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Jung YS, Kim YE, Ock M, Yoon SJ. Measuring the Burden of Disease in Korea Using Disability-Adjusted Life Years (2008-2020). J Korean Med Sci 2024; 39:e67. [PMID: 38412612 PMCID: PMC10896705 DOI: 10.3346/jkms.2024.39.e67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 12/28/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The measurement of health levels and monitoring of characteristics and trends among populations and subgroups are essential for informing evidence-based policy decisions. This study aimed to examine the burden of disease in Korea for both the total population and subgroups in 2020, as well as analyze changes in disease burden from 2008 to 2020. METHODS We employed the methodology developed in the Korean National Burden of Disease and Injuries Study to calculate disability-adjusted life years (DALYs) by sex, causes, region, and income level from 2008 to 2020. DALYs were derived by combining years of life lost and years lived with disability. RESULTS In 2020, the burden of disease for the Korean population was estimated to be 25,439 DALYs per 100,000 population, reflecting a 13.8% increase since 2008. The leading causes of DALYs were diabetes mellitus, followed by low back pain and ischemic stroke. A sex-specific gap reversal was observed, with the disease burden for men surpassing that of women starting in 2017. Furthermore, variations in disease burden were identified across 250 regions and income quintiles. CONCLUSION It is imperative to establish appropriate health policies that prioritize the diseases with significantly increasing burdens and subgroups experiencing high disease burdens. The findings of this study are expected to serve as a foundation for developing healthcare policies aimed at improving the health levels of Koreans and achieving health equity.
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Affiliation(s)
- Yoon-Sun Jung
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Young-Eun Kim
- Department of Big Data Strategy, National Health Insurance Service, Wonju, Korea
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.
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Kim I, Bae H. Age- and cause-specific contributions to increase in life expectancy at birth in Korea, 2000-2019: a descriptive study. BMC Public Health 2024; 24:431. [PMID: 38341549 PMCID: PMC10859017 DOI: 10.1186/s12889-024-17974-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/03/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Korea's life expectancy at birth has consistently increased in the 21st century. This study compared the age and cause-specific contribution to the increase in life expectancy at birth in Korea before and after 2010. METHODS The population and death numbers by year, sex, 5-year age group, and cause of death from 2000 to 2019 were acquired. Life expectancy at birth was calculated using an abridged life table by sex and year. The annual age-standardized and age-specific mortality by cause of death was also estimated. Lastly, the age and cause-specific contribution to the increase in life expectancy at birth in the two periods were compared using a stepwise replacement algorithm. RESULTS Life expectancy at birth in Korea increased consistently from 2010 to 2019, though slightly slower than from 2000 to 2009. The cause-specific mortality and life expectancy decomposition analysis showed a significant decrease in mortality in chronic diseases, such as neoplasms and diseases of the circulatory system, in the middle and old-aged groups. External causes, such as transport injuries and suicide, mortality in younger age groups also increased life expectancy. However, mortality from diseases of the respiratory system increased in the very old age group during 2010-2019. CONCLUSIONS Life expectancy at birth in Korea continued to increase mainly due to decreased mortality from chronic diseases and external causes during the study period. However, the aging of the population structure increased vulnerability to respiratory diseases. The factors behind the higher death rate from respiratory disease should be studied in the future.
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Affiliation(s)
- Ikhan Kim
- Department of Medical Humanities and Social Medicine, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan, 49267, Korea.
| | - Hyeona Bae
- Department of Medical Humanities and Social Medicine, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan, 49267, Korea
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Hua J, Li L, Ning P, Schwebel DC, He J, Rao Z, Cheng P, Li R, Fu Y, Li J, Wang W, Zhang N, Hu G. Road traffic death coding quality in the WHO Mortality Database. Bull World Health Organ 2023; 101:637-648. [PMID: 37772197 PMCID: PMC10523810 DOI: 10.2471/blt.23.289683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 05/21/2023] [Accepted: 07/04/2023] [Indexed: 09/30/2023] Open
Abstract
Objective To evaluate the precision and dependability of road traffic mortality data recorded in the World Health Organization Mortality Database and investigate how uncorrected data influence vital mortality statistics used in traffic safety programmes worldwide. Methods We assessed country and territory-specific data quality from 2015 to 2020 by calculating the proportions of five types of nonspecific cause of death codes related to road traffic mortality. We compared age-adjusted road traffic mortality and changes in the average annual mortality rate before and after correcting the deaths with nonspecific codes. We generated road traffic mortality projections with both corrected and uncorrected codes, and redistributed the data using the proportionate method. Findings We analysed data from 124 countries and territories with at least one year of mortality data from 2015 to 2020. The number of countries and territories reporting more than 20% of deaths with ill-defined or unknown cause was 2; countries reporting injury deaths with undetermined intent was 3; countries reporting unspecified unintentional injury deaths was 21; countries reporting unspecified transport crash deaths was 3; and countries reporting unspecified unintentional road traffic deaths was 30. After redistributing deaths with nonspecific codes, road traffic mortality changed by greater than 50% in 7% (5/73) to 18% (9/51) of countries and territories. Conclusion Nonspecific codes led to inaccurate mortality estimates in many countries. We recommend that injury researchers and policy-makers acknowledge the potential pitfalls of relying on raw or uncorrected road traffic mortality data and instead use corrected data to ensure more accurate estimates when improving road traffic safety programmes.
