0.29-0.72; p = 0.001), hypovolemia (AOR 0.66, 95% CI: 0.49-0.82; p = 0.009) and higher association of lower gastrointestinal bleed (AOR 1.94, 95% CI: 1.48-2.54; p < 0.001) with ERGD compared to PTC. Conclusions: ERGD is a safer alternative to PTC in patients with AC. The risk complications are lower in ERGD compared to PTC but no difference exists based on mortality or conversion to open cholecystectomy.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.4
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• pp.376-383
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• 2021

The aim of this study was to determine the prevalence and incidence and evaluate the current status of dental treatment of Amelogenesis imperfecta (AI) and Dentinogenesis imperfecta (DI) in South Korea. The data was based on National Health Insurance Service (NHIS)-National Sample Cohort Database (2002 - 2015) and Jeonbuk National University (JBNU) Dental Hospital (2011 - 2020). The NHIS data analysis showed prevalence of AI and DI were 11.6 and 2.4 per 100,000 people, respectively. The annual incidence of AI and DI for 2013 - 2015 were 2.2 and 0.5 per 100,000. There were no statistically significant differences regarding the number of visits, the reimbursable cost among AI, DI patients and others. In the patient analysis of the JBNU dental hospital, proportion of the reimbursable and non-reimbursable cost for AI patients were 12.1% and 87.9%, while DI patients accounted for 18.6% and 81.4%.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.3
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• pp.504-511
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• 2010

Diabetes is a disease that contains a high concentration of glucose in blood and due to defects in either insulin secretion or insulin action. Although the distinctive causes and factors of diabetes have not been clarified, the genetic factors are suggested as a main susceptibility until now. SNP (Single Nucleotide Polymorphism), as the most common genetic variation, has an influence on personal susceptibility for diseases. A nonsynonymous SNP, which changes the amino acid of the protein and its function, is especially important. Therefore, this study hypothesized that there are associations between specific SNPs of the targeted genes. Transcription factor 7-like 2 (TCF7L2) and fat mass and obesity associated (FTO) genes were selected as target genes from the results of genome-wide association and other related research studies. Second, four nonsynonymous SNPs (three in TCF7L2 and one in FTO gene) were selected as target SNPs by using public database of NCBI (National Center for Biotechnology Information). The recruited personnel was classified into three subgroups of diabetes, impaired fasting glucose (IFG) and normal groups. The individual genotypes of each group were analyzed by resequencing. None of genetic variations at four targeted SNP sites was revealed in all samples of this study. However, this study found two new SNPs that were not reported in TCF7L2 gene. One is synonymous SNP, which is heterozygous of C/T and no amino acid change of asparagine/asparagines, was located at c1641 and found in one normal person. Another is nonsynonymous SNP, which is heterozygous of G/A, was located at c1501 and found in two samples. This new discovered nonsynonymous SNP induce the amino acid change from alanine to threonine. Moreover, this new nonsynonymous SNP was found among two persons, one of whom was a diabetes patient and the other one was a person at boundary between IFG and normal, suggesting that this variant might be associated with IFG or diabetes. Even if there is a limitation of sample number for statistical power, this study has an importance due to the discovery of new SNPs. In the future study, a large sample number of diabetes cohort will be needed to investigate the frequency and association with new discovered SNP.