• 한국환경보건학회지
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• 제47권5호
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• pp.486-495
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• 2021

Background: Particulate matter (PM) is one of the leading causes of premature death worldwide. Previous studies in South Korea have applied a relative risk calculated from Western populations when estimating the disease burden attributable to PM. However, the relative risk of PM on health outcomes may not be the same across different countries or regions. Objectives: This study aimed to estimate the premature deaths and socioeconomic costs attributable to long-term exposure to PM in South Korea. We considered not only the difference in PM concentration between regions, but also the difference in relative risk. Methods: National monitoring data of PM concentrations was obtained, and missing values were imputed using the AERMOD model and linear regression model. As a surrogate for relative risk, hazard ratios (HRs) of PM for cardiovascular and respiratory mortality were estimated using the National Health Insurance Service-National Sample Cohort. The nation was divided into five areas (metropolitan, central, southern, south-eastern, and Gangwon-do Province regions). The number of PM attributable deaths in 2018 was calculated at the district level. The socioeconomic cost was derived by multiplying the number of deaths and the statistical value of life. Results: The average PM₁₀ concentration for 2014~2018 was 45.2 ㎍/m³. The association between long-term exposure to PM₁₀ and mortality was heterogeneous between areas. When applying area-specific HRs, 23,811 premature deaths from cardiovascular and respiratory disease in 2018 were attributable to PM₁₀ (reference level 20 ㎍/m³). The corresponding socioeconomic cost was about 31 trillion won. These estimated values were higher than that when applying nationwide HRs. Conclusions: This study is the first research to estimate the premature mortality caused by long-term exposure to PM using relative risks derived from the national population. This study will help precisely identify the national and regional health burden attributed to PM and establish the priorities of air quality policy.

• Journal of Preventive Medicine and Public Health
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• 제46권4호
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• pp.155-164
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• 2013

Noncommunicable diseases (NCDs) are the most important causes of premature mortality and disability-adjusted life years in Korea. NCDs are also the main contributor to socioeconomic inequalities in mortality and life expectancy. Reduction of NCDs and NCD inequalities would result in significant improvement in healthy life expectancy and health equity in Korea. Major NCD risk factors such as dietary risks (including salt intake), alcohol consumption, cigarette smoking, and high blood pressure were found to be the leading modifiable risk factors of disability-adjusted life years in Korea, based on the 2010 Global Burden of Disease Study. Several Korean studies have shown that these risk factors play an important role in creating socioeconomic inequalities in NCD mortality and total mortality. Current international discussions on NCD policies in the United Nations and the World Health Organization would provide better opportunities for developing aggressive population-wide policy measures in Korea. Considering the paucity of population-wide policies to control major NCD risk factors in Korea, rigorous population approaches such as taxation and regulation of unhealthy commodities as well as public education and mass campaigns should be further developed in Korea.

• Journal of Preventive Medicine and Public Health
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• 제45권5호
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• pp.291-300
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• 2012

Objectives: We aimed to estimate the annual socioeconomic burden of coronary heart disease (CHD) in Korea in 2005, using the National Health Insurance (NHI) claims data. Methods: A prevalence-based, top-down, cost-of-treatment method was used to assess the direct and indirect costs of CHD (International Classification of Diseases, 10th revision codes of I20-I25), angina pectoris (I20), and myocardial infarction (MI, I21-I23) from a societal perspective. Results: Estimated national spending on CHD in 2005 was $2.52 billion. The majority of the spending was attributable to medical costs (53.3%), followed by productivity loss due to morbidity and premature death (33.6%), transportation (8.1%), and informal caregiver costs (4.9%). While medical cost was the predominant cost attribute in treating angina (74.3% of the total cost), premature death was the largest cost attribute for patients with MI (66.9%). Annual per-capita cost of treating MI, excluding premature death cost, was $3183, which is about 2 times higher than the cost for angina ($1556). Conclusions: The total insurance-covered medical cost ($1.13 billion) of CHD accounted for approximately 6.02% of the total annual NHI expenditure. These findings suggest that the current burden of CHD on society is tremendous and that more effective prevention strategies are required in Korea.