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Affiliation(s)
- Junjie Hua
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 172 Tong Zi Po Street, Changsha, 410072, China
| | - Peishan Ning
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 172 Tong Zi Po Street, Changsha, 410072, China
| | - David C Schwebel
- Department of Psychology, University of Alabama, Birmingham, United States of America
| | - Jieyi He
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 172 Tong Zi Po Street, Changsha, 410072, China
| | - Zhenzhen Rao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 172 Tong Zi Po Street, Changsha, 410072, China
| | - Peixia Cheng
- Department of Child, Adolescent and Women's Health, Capital Medical University, Beijing, China
| | - Ruotong Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 172 Tong Zi Po Street, Changsha, 410072, China
| | - Yanhong Fu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 172 Tong Zi Po Street, Changsha, 410072, China
| | - Jie Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 172 Tong Zi Po Street, Changsha, 410072, China
| | - Wanhui Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 172 Tong Zi Po Street, Changsha, 410072, China
| | - Na Zhang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 172 Tong Zi Po Street, Changsha, 410072, China
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 172 Tong Zi Po Street, Changsha, 410072, China
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Rodzlan Hasani WS, Muhamad NA, Hanis TM, Maamor NH, Wee CX, Omar MA, Ganapathy SS, Abdul Karim Z, Musa KI. The burden of premature mortality from cardiovascular diseases: A systematic review of years of life lost. PLoS One 2023; 18:e0283879. [PMID: 37083866 PMCID: PMC10121009 DOI: 10.1371/journal.pone.0283879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/19/2023] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION Premature mortality refers to deaths that occur before the expected age of death in a given population. Years of life lost (YLL) is a standard parameter that is frequently used to quantify some component of an "avoidable" mortality burden. OBJECTIVE To identify the studies on premature cardiovascular disease (CVD) mortality and synthesise their findings on YLL based on the regional area, main CVD types, sex, and study time. METHOD We conducted a systematic review of published CVD mortality studies that reported YLL as an indicator for premature mortality measurement. A literature search for eligible studies was conducted in five electronic databases: PubMed, Scopus, Web of Science (WoS), and the Cochrane Central Register of Controlled Trials (CENTRAL). The Newcastle-Ottawa Scale was used to assess the quality of the included studies. The synthesis of YLL was grouped into years of potential life lost (YPLL) and standard expected years of life lost (SEYLL) using descriptive analysis. These subgroups were further divided into WHO (World Health Organization) regions, study time, CVD type, and sex to reduce the effect of heterogeneity between studies. RESULTS Forty studies met the inclusion criteria for this review. Of these, 17 studies reported premature CVD mortality using YPLL, and the remaining 23 studies calculated SEYLL. The selected studies represent all WHO regions except for the Eastern Mediterranean. The overall median YPLL and SEYLL rates per 100,000 population were 594.2 and 1357.0, respectively. The YPLL rate and SEYLL rate demonstrated low levels in high-income countries, including Switzerland, Belgium, Spain, Slovenia, the USA, and South Korea, and a high rate in middle-income countries (including Brazil, India, South Africa, and Serbia). Over the past three decades (1990-2022), there has been a slight increase in the YPLL rate and the SEYLL rate for overall CVD and ischemic heart disease but a slight decrease in the SEYLL rate for cerebrovascular disease. The SEYLL rate for overall CVD demonstrated a notable increase in the Western Pacific region, while the European region has experienced a decline and the American region has nearly reached a plateau. In regard to sex, the male showed a higher median YPLL rate and median SEYLL rate than the female, where the rate in males substantially increased after three decades. CONCLUSION Estimates from both the YPLL and SEYLL indicators indicate that premature CVD mortality continues to be a major burden for middle-income countries. The pattern of the YLL rate does not appear to have lessened over the past three decades, particularly for men. It is vitally necessary to develop and execute strategies and activities to lessen this mortality gap. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021288415.
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Affiliation(s)
- Wan Shakira Rodzlan Hasani
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Tengku Muhammad Hanis
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Nur Hasnah Maamor
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Chen Xin Wee
- Department of Public Health Medicine, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Shubash Shander Ganapathy
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Zulkarnain Abdul Karim
- Office of The Manager, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Ellingsen CL, Alfsen GC, Ebbing M, Pedersen AG, Sulo G, Vollset SE, Braut GS. Garbage codes in the Norwegian Cause of Death Registry 1996-2019. BMC Public Health 2022; 22:1301. [PMID: 35794568 PMCID: PMC9261062 DOI: 10.1186/s12889-022-13693-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 06/23/2022] [Indexed: 11/22/2022] Open
Abstract
Background Reliable statistics on the underlying cause of death are essential for monitoring the health in a population. When there is insufficient information to identify the true underlying cause of death, the death will be classified using less informative codes, garbage codes. If many deaths are assigned a garbage code, the information value of the cause-of-death statistics is reduced. The aim of this study was to analyse the use of garbage codes in the Norwegian Cause of Death Registry (NCoDR). Methods Data from NCoDR on all deaths among Norwegian residents in the years 1996–2019 were used to describe the occurrence of garbage codes. We used logistic regression analyses to identify determinants for the use of garbage codes. Possible explanatory factors were year of death, sex, age of death, place of death and whether an autopsy was performed. Results A total of 29.0% (290,469/1,000,128) of the deaths were coded with a garbage code; 14.1% (140,804/1,000,128) with a major and 15.0% (149,665/1,000,128) with a minor garbage code. The five most common major garbage codes overall were ICD-10 codes I50 (heart failure), R96 (sudden death), R54 (senility), X59 (exposure to unspecified factor), and A41 (other sepsis). The most prevalent minor garbage codes were I64 (unspecified stroke), J18 (unspecified pneumonia), C80 (malignant neoplasm with unknown primary site), E14 (unspecified diabetes mellitus), and I69 (sequelae of cerebrovascular disease). The most important determinants for the use of garbage codes were the age of the deceased (OR 17.4 for age ≥ 90 vs age < 1) and death outside hospital (OR 2.08 for unknown place of death vs hospital). Conclusion Over a 24-year period, garbage codes were used in 29.0% of all deaths. The most important determinants of a death to be assigned a garbage code were advanced age and place of death outside hospital. Knowledge of the national epidemiological situation, as well as the rules and guidelines for mortality coding, is essential for understanding the prevalence and distribution of garbage codes, in order to rely on vital statistics. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13693-w.
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Affiliation(s)
- Christian Lycke Ellingsen
- Department of Pathology, Stavanger University Hospital, PO Box 8100, N-4068, Stavanger, Norway. .,Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, N-5020, Bergen, Norway.
