Jong Heon Park

Data Resource Profile: The National Health Information Database of the National Health Insurance Service in South Korea

Seong, Sang Cheol; Kim, Yeon-Yong; Khang, Young-Ho; Park, Jong Heon; Kang, Hee-Jin; Lee, Heeyoung; Do, Cheol-Ho; Song, Jong-Sun; Bang, Ji Hyon; Ha, Seongjun; Lee, Eun-Joo; Shin, Soon Ae.October, 2016.Data resource profile,Articles,[Wentworthville, Australia]International Epidemiological Association,6

Cohort profile: the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) in Korea

Purpose The National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) is a cohort of participants who participated in health screening programmes provided by the NHIS in the Republic of Korea. The NHIS constructed the NHIS-HEALS cohort database in 2015. The purpose of this cohort is to offer relevant and useful data for health researchers, especially in the field of non-communicable diseases and health risk factors, and policy-maker. Participants To construct the NHIS-HEALS database, a sample cohort was first selected from the 2002 and 2003 health screening participants, who were aged between 40 and 79 in 2002 and followed up through 2013. This cohort included 514 866 health screening participants who comprised a random selection of 10% of all health screening participants in 2002 and 2003. Findings to date The age-standardised prevalence of anaemia, diabetes mellitus, hypertension, obesity, hypercholesterolaemia and abnormal urine protein were 9.8%, 8.2%, 35.6%, 2.7%, 14.2% and 2.0%, respectively. The age-standardised mortality rate for the first 2 years (through 2004) was 442.0 per 100 000 person-years, while the rate for 10 years (through 2012) was 865.9 per 100 000 person-years. The most common cause of death was malignant neoplasm in both sexes (364.1 per 100 000 person-years for men, 128.3 per 100 000 person-years for women). Future plans This database can be used to study the risk factors of non-communicable diseases and dental health problems, which are important health issues that have not yet been fully investigated. The cohort will be maintained and continuously updated by the NHIS.

Mental health of people with retinitis pigmentosa.

Purpose The purpose of this study was to evaluate and compare the mental health of patients with retinitis pigmentosa (RP) with that of the general population of Korea. Methods Online surveys were completed by patients registered with the KRPS (Korean Retinitis Pigmentosa Society), an online organization that promotes research on RP and provides advocacy and online and offline support and information for patients with RP. Control population was selected from the fourth round of the KNHANES (Korean National Health and Nutrition Examination Survey). One hundred eighty-seven patients with RP were matched with the control population using the propensity-score method to optimize comparative analysis. Results Stress was reported in 51.9% of RP patients and 29.4% of controls (p < 0.001). Depressive mood of at least 2 weeks’ duration in the previous year was reported by 34.8 and 17.1% of patients and controls, respectively (p < 0.001). Suicidal thoughts were reported by 38.5 and 12.9% of patients and controls, respectively (p < 0.001), although there was no significant difference in the number of suicide attempts between the groups (2.1 vs. 1.6%, p = 0.703). In multivariate analysis, disability rating was significantly associated with stress (adjusted odds ratio, 0.46; 95% confidence interval, 0.24 to 0.88). Conclusions People with RP had poorer mental health than the general population. Further investigations are warranted on the mental health of RP patients, and appropriate welfare services are needed to decrease the impact of mental illness in this population.

The Relationship Between the Social Network of Community-living Elders and Their Health-related Quality of Life in Korean Province

Objectives This study aimed to collect information that will help enhance the social networks and improve the quality of life among elderly people by observing the relationship between their social network and health-related quality of life (HRQoL) and by analyzing social network factors affecting HRQoL. Methods This study was based on the 2008 Community Health Survey in Yeoncheon County. Three hundred elders were included in the study population. We compared the revised Lubben Social Network Scale (LSNS-R) score and Euro quality of life-5 dimensions health status index by demographic characteristics and chronic disease prevalence. We analyzed the data using multiple regression and tobit regression by setting the HRQoL as the dependent variable and social network and other characteristics as the independent variables. We analyzed social network factors by using factor analysis. Results The LSNS-R score differed significantly according to age and existence of a spouse. According to the results from the hierarchical multiple regression analysis, the LSNS-R explained 0.10 of the variance and LSNS-R friends factor explained 0.10 of the variance. The tobit regression indicated that the contribution of the LSNS-R family size factor to the regression coefficient of the independent variable that affected the HRQoL was BT=2.96, that of the LSNS-R family frequency factor was BT=3.60, and that of LSNS-R friends factor was BT=5.41. Conclusions Social networks among elderly people had a significant effect on HRQoL and their networks of friends had a relatively higher effect than those of family members.