• Journal of Preventive Medicine and Public Health
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• 제53권4호
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• pp.266-274
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• 2020

Objectives: Describe out-of-pocket payment (OOP) and the proportion of Peruvian households with catastrophic health expenditure (CHE) and evaluate changes in socioeconomic inequalities in CHE between 2008 and 2017. Methods: We used data from the 2008 and 2017 National Household Surveys on Living and Poverty Conditions (ENAHO in Spanish), which are based on probabilistic stratified, multistage and independent sampling of areas. OOP was converted into constant dollars of 2017. A household with CHE was assumed when the proportion between OOP and payment capacity was ≥0.40. OOP was described by median and interquartile range while CHE was described by weighted proportions and 95% confidence intervals (CIs). To estimate the socioeconomic inequality in CHE we computed the Erreygers concentration index. Results: The median OOP reduced from 205.8 US dollars to 158.7 US dollars between 2008 and 2017. The proportion of CHE decreased from 4.9% (95% CI, 4.5 to 5.2) in 2008 to 3.7% (95% CI, 3.4 to 4.0) in 2017. Comparison of socioeconomic inequality of CHE showed no differences between 2008 and 2017, except for rural households in which CHE was less concentrated in richer households (p<0.05) and in households located on the rest of the coast, showing an increase in the concentration of CHE in richer households (p<0.05). Conclusions: Although OOP and CHE reduced between 2008 and 2017, there is still socioeconomic inequality in the burden of CHE across different subpopulations. To reverse this situation, access to health resources and health services should be promoted and guaranteed to all populations.

• 근관절건강학회지
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• 제6권1호
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• pp.85-99
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• 1999

Chronic disease such as rheumatoid arthritis is believed to induce a significant psychosocial stressors. The concept of illness intrusiveness-illness induced life style disruptions-was hypothesized to affect psychosocial status. And demographic, socioeconomic, disease and social characteristics were hypotehsized to affect illness intrusiveness. Hierarchial multiple regression analyses were used. As a result, among the demographic factors gender was identified as contributor to directly increase the psychosocial stress and education level was identified to affect the psychosocial stress through illness intrusiveness. Among socioeconomic factors, the burden about the cost of medical treatment was found to indirectly affect the psychosocial stress through the illness intrusiveness. Also income and job were found to affect directly the psychosocial status. Among the disease characteristics, only the pain level was identified to increase the psychosocial stress through the illness intrusiveness. Among the social characteristics, perceived social support is identified to increase the psychosocial stress through the illness intrusiveness. Based upon these results, some suggestions were made for minimizing illness intrusiveness in rheumatoid arthritis and future research.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5249-5255
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• 2013

Background: The purpose of this study was to develop a single measure of cancer burden (SMCB), which can prioritize cancer sites by considering incidence and mortality. Materials and Methods: Incidence data from 1999 to 2010 were obtained from the Korea Central Cancer Registry. Mortality data from 1999 to 2010 were obtained from Statistics Korea. The SMCB was developed by adding incidence and mortality scores. The respective scores were given such that incidence and mortality were classified by ten ranges of equal intervals. Results: According to the SMCB in 2010, stomach cancer ranked $1^{st}$ in males with 20 points, and colorectal cancer was $2^{nd}$ with 11 points. Breast cancer and thyroid cancer were joint $1^{st}$ with 11 points for females. The SMCB for females was less than that for males. The burden of stomach cancer was $1^{st}$ in males from 1999-2010. The incidences of lung cancer and liver cancer decreased, whereas thyroid cancer and colon cancer increased during the period. Breast cancer and thyroid cancer burden showed tendencies to increase in females. Comparison of SMCB with disability-adjusted life years (DALY) and socioeconomic costs in 2005 showed that the top five cancer sites were similar, but there were differences in the size of the cancer burden. Conclusions: The SMCB indicated that the burdens of stomach cancer in males and thyroid and breast cancers in females were large. The single measure showed an advantage, reflected as the equivalent dimensions of incidence and mortality, whereas DALY and economic costs showed tendencies to reflect premature death.

• 한국국방경영분석학회지
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• 제30권1호
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• pp.135-152
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• 2004

Ever since Benoit's(1973, 1978) study, the relationship between defense spending and economic growth has been the subject of extensive empirical works. While a number of studies have reported that higher defense expenditure stimulate economic growth, many other studies have reported that an increase in military burden may hinder economic growth. To the extent that countries differ substantially in socioeconomic structures, the effects of defense spending cannot be generalized across countries. In this paper, Granger causality tests are performed between Korean defense expenditure and economic growth, consumption, investment, inflation and unemployment rate during the period from 1970 to 2002. The results show that Korean defense expenditure did not affect economic growth and unemployment rate. However, Korean defense expenditure caused consumption and inflation to decrease and investment to increase. On the other hand Korean defense expenditure was not Granger-caused by economic growth, consumption, investment, inflation and unemployment rate. In conclusion, the opportunity cost of Korean defense expenditure seemed to be relatively moderate considering Korean security environment. Even if it was not statistically significant, Korean defense burden at least did not bother economic growth.