| | - G Cecilie Alfsen
- Department of Pathology, Akershus University Hospital, PO Box 1000, N-1478, Lørenskog, Norway.,Faculty of Medicine, University of Oslo, PO Box 1078, Blindern, N-0316, Oslo, Norway
| | - Marta Ebbing
- Department of Research and Development, Haukeland University Hospital, PO Box 1400, N-5021, Bergen, Norway
| | - Anne Gro Pedersen
- Department for Health Data and Collection, Norwegian Institute of Public Health, PO Box 973, Sentrum, N-5808, Bergen, Norway
| | - Gerhard Sulo
- Centre for Disease Burden, Norwegian Institute of Public Health, PO Box 973, Sentrum, N-5808, Bergen, Norway
| | - Stein Emil Vollset
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, N-5020, Bergen, Norway.,Department of Health Metrics Sciences and Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA
| | - Geir Sverre Braut
- Department of Research, Stavanger University Hospital, PO Box 8100, N-4068, Stavanger, Norway
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Monasta L, Alicandro G, Pasovic M, Cunningham M, Armocida B, Ronfani L, Naghavi M, Monasta L, Alicandro G, Pasovic M, Cunningham M, Armocida B, Albano L, Beghi E, Beghi M, Bosetti C, Bragazzi NL, Carreras G, Castelpietra G, Catapano AL, Cattaruzza MS, Collatuzzo G, Conti S, Damiani G, Ferrara P, Fornari C, Gallus S, Giampaoli S, Golinelli D, Isola G, Lauriola P, La Vecchia C, Leonardi M, Magnani FG, Minelli G, Moccia M, Pedersini P, Perico N, Raggi A, Remuzzi G, Sanmarchi F, Sattin D, Unim B, Villafañe JH, Violante FS, Murray CJL, Ronfani L, Naghavi M. Redistribution of garbage codes to underlying causes of death: a systematic analysis on Italy and a comparison with most populous Western European countries based on the Global Burden of Disease Study 2019. Eur J Public Health 2022; 32:456-462. [PMID: 35061890 PMCID: PMC9159332 DOI: 10.1093/eurpub/ckab194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background The proportion of reported causes of death (CoDs) that are not underlying causes can be relevant even in high-income countries and seriously affect health planning. The Global Burden of Disease (GBD) study identifies these ‘garbage codes’ (GCs) and redistributes them to underlying causes using evidence-based algorithms. Planners relying on vital registration data will find discrepancies with GBD estimates. We analyse these discrepancies, through the analysis of GCs and their redistribution. Methods We explored the case of Italy, at national and regional level, and compared it to nine other Western European countries with similar population sizes. We analysed differences between official data and GBD 2019 estimates, for the period 1990–2017 for which we had vital registration data for most select countries. Results In Italy, in 2017, 33 000 deaths were attributed to unspecified type of stroke and 15 000 to unspecified type of diabetes, these making a fourth of the overall garbage. Significant heterogeneity exists on the overall proportion of GCs, type (unspecified or impossible underlying causes), and size of specific GCs among regions in Italy, and among the select countries. We found no pattern between level of garbage and relevance of specific GCs. Even locations performing below average show interesting lower levels for certain GCs if compared to better performing countries. Conclusions This systematic analysis suggests the heterogeneity in GC levels and causes, paired with a more detailed analysis of local practices, strengths and weaknesses, could be a positive element in a strategy for the reduction of GCs in Italy.
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Affiliation(s)
- Lorenzo Monasta
- Institute for Maternal and Child Health–IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Gianfranco Alicandro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Cystic Fibrosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maja Pasovic
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Matthew Cunningham
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Benedetta Armocida
- Institute for Maternal and Child Health–IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Luca Ronfani
- Institute for Maternal and Child Health–IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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Park S, Kim SH. Does the Application of International Classification of Disease Codes for the Cause of Death on Death Certificates Reduce Garbage Codes? INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221081433. [PMID: 35384751 PMCID: PMC8990542 DOI: 10.1177/00469580221081433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION This study aimed to determine if applying International Classification of Diseases (ICD) disease codes directly as the cause of death (COD) on death certificates (DCs) instead of writing or typing the COD could reduce the use of garbage codes. METHODS Beginning in April of 2016, a documentation process change was made, retiring the process of hand-writing or typing the COD onto DCs to directly applying ICD disease codes that were registered during the patient's course of treatment. The DCs issued at the emergency department (ED) 1 year before (Pre-code group) and after (Code group) applying ICD disease codes directly on DCs was instituted were retrospectively analyzed. The occurrence of garbage codes along with other major and minor errors was compared between the two groups. The investigation and judgment of errors were performed by four emergency physicians. RESULTS The overall garbage code occurrence in the Code group (25%) was significantly lower than that in the Pre-code group (49%). Fewer garbage codes were used in the Code group with an average of .5 in the Pre-code group and .3 in the Code group. No significant difference was identified in major error occurrences except for in the garbage codes. Minor errors were more common in the Pre-code group than in the Code group. CONCLUSION The overall use of garbage codes on DCs could be reduced by changing the process by which physicians complete DCs, that is, the application of documenting ICD disease codes directly as the COD on DCs.
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Affiliation(s)
- Soobeom Park
- Department of Emergency Medicine,
University of Ulsan College of Medicine, Ulsan University
Hospital, Dong-gu Ulsan, Korea
| | - Sun Hyu Kim
- Department of Emergency Medicine,
University of Ulsan College of Medicine, Ulsan University
Hospital, Dong-gu Ulsan, Korea
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Kim KA, Kim YE, Yoon SJ. Descriptive epidemiology on the trends and sociodemographic risk factors of disease burden in years of life lost due to suicide in South Korea from 2000 to 2018. BMJ Open 2021; 11:e043662. [PMID: 33637545 PMCID: PMC7919599 DOI: 10.1136/bmjopen-2020-043662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES In 2018, South Korea's suicide mortality rate was 26.59 deaths per 100 000 people; this figure is 2.2 times higher than that of the year 2000, during which 12.22 deaths per 100 000 people were ascribed to suicide. This study aims to observe the trend of disease burden in years of life lost (YLL) due to suicide from 2000 to 2018 in South Korea and investigate the related sociodemographic risk factors. DESIGN This quantitative research used secondary data-including claim data, cause of death statistics, life tables and census data-from national health insurance corporation and Statistics Korea. Based on the methodology of Korean National Burden of Disease study, this study used an incidence-based approach to measure YLL. RESULTS The total YLL due to suicide during the last two decades was 4 298 886 years; the average YLL per death was 18.65 years. The YLL rate per 100 000 people was 482 (male: 664, female: 300) in 2018, 1.7 times higher than the 387 (male 387, female 183) in 2000. Low education levels and non-marital status were shown to be related to the increase in YLL rate. CONCLUSION These results show the increasing disease burden of suicide in South Korea and suggest the necessity of more in-depth research to analyse correlation and causation with sociodemographic risk factors.
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Affiliation(s)
- Keun A Kim
- School of Military Medicine, The Armed Force Medical Command, Daejeon, South Korea
| | - Young-Eun Kim
- Department of Big Data Strategy, National Health Insurance Service, Wonju, South Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine of Seoul, Seoul, South Korea
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von der Lippe E, Devleesschauwer B, Gourley M, Haagsma J, Hilderink H, Porst M, Wengler A, Wyper G, Grant I. Reflections on key methodological decisions in national burden of disease assessments. Arch Public Health 2020; 78:137. [PMID: 33384020 PMCID: PMC7774238 DOI: 10.1186/s13690-020-00519-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 12/08/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Summary measures of population health are increasingly used in different public health reporting systems for setting priorities for health care and social service delivery and planning. Disability-adjusted life years (DALYs) are one of the most commonly used health gap summary measures in the field of public health and have become the key metric for quantifying burden of disease (BoD). BoD methodology is, however, complex and highly data demanding, requiring a substantial capacity to apply, which has led to major disparities across researchers and nations in their resources to perform themselves BoD studies and interpret the soundness of available estimates produced by the Global Burden of Disease Study. METHODS BoD researchers from the COST Action European Burden of Disease network reflect on the most important methodological choices to be made when estimating DALYs. The paper provides an overview of eleven methodological decisions and challenges drawing on the experiences of countries working with BoD methodology in their own national studies. Each of these steps are briefly described and, where appropriate, some examples are provided from different BoD studies across the world. RESULTS In this review article we have identified some of the key methodological choices and challenges that are important to understand when calculating BoD metrics. We have provided examples from different BoD studies that have developed their own strategies in data usage and implementation of statistical methods in the production of BoD estimates. CONCLUSIONS With the increase in national BoD studies developing their own strategies in data usage and implementation of statistical methods in the production of BoD estimates, there is a pressing need for equitable capacity building on the one hand, and harmonization of methods on the other hand. In response to these issues, several BoD networks have emerged in the European region that bring together expertise across different domains and professional backgrounds. An intensive exchange in the experience of the researchers in the different countries will enable the understanding of the methods and the interpretation of the results from the local authorities who can effectively integrate the BoD estimates in public health policies, intervention and prevention programs.