Prepregnancy factors as determinants of the development of diabetes mellitus after first pregnancy

CONTEXT The identification of modifiable factors at prepregnancy or early pregnancy as well as continued monitoring and management of these factors before and during pregnancy may reduce the incidence of diabetes mellitus (DM) among women, regardless of gestational diabetes mellitus (GDM) status. OBJECTIVE This study aimed to identify prepregnancy factors for the development of DM in women with or without GDM in their first pregnancy. DESIGN AND PARTICIPANTS This retrospective, observational, cohort study included data for 53 109 women who underwent a National Health Screening Examination through the National Health Insurance Corporation between 2002 and 2003 and had their first delivery in 2004 with follow-up until 2012. MAIN OUTCOMES The main outcome of the study was the risk of developing DM after 8 years in women with and without GDM during their first pregnancy. RESULTS The cumulative risks of developing DM after 8 years were 8.4% and 3.3% in women with and without GDM during their first pregnancy, respectively. Old age, a family history of DM, obesity, a high fasting glucose level, and high total cholesterol level were associated with DM development in women without GDM. In women with GDM, a family history of DM, prepregnancy obesity, a high fasting glucose level, and a high total cholesterol level were associated with DM. When stratified by GDM status and the number of prepregnancy risk factors, the number of prepregnancy risk factors was associated with the risk of DM in women with or without GDM. Women with GDM had a higher risk of DM for the same number of prepregnancy risk factors than women without GDM. CONCLUSION The results show that GDM may be a marker for development of DM in the future because it shares the same risk factors with DM development. Thus, eliminating other risk factors in women with GDM may lead to a reduction in the risk of DM.

The Effect of Sleep Duration on the Risk of Unintentional Injury in Korean Adults

Objectives The decrease or increase in sleep duration has recently been recognized as a risk factor for several diseases, including hypertension and obesity. Many studies have explored the relationship of decreased sleep durations and injuries, but few have examined the relationship between increased sleep duration and injury. The objective of this research is to identify the risk for injury associated with both decreased and increased sleep durations. Methods Data from the 2010 Community Health Survey were used in this study. We conducted logistic regression with average sleep duration as the independent variable, injury as a dependent variable, and controlling for age, sex, occupation, education, region (cities and provinces), smoking, alcohol use, body mass index, hypertension, diabetes, arthritis, and depression. Seven categories of sleep duration were established: ≤4, 5, 6, 7, 8, 9, and ≥10 hours. Results Using 7 hours of sleep as the reference, the adjusted injury risk (odds ratio) for those sleeping a total of ≤4 h/d was 1.53; 1.28 for 5 hours, for 1.11 for 6 hours, 0.98 for 8 hours, 1.12 for 9 hours, and 1.48 for ≥10 hours. The difference in risk was statistically significant for each category except for the 8 and 9 hours. In this study, risk increased as the sleep duration decreased or increased, except for the 8 and 9 hours. Conclusions This research found that either a decrease or increase in sleep duration was associated with an increased risk for injury. The concept of proper sleep duration can be evaluated by its associated injury risk.

The Effect of Geographic Units of Analysis on Measuring Geographic Variation in Medical Services Utilization

Objectives: We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea. Methods: To compare geographic variation in geographic units of analysis, we calculated the age–sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units. Results: Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures. Conclusions: Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.

Metabolic syndrome in the non-pregnant state is associated with the development of preeclampsia.