• 대한소화기학회지
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• 제72권5호
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• pp.252-257
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• 2018

This guidance is an updated version of the irritable bowel syndrome (IBS) guidelines based on evidence-based medicine. IBS is a common chronic gastrointestinal syndrome that occurs in approximately 10% of the population and causes chronic abdominal pain as well as bowel habit changes, such as stool frequency or consistency. The final diagnosis of IBS is based on the exclusion of organic diseases that would explain the symptoms and the absence of endoscopic abnormalities. IBS can reduce the quality of life and cause a major disease burden, such as repeated examinations and continuous drug use, by mistaking organic diseases including malignancy. The major changes are as follows: 1) when to perform a colonoscopy under the impression of IBS; 2) effect of a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyol diet; 3) impact of probiotics in IBS; and 4) role of antibiotics in IBS. The Korean Society of Neurogastroenterology and Motility recently updated these guidelines to support physicians for qualified medical services and reduce the socioeconomic burden of IBS.

• Nutrition Research and Practice
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• 제13권2호
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• pp.134-140
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• 2019

BACKGROUND/OBJECTIVES: Excessive sugar consumption may increase the risk for development of several diseases. Although average dietary sugar intake of Koreans is within the recommended level, an increasing trend has been found in all age groups. This study aimed to evaluate the population attributable fractions (PAF) to dietary sugar for disease and death in Korea, and to estimate the socioeconomic effects of a reduction in dietary sugar. MATERIALS/METHODS: The prevalence of sugar-sweetened beverages (SSB) overconsumption (${\geq}20g$ of sugar from beverages) was analyzed using the Korean National Health and Nutrition Examination Survey 2015. Disease-specific relative risks of excessive SSB consumption were obtained through reviewing previous studies. Using the prevalence of SSB overconsumption and each relative risk, PAFs for morbidity and mortality were calculated. Socioeconomic costs of diseases and death attributable to SSB overconsumption were estimated by using representative data on national medical expenditures, health insurance statistics, employment information, and previous reports. RESULTS: Disease-specific PAF to SSB consumption ranged from 3.11% for stroke to 9.05% for obesity and dental caries, respectively. Costs from disease caused by SSB overconsumption was estimated at 594 billion won in 2015. About 39 billion won was estimated to be from SSB consumption-related deaths, and a total of 633 billion won was predicted to have been saved through preventing SSB overconsumption. CONCLUSIONS: Sugars overconsumption causes considerable public burdens, although the cost estimates do not include any informal expenditure. Information on these socioeconomic effects helps both health professionals and policy makers to create and to implement programs for reducing sugar consumption.

• 한방재활의학과학회지
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• 제24권4호
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• pp.137-143
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• 2014

Objectives Low back pain causes disability and incurs large socioeconomic burden. Many cases of acute low back pain progress into chronic conditions. As the treatment period extends, burden of socioeconomic expenses also rises. Thus this study is to investigate whether history period influences improvement rate of pain and disability in the patients who receive conservative Korean medicine treatment. Methods 447 inpatients who received conservative Korean Medicine treatment for the management of low back pain have been grouped into acute, sub-acute and chronic according to the length of history period. NRS, ODI and improvement rate of each group were investigated. Treatment every patient has received as follow; acupuncture, herbal medicine, Chuna manipulation, bee venom, and physical treatment. Results Acute patients showed improvement with NRS of $3.98{\pm}2.50$ and ODI of $28.04{\pm}21.54$. The NRS of sub-acute patients showed improvement with NRS of $2.81{\pm}2.07$, ODI also showed improvement with $11.64{\pm}13.94$. Statistically significant difference was observed in NRS, ODI and improvement for acute patients. Improvement in pain and disability was observed to be larger. Conclusions It demonstrated that receiving valid conservative Korean medicine treatment is beneficial for low back pain patients in improvement of their pain and disability.