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Affiliation(s)
- Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | | | - Michelle Gourley
- Indigenous Data Analysis and Reporting Unit, Australian Institute of Health and Welfare, Canberra, Australia
| | - Juanita Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Henk Hilderink
- Centre for Public Health Forecasting, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Michael Porst
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Annelene Wengler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Grant Wyper
- Public Health Scotland, Edinburgh, Scotland, UK
| | - Ian Grant
- Public Health Scotland, Edinburgh, Scotland, UK
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Go DS, Kim YE, Yoon SJ. Development of the Korean Community Health Determinants Index (K-CHDI). PLoS One 2020; 15:e0240304. [PMID: 33031396 PMCID: PMC7544091 DOI: 10.1371/journal.pone.0240304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 09/23/2020] [Indexed: 12/02/2022] Open
Abstract
This study developed and validated a Korean community health determinants index (K-CHDI), which can be used to assess the health status of the community. To develop composite indicators, we followed the guidelines of the Joint Research Centre of the Organization for Economic Cooperation and Development. We reviewed previous studies and formed a theoretical framework to systematize our domains and indicators, which were decided through a Delphi survey of healthcare experts. Data on indicators were obtained from the Korean Statistics and Community Health Survey. We applied the Min-Max normalization method and measured weights by the analytic hierarchy process. Health outcomes were estimated using mortality, years of life lost, years lived with disability, and disability-adjusted life years by standardizing sex and age. The value of the index is between 0 and 1; higher values indicate more positive health determinants. K-CHDI for 250 subnational regions (cities, counties, and districts, or Si·Gun·Gu) were correlated with health outcomes. The correlation coefficient was stronger in large cities than in medium-sized areas and small areas, and the higher the K-CHDI group, the higher the coefficient. The K-CHDI represents a reference standard for estimating health status using health determinants as composite indicators at the subnational level.
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Affiliation(s)
- Dun-Sol Go
- Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong, South Korea
| | - Young-Eun Kim
- Big Data Department, National Health Insurance Service, Wonju, South Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
- * E-mail:
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11
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Factors Associated with Regional Years of Life Lost (YLLs) due to Suicide in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144961. [PMID: 32660073 PMCID: PMC7400422 DOI: 10.3390/ijerph17144961] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/25/2020] [Accepted: 07/07/2020] [Indexed: 01/06/2023]
Abstract
South Korea’s suicide rate has remained among the highest in the world for some years, and there is also a gap in suicide rates among regions within the country. This study investigates the differences in years of life lost (YLLs) due to suicide in 250 districts and the factors associated with regional YLLs in South Korea in 2016. The relationships between YLLs due to suicide by region and factors such as population characteristics, health behaviors, socioeconomic factors, and mental health resources in the community were examined through multiple linear regression analysis. The gap between districts with the highest and lowest YLL due to suicide per 100,000 people was more than a 7-times difference. Factors related to YLLs due to suicide by region were physical activity rates and community mental healthcare centers, and there were differences in these factors according to gender. In conclusion, to prevent suicide at the community level, it is necessary to consider gender in establishing intervention strategies. The community needs to play an active role in promoting mental health and reducing suicide among local residents and to continue to invest in the support and management of those at high risk of suicide.
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12
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Shin Y, Park B, Lee HA, Park B, Han H, Choi EJ, Kim NE, Park H. Disease-Specific Mortality and Prevalence Trends in Korea, 2002-2015. J Korean Med Sci 2020; 35:e27. [PMID: 31997615 PMCID: PMC6995809 DOI: 10.3346/jkms.2020.35.e27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 12/11/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Evaluation of mortality and prevalence trends is important for health planning and priority decision-making in health policy. This study was performed to examine disease-specific mortality and prevalence trends for diseases in Korea from 2002 to 2015. METHODS In this study, 206 mutually exclusive diseases and injuries were classified into 21 cause clusters, which were divided into three cause groups: 1) communicable, maternal, neonatal, and nutritional conditions; 2) non-communicable diseases (NCDs); and 3) injuries. Cause specific trends for age-standardized mortality and prevalence rates were analyzed by the joinpoint regression method. RESULTS Between 2002 and 2015, the age-standardized mortality declined to about 177 per 100,000 population, while the age-standardized prevalence rate increased to approximately 68,065 per 100,000 population. Among the 21 cause clusters, most of the disease mortality rates showed decreasing trends. However, neurological disorders, self-harm, and interpersonal violence included periods during which the mortality rates increased in 2002-2015. In addition, the trends for prevalence rates of human immunodeficiency virus infection and acquired immune deficiency syndrome, tuberculosis, transport injuries, and self-harm, and interpersonal violence differed from the overall prevalence rates. The annual percent change in prevalence rates for transport injuries increased during 2004-2007, and then decreased. The self-harm and interpersonal violence prevalence rates decreased from 2004 to 2014. CONCLUSION Between 2002 and 2015, overall decreasing trends in the mortality rate and increasing trends in the prevalence rate were observed for all causes in Korea. Especially, NCDs represented an important part of the increasing trends in Korea. For clusters of diseases with unusual trends, proper management must be considered.