BACKGROUND The aim of this study was to investigate the association between metabolic syndrome in the non-pregnant state and the development of preeclampsia. METHODS We enrolled 212,463 Korean women who had their first delivery between January, 2011 and December, 2012 and had undergone a national health screening examination through the National Health Insurance during the 1-2 years before their first delivery. Women who had hypertension in the non-pregnant state were excluded. The presence of metabolic syndrome was defined using the modified criteria published in National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS The prevalence of metabolic syndrome in non-pregnant state was 1.2%. Preeclampsia developed in 3.1% and its prevalence among women with and without metabolic syndrome was 7.3% and 3.0%, respectively. The pre-pregnancy prevalence of metabolic syndrome was higher in women who developed preeclampsia compared to that in those who had a normal pregnancy (1.1% vs. 2.8%; p<0.001). On multivariate regression analysis, women with metabolic syndrome had an increased risk of developing preeclampsia (odds ratio: 1.48; 95% CI: 1.26 to 1.74) compared to that in those without metabolic syndrome, after adjusting for age, family history of hypertension, smoking status, and pre-pregnancy body mass index. The risk of preeclampsia increased with a rise in the number of components of metabolic syndrome. CONCLUSION Metabolic syndrome in the non-pregnant state was associated with the development of preeclampsia. Further studies are needed to evaluate whether early intervention for metabolic syndrome before pregnancy can decrease the risk of developing preeclampsia.

Retrospective observation on contribution and limitations of screening for breast cancer with mammography in Korea: detection rate of breast cancer and incidence rate of interval cancer of the breast

BackgroundThe purpose of this study was to determine the benefits and limitations of screening for breast cancer using mammography.MethodsDescriptive design with follow-up was used in the study. Data from breast cancer screening and health insurance claim data were used. The study population consisted of all participants in breast cancer screening from 2009 to 2014. Crude detection rate, positive predictive value and sensitivity and specificity of breast cancer screening and, incidence rate of interval cancer of the breast were calculated.ResultsThe crude detection rate of breast cancer screening per 100,000 participants increased from 126.3 in 2009 to 182.1 in 2014. The positive predictive value of breast cancer screening per 100,000 positives increased from 741.2 in 2009 to 1,367.9 in 2014. The incidence rate of interval cancer of the breast per 100,000 negatives increased from 51.7 in 2009 to 76.3 in 2014. The sensitivities of screening for breast cancer were 74.6% in 2009 and 75.1% in 2014 and the specificities were 83.1% in 2009 and 85.7% in 2014.ConclusionsTo increase the detection rate of breast cancer by breast cancer screening using mammography, the participation rate should be higher and an environment where accurate mammography and reading can be performed and reinforcement of quality control are required. To reduce the incidence rate of interval cancer of the breast, it will be necessary to educate women after their 20s to perform self-examination of the breast once a month regardless of participation in screening for breast cancer.

Health Behaviors of People with Retinitis Pigmentosa in the Republic of Korea

Abstract Purpose: To investigate the health behaviors of people with retinitis pigmentosa (RP) in the Republic of Korea. Methods: An online questionnaire was used to survey members of the Korean Retinitis Pigmentosa Society (KRPS), over 3 months from December 2010 to February 2011. Controls were selected from participants of the 4th Korean National Health and Nutrition Examination Survey and were matched with people with RP using the propensity score method to optimize comparative analysis. A semi-structured interview was also conducted with five members of the KRPS to identify potential reasons for physical inactivity and unhealthy diet and to develop effective interventions. Results: A total of 194 eligible people with RP responded to the online survey, and 187 individuals were matched with the control population by propensity score matching. RP subjects reported a lower rate of current smoking and greater use of preventive healthcare services. However, people with RP were more physically inactive (50.8% vs 27.3%, p < 0.001) and consumed more fast food (69.5% vs 58.3%, p = 0.024) than the control population. Conclusion: Physical inactivity and fast food consumption were more frequently reported in people with RP than the general population. Efforts to understand the possible reasons and develop interventions to improve these health behaviors are warranted.