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Affiliation(s)
- Yoonhee Shin
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Bomi Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hye Ah Lee
- Clinical Trial Center, Mokdong Hospital, Ewha Womans University, Seoul, Korea
| | - Bohyun Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Hyejin Han
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Eun Jeong Choi
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Nam Eun Kim
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
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13
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Studying Geographic Inequalities in Mortality in Contexts with Deficient Data Sources: Lessons from Ecuador. Epidemiology 2019; 31:290-300. [PMID: 31834014 DOI: 10.1097/ede.0000000000001146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In Ecuador, there are inequalities in the completeness and quality of the mortality registry between men and women and among geographical areas. Consequently, using cause of death statistics leads to several difficulties. Our aim was to analyze geographical inequalities in mortality due to some of the main specific causes of death in the provinces of Ecuador (2001-2016) after correction for the deficiencies found in the mortality registry. METHODS This ecologic study used mortality data from 2001 to 2016 for the 22 provinces of Ecuador at the beginning of the study period. We assessed completeness using death distribution methods for the intercensal period 2001-2010. We assessed quality by estimating the percentage of garbage codes for the entire study period. We corrected mortality using completeness as a correction factor and applying a garbage code redistribution protocol. We estimated age-standardized mortality ratios in the provinces of Ecuador for men and women, before and after applying the correction methods. RESULTS We found substantial changes in the number of deaths due to the selected causes after garbage code redistribution and correction for completeness. These changes corresponded to the deficiencies in completeness and quality found in the study areas and the manner in which garbage codes were redistributed to each of the studied causes. We observed changes in the geographical patterns of mortality due to specific causes. CONCLUSIONS Correcting deficiencies in the mortality registry resulted not only in changes in the number of deaths but also in the geographical patterns of mortality in Ecuador.
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14
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Lee YR, Oh IH. The Author's Response: Economic Burden of Chronic Kidney Disease in Korea. J Korean Med Sci 2019; 34:e221. [PMID: 31432654 DOI: 10.3346/jkms.2019.34.e221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ye Rin Lee
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - In Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.
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15
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Peralta A, Benach J, Borrell C, Espinel-Flores V, Cash-Gibson L, Queiroz BL, Marí-Dell'Olmo M. Evaluation of the mortality registry in Ecuador (2001-2013) - social and geographical inequalities in completeness and quality. Popul Health Metr 2019; 17:3. [PMID: 30922340 PMCID: PMC6437878 DOI: 10.1186/s12963-019-0183-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 02/06/2019] [Indexed: 01/08/2023] Open
Abstract
Background Mortality registries are an essential data source for public health surveillance and for planning and evaluating public policy. Nevertheless, there are still large inequalities in the completeness and quality of mortality registries between and within countries. In Ecuador, there have been few nationwide evaluations of the mortality registry and no evaluations of inequalities between provinces. This kind of analysis is fundamental for strengthening the vital statistics system. Methods Ecological study assessing the completeness, quality and internal consistency of mortality data in the provinces of Ecuador, using 13 years of mortality data (2001–2013). Completeness was assessed using three types of death distribution methods (DDMs), quality by estimating the percentages of garbage codes and deaths with unspecified age or sex in the registered deaths, and internal consistency by estimating the percentage of deaths with reported causes of deaths considered impossible in some age–sex combinations. Finally, we propose a classification of the mortality registry in the studied areas based on completeness and quality. Results Completeness estimates (mean of the three methods used) in the provinces ranged from 21 to 87% in women and from 35 to 89% in men. The percentage of garbage codes in the provinces ranged from 21 to 56% in women and from 25 to 52% in men. Garbage coding was higher in women and in older age groups. The percentage of deaths with unspecified age or sex, and the percentage of deaths with reported causes of deaths considered impossible in some age–sex combinations was low in all the studied areas. The mortality registry could only be classified as acceptable in one area for men and one area for women. Conclusions We found substantial inequalities by sex, geographical areas and age in the completeness and quality of the mortality registry of Ecuador. The findings of this study will be helpful to direct measures to improve Ecuador’s vital statistics system and to generate strategies to reduce bias when using mortality data to analyse health inequalities in the country. Electronic supplementary material The online version of this article (10.1186/s12963-019-0183-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrés Peralta
- Agència de Salut Pública de Barcelona, Plaça Lesseps 1, 08023, Barcelona, Catalonia, Spain. .,Health Inequalities Research Group, Employment Conditions Knowledge Network (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Ramon Trias Fargas, 25-27, 08005, Barcelona, Spain. .,Johns Hopkins University, Pompeu Fabra University Public Policy Center, Barcelona, Spain.
| | - Joan Benach
- Health Inequalities Research Group, Employment Conditions Knowledge Network (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Ramon Trias Fargas, 25-27, 08005, Barcelona, Spain.,Johns Hopkins University, Pompeu Fabra University Public Policy Center, Barcelona, Spain.,Transdisciplinary Research Group on Socioecological Transitions (GinTRANS2), Universidad Autónoma Madrid, 28049, Madrid, Spain
| | - Carme Borrell
- Agència de Salut Pública de Barcelona, Plaça Lesseps 1, 08023, Barcelona, Catalonia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Verónica Espinel-Flores
- Agència de Salut Pública de Barcelona, Plaça Lesseps 1, 08023, Barcelona, Catalonia, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Lucinda Cash-Gibson
- Health Inequalities Research Group, Employment Conditions Knowledge Network (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Ramon Trias Fargas, 25-27, 08005, Barcelona, Spain.,Johns Hopkins University, Pompeu Fabra University Public Policy Center, Barcelona, Spain
| | - Bernardo L Queiroz
- Department of Demography and Cedeplar, Faculdade de Ciências Econômicas, FACE/UFMG, Campus Pampulha, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, CEP 31270-901, Brazil
| | - Marc Marí-Dell'Olmo
- Agència de Salut Pública de Barcelona, Plaça Lesseps 1, 08023, Barcelona, Catalonia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
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16
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Lee YR, Cho B, Jo MW, Ock M, Lee D, Lee D, Kim MJ, Oh IH. Measuring the Economic Burden of Disease and Injury in Korea, 2015. J Korean Med Sci 2019; 34:e80. [PMID: 30923489 PMCID: PMC6434156 DOI: 10.3346/jkms.2019.34.e80] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 01/16/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Disease burden can be represented by health-related parameters such as disability-adjusted life years and economic burden. Economic burden is an important index, as it estimates the maximum possible cost reduction if a disease is prevented. This study aimed to determine the economic burden of 238 diseases and 22 injuries in Korea in 2015. METHODS Economic burden was estimated with a human resources approach from a social perspective, and direct and indirect costs were calculated from insurance claims data and a cause of death database. Direct costs were divided into medical costs (including hospital admission, outpatient visit, and medication use) and nonmedical costs (including transportation and caregiver costs). Indirect costs from lost productivity, either from the use of healthcare service or premature death, were analyzed. RESULTS In 2015, the estimated economic burden was USD 133.7 billion (direct: USD 65.5 billion, indirect: USD 68.2 billion). The total cost of communicable diseases was USD 16.0 billion (11.9%); non-communicable diseases, USD 92.3 billion (69.1%); and injuries, USD 25.4 billion (19.0%). Self-harm had the highest costs (USD 8.3 billion), followed by low back pain (LBP, USD 6.6 billion). For men, self-harm had the highest cost (USD 7.1 billion), while LBP was the leading cost (USD 3.7 billion) for women. CONCLUSION A high percentage of Korea's total socioeconomic disease burden is due to chronic diseases; however, unnoticed conditions such as infectious diseases, injuries, and LBP are high in certain age groups and differ by gender, emphasizing the need for targeted social interventions to manage and prevent disease risk factors.
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Affiliation(s)
- Ye-Rin Lee
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Bogeum Cho
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Donghoon Lee
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Doungkyu Lee
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Moon Jung Kim
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
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17
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Yoon SJ, Go DS, Park H, Jo MW, Oh IH, Kim YE. The Korean National Burden of Disease Study: from Evidence to Policy. J Korean Med Sci 2019; 34:e89. [PMID: 30923492 PMCID: PMC6434148 DOI: 10.3346/jkms.2019.34.e89] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 08/27/2018] [Indexed: 01/26/2023] Open
Abstract
Following the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), disability-adjusted life years (DALYs) have been widely used as a summary measure of population health. The DALY metric is a comprehensive measurement of population health, enabling comparison among groups. However, the available data and reliance on estimates to supplement the data gap require contextualization at the national level, and the outcomes of which are more appropriate for national policymakers. The Korean National Burden of Disease (KNBD) study was initiated by the Research and Development Project of the Ministry of Health and Welfare, funded by a 5-year grant from 2013, to contextualize the GBD method to the Korean population. Here, we provide a comprehensive overview of the KNBD study with its achievements and challenges and discuss the implications for public health policies.
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Affiliation(s)
- Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Dun-Sol Go
- Department of Public Health, Graduate School, Korea University, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Young-Eun Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
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18
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Go DS, Kim YE, Radnaabaatar M, Jung Y, Jung J, Yoon SJ. Regional Differences in Years of Life Lost in Korea from 1997 to 2015. J Korean Med Sci 2019; 34:e91. [PMID: 30923494 PMCID: PMC6434157 DOI: 10.3346/jkms.2019.34.e91] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/01/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Reducing the gaps in health inequality at a regional level and improving health equity have been emphasized in Korea, it is essential to accurately measure the burden of disease by region. This study aimed to estimate years of life lost (YLLs) in 17 Si and Do of Korea from 1997 to 2015 and determine the trends of regional differences in health status and disease structure. METHODS YLL was calculated by subtracting the age at death from the life expectancy. Data on the region, gender, and age-stratified cause-specific death were obtained from the Korean Statistical Information Service of Statistics Korea. RESULTS Age-standardized YLLs per 100,000 population decreased by year in all regions from 1997 to 2015 by 27.4% (27.5% for men; 27.2% for women). Despite the decline in YLLs, the regions with the highest and lowest YLLs did not change between 1997 and 2015. The diseases showing regional differences were caused by injury, often classified as avoidable mortality. We also confirmed that YLLs were higher in the regions with a higher deprivation index. CONCLUSION The present study identified that YLLs differed by regions in Korea with specific causes. The findings of this study can be used by decision-makers to prioritize the reduction of regional gaps in premature deaths.
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Affiliation(s)
- Dun-Sol Go
- Department of Public Health, Graduate School, Korea University, Seoul, Korea
| | - Young-Eun Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | | | - Yunsun Jung
- Department of Public Health, Graduate School, Korea University, Seoul, Korea
| | - Jaehun Jung
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
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19
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Park SY, Yoon SJ, Park H, Jo MW, Oh IH. Comparative Research for the Healthcare Budget and Burden of Disease in Perspective Resource Allocation. J Korean Med Sci 2019; 34:e81. [PMID: 30923490 PMCID: PMC6434158 DOI: 10.3346/jkms.2019.34.e81] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 01/16/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Burden of disease can be used to prioritize the healthcare budget allocation. We analyzed the research and development (R&D) budget of the Ministry of Health and Welfare (MOHW) in 2018 and compared the results with those of the 2015 Korean National Burden of Disease (KNBD) study. METHODS The 2018 MOHW R&D Project integrated implementation plan was used to analyze the R&D budget of the MOHW. The budget was allocated according to the KNBD disease group and according to the budget lines. The allocated budget was compared with the economic burden and the disability adjusted life years (DALYs) in 2015. Also, for budget targets for risk factors, DALYs of attributable risk factors were compared with corresponding budgets. RESULTS In 2018, the MOHW major R&D budget of USD 435.1 million accounted for 3% of the total government budget. Within the disease specific R&D budget, 35.9% was allocated to communicable disease groups, 64.1% to non-communicable diseases, and 0% to injury and violence. Among level 2 disease groups, neoplasm was ranked first. Among risk factors, climate change and behavioral risk were targeted for R&D. CONCLUSIONS It would be difficult to say that current R&D allocations focus to minimize the burden of disease. A mismatch was observed between the R&D budget and the burden of disease in terms of economic burden and DALYs. There was a similar finding for risk factors R&D. A novel approach for allocating government R&D funding that is based on the goal of minimizing the disease burden in the Korean population should be considered.
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Affiliation(s)
- So-Youn Park
- Department of Medical Education and Humanities, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
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20
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Kim YE, Park H, Jo MW, Oh IH, Go DS, Jung J, Yoon SJ. Trends and Patterns of Burden of Disease and Injuries in Korea Using Disability-Adjusted Life Years. J Korean Med Sci 2019; 34:e75. [PMID: 30923488 PMCID: PMC6434149 DOI: 10.3346/jkms.2019.34.e75] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 10/23/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND It is extremely important to objectively take a view of population health to provide useful information to decision makers, health-sector leaders, researchers, and informed citizens. This study aims to examine the burden of disease in Korea as of 2015, and to study how the burden of disease changes with the passage of time. METHODS We used results from the Korean National Burden of Disease and Injuries Study 2015 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive disability-adjusted life years (DALYs) by gender and age groups from 2007 to 2015. DALYs were calculated as the sum of the years of life lost (YLLs) and the years lived with disability (YLDs). RESULTS In 2015, the burden of disease for Korean people was calculated at 29,476 DALYs per 100,000 population. DALYs caused by low back pain were the highest, followed by diabetes mellitus and chronic obstructive pulmonary disease. The burden of disease showed a consistently increasing trend from 2007 to 2015. Although YLLs have been on the decrease since 2011, the increase in YLDs has contributed to the overall rise in DALYs. The DALYs per 100,000 population in 2015 increased by 28.1% compared to 2007. CONCLUSION As for the diseases for which the burden of disease is substantially increasing, it is needed to establish appropriate policies in a timely manner. The results of this study are expected to be the basis for prioritizing public health and health care policies in Korea.
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Affiliation(s)
- Young-Eun Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Dun-Sol Go
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jaehun Jung
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
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Rezaei N, Asadi-Lari M, Sheidaei A, Khademi S, Gohari K, Delavari F, Delavari A, Abdolhamidi E, Chegini M, Rezaei N, Jamshidi H, Bahrami Taghanaki P, Hasan M, Yoosefi M, FarzadFar F. Liver cirrhosis mortality at national and provincial levels in Iran between 1990 and 2015: A meta regression analysis. PLoS One 2019; 14:e0198449. [PMID: 30645598 PMCID: PMC6333345 DOI: 10.1371/journal.pone.0198449] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 05/18/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Liver cirrhosis mortality number has increased over the last decades. We aimed to estimate the liver cirrhosis mortality rate and its trends for the first time by sex, age, geographical distribution, and cause in Iran. METHOD Iranian Death Registration System, along with demographic (Complete and Summary Birth History, Maternal Age Cohort and Period methods) and statistical methods (Spatio-temporal and Gaussian process regression models) were used to address the incompleteness and misclassification and uncertainty of death registration system to estimate annual cirrhosis mortality rate. Percentages of deaths were proportionally redistributed into cirrhosis due to hepatitis B, C and alcohol use based on the data from the Global Burden of Disease (GBD) 2010 study. RESULTS Liver cirrhosis mortality in elder patients was 12 times higher than that in younger patients at national level in 2015. Over the 26 years, liver cirrhosis mortality in males has increased more than that in females. Plus, the percentage of change in age adjusted mortality rate at provincial levels varied between decreases of 64.53% to nearly 17% increase. Mortality rate has increased until 2002 and then decreased until 2015.The province with highest mortality rate in 2015 has nearly two times greater rate compare to the lowest. More than 60% of liver cirrhosis mortality cases at national level are caused by hepatitis B and C infection. The rate of hepatitis B mortality is four times more than that from hepatitis C. CONCLUSION This study demonstrated an increasing and then decreasing pattern in cirrhosis mortality that could be due to national vaccination of hepatitis B program. However monitoring, early detection and treatment of risk factors of cirrhosis, mainly in high risk age groups and regions are essential. Cirrhosis mortality could be diminished by using new non-invasive methods of cirrhosis screening, hepatitis B vaccination, definite treatment of hepatitis C.
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Affiliation(s)
- Negar Rezaei
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Khademi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kimiya Gohari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnaz Delavari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Delavari
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Abdolhamidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Chegini
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Jamshidi
- School of Medicine, Dep. Of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Milad Hasan
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Yoosefi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad FarzadFar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Kim YE, Lee YR, Yoon SJ, Kim YA, Oh IH. Years of Life Lost due to Premature Death in People with Disabilities in Korea: the Korean National Burden of Disease Study Framework. J Korean Med Sci 2019; 34:e22. [PMID: 30636948 PMCID: PMC6327094 DOI: 10.3346/jkms.2019.34.e22] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/10/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Several studies have been conducted regarding people with disabilities, however no studies have estimated the disease burden due to premature death. As such, we aimed to compare the years of life lost (YLLs) due to premature death between a population with disabilities and the total population of Korea. METHODS To calculate the YLLs in people with disabilities, we combined disability registration data from the 2002-2011 Ministry of Health and Welfare of Korea and the causes of mortality data by Statistics Korea for 3,158,231 people. RESULTS YLLs of people with disabilities were 517,337, which accounted for 23.4% of YLLs of the total population. YLLs per 100,000 people with disabilities were approximately 3.8 times higher than those in the total Korean population. Ischemic stroke was associated with the highest YLLs per 100,000 people, followed by ischemic heart disease, hemorrhagic, and other non-ischemic stroke, diabetes mellitus, and self-harm. Among individuals with physical disabilities, ischemic heart disease was associated with the highest YLLs. For intellectual disability, epilepsy contributed to the most YLLs. For individuals with mental disability, self-harm was the largest contributor to YLLs. CONCLUSION The burden of disease was higher in the population with disabilities than that in the general population. Cardiovascular diseases and cancer had a higher burden of disease than did other diseases in the population with disabilities; thus, overall, non-communicable diseases have a higher burden of disease than communicable diseases or injuries in the population with disabilities than in the general population.
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Affiliation(s)
- Young-Eun Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ye-Rin Lee
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young-Ae Kim
- Cancer Policy Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
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Marinho MF, França EB, Teixeira RA, Ishitani LH, Cunha CCD, Santos MRD, Frederes A, Cortez-Escalante JJ, Abreu DMXD. Dados para a saúde: impacto na melhoria da qualidade da informação sobre causas de óbito no Brasil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22Suppl 3:e19005.supl.3. [DOI: 10.1590/1980-549720190005.supl.3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 08/27/2019] [Indexed: 02/06/2023] Open
Abstract
RESUMO Introdução: Conhecer o número de óbitos e suas causas se constitui em informação de relevância para gestores de saúde pública. Entretanto, muitas vezes a causa do óbito é classificada com códigos pouco úteis para as análises de mortalidade, denominados códigos garbage (CG). Objetivo: Descrever e avaliar o impacto da investigação da causa básica de morte mal classificada no atestado de óbito em 2017. Métodos: Com base em protocolo padronizado, foram pesquisadas mortes com CG de 60 municípios que foram foco da intervenção, principalmente em prontuários hospitalares e serviços de autopsia. No nível estadual de gestão do Sistema de Informação de Mortalidade também foram desenvolvidas ações para melhoria da classificação da causa do óbito, com consequente adesão da maioria dos demais municípios (n = 4.022), o que permitiu comparações com os resultados da investigação de CG nas 60 cidades. Resultados: No país, de 108.826 CG investigadas em 2017, 48% foram reclassificadas para causas específicas. Já nos 60 municípios selecionados, 58% dos 35.366 óbitos por CG pesquisados foram reclassificados. A proporção de óbitos por CG declinou em 11% no país e 17% nos municípios em que houve intervenção. Discussão: Este é o primeiro estudo que investigou CG em registros médicos de mais de 100 mil mortes. A pesquisa possibilitou reclassificar para causas básicas específicas cerca de metade dos óbitos por CG investigados. As 60 cidades que foram alvo da intervenção tiveram melhor resultado que as demais cidades. Conclusão: A intervenção mostrou ser uma iniciativa adequada para a melhoria da qualidade da informação sobre causa de morte e deve ser estimulada.
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Kim YM. Premature Deaths Attributable to Exposure to Ambient Fine Particulate Matter in the Republic of Korea: Implication for Future Environmental Health. J Korean Med Sci 2018; 33:e243. [PMID: 30190658 PMCID: PMC6125316 DOI: 10.3346/jkms.2018.33.e243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 08/10/2018] [Indexed: 11/20/2022] Open
Affiliation(s)
- Young-Min Kim
- Environmental Health Center for Atopic Diseases, Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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25
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Kim JH, Oh IH, Park JH, Cheong HK. Premature Deaths Attributable to Long-term Exposure to Ambient Fine Particulate Matter in the Republic of Korea. J Korean Med Sci 2018; 33:e251. [PMID: 30190659 PMCID: PMC6125317 DOI: 10.3346/jkms.2018.33.e251] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 08/12/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Ambient fine particulate matter (PM2.5) is the major environmental health risk factor in Korea. Exposure to PM2.5 has been a growing public concern nationwide. With the rapid aging of the Korean population, the health effects attributable to long-term exposure to PM2.5 were expected to increase further in the future. We aimed to estimate premature deaths attributable to long-term exposure to ambient PM2.5 in Korea. METHODS A modelled estimation of long-term exposure to PM2.5 was used to calculate the nationwide exposure level. Hazard ratios of long-term exposure to PM2.5 were obtained from a large prospective cohort study in North America. Modified cause of death (CoD) data, which applied the garbage code reclassification algorithm, were used to calculate premature deaths attributable to long-term exposure to PM2.5. RESULTS From 1990 to 2013, the average population-weighted PM2.5 concentration in Korea was 30.2 μg/m3. The estimated number of premature deaths was 17,203 (95% confidence interval [CI], 11,056-22,772). The most common CoD was ischemic stroke (5,382; 3,101-7,403), followed by cancer of trachea, bronchus, and lung (4,958; 2,857-6,820), hemorrhagic stroke (3,452; 1,989-4,748), and ischemic heart disease (3,432; 1,383-5,358). CONCLUSION Premature deaths due to long-term exposure to PM2.5 accounted for 6.4% of all deaths in Korea. However, individual efforts alone cannot prevent the effects of air pollution. This disease burden study can serve as a basis for the establishment of government policies and budgets and can be used to assess the effectiveness of environmental health policies.
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Affiliation(s)
- Jong-Hun Kim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Jae-Hyun Park
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Hae-Kwan Cheong
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
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26
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Wu Y, Cheng X, Ning P, Cheng P, Schwebel DC, Hu G. Comparing U.S. Injury Death Estimates from GBD 2015 and CDC WONDER. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15010087. [PMID: 29316676 PMCID: PMC5800186 DOI: 10.3390/ijerph15010087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/31/2017] [Accepted: 01/03/2018] [Indexed: 01/14/2023]
Abstract
Objective: The purpose of the present study was to examine consistency in injury death statistics from the United States CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) with those from GBD 2015 estimates. Methods: Differences in deaths and the percent difference in deaths between GBD 2015 and CDC WONDER were assessed, as were changes in deaths between 2000 and 2015 for the two datasets. Results: From 2000 to 2015, GBD 2015 estimates for the U.S. injury deaths were somewhat higher than CDC WONDER estimates in most categories, with the exception of deaths from falls and from forces of nature, war, and legal intervention in 2015. Encouragingly, the difference in total injury deaths between the two data sources narrowed from 44,897 (percent difference in deaths = 41%) in 2000 to 34,877 (percent difference in deaths = 25%) in 2015. Differences in deaths and percent difference in deaths between the two data sources varied greatly across injury cause and over the assessment years. The two data sources present consistent changes in direction from 2000 to 2015 for all injury causes except for forces of nature, war, and legal intervention, and adverse effects of medical treatment. Conclusions: We conclude that further studies are warranted to interpret the inconsistencies in data and develop estimation approaches that increase the consistency of the two datasets.
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Affiliation(s)
- Yue Wu
- Department of Environmental and Occupational Health, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China.
| | - Xunjie Cheng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China.
| | - Peishan Ning
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China.
| | - Peixia Cheng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China.
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China.
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Yoon J, Oh IH, Seo H, Kim EJ, Gong YH, Ock M, Lim D, Lee WK, Lee YR, Kim D, Jo MW, Park H, Yoon SJ. Disability-adjusted Life Years for 313 Diseases and Injuries: the 2012 Korean Burden of Disease Study. J Korean Med Sci 2016; 31 Suppl 2:S146-S157. [PMID: 27775252 PMCID: PMC5081296 DOI: 10.3346/jkms.2016.31.s2.s146] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 06/12/2016] [Indexed: 01/28/2023] Open
Abstract
This study is part of a 5-year research project on the national burden of diseases, injuries, and risk factors in Korea. Using disability-adjusted life years (DALYs), a metric introduced by the 1990 Global Burden of Disease (GBD) project, we performed a comprehensive and detailed assessment of the magnitude and distribution of both fatal and non-fatal health problems in the Korean population. The concept and general approach were consistent with the original GBD study, with some methodological modifications to make the study more suitable for Korea. We computed DALYs for 313 causes in both sexes and nine age groups using the entire population's medical records and newly generated Korean disability weights. In 2012, the dominant disease burden was non-communicable diseases, which accounted for 85.21% of total DALYs, while injuries accounted for 7.77% and communicable, maternal, neonatal, and nutritional disorders for 7.02%. Of the total DALYs, 88.67% were from years lived with disability and 11.32% were from years of life lost due to premature mortality. Diabetes mellitus was the leading cause of DALYs, followed by low back pain, chronic obstructive pulmonary disease, ischemic heart disease, ischemic stroke, cirrhosis of the liver, falls, osteoarthritis, motorized vehicle with three or more wheels, and self-harm. The results reported here identify key health challenges and opportunities for future health interventions and policy changes, and provide information that will help assess the major public health issues in Korea, a nation faced with one of the world's most rapidly ageing populations.
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Affiliation(s)
- Jihyun Yoon
- Department of Public Health, Graduate School, Korea University, Seoul, Korea
| | - In Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Hyeyoung Seo
- Department of Public Health, Graduate School, Korea University, Seoul, Korea
| | - Eun Jung Kim
- Department of Nursing, Pyeongtaek University, Pyeongtaek, Korea
| | - Young Hoon Gong
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Minsu Ock
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Dohee Lim
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Won Kyung Lee
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Ye Rin Lee
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Dongwoo Kim
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Min Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Seok Jun Yoon
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.
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28
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Lee YR, Moon K, Kim YA, Park SY, Oh CM, Lee KS, Oh IH. Disability-Adjusted Life Years for Communicable Disease in the Korean Burden of Disease Study 2012. J Korean Med Sci 2016; 31 Suppl 2:S178-S183. [PMID: 27775255 PMCID: PMC5081299 DOI: 10.3346/jkms.2016.31.s2.s178] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/30/2016] [Indexed: 11/20/2022] Open
Abstract
Globally, the incidence of communicable diseases has decreased compared to non-communicable diseases. However, chronic communicable diseases such as HIV/AIDS and tuberculosis persist worldwide. Furthermore, emerging new infections such as H1N1 influenza pose a new threat to public health. However, most studies have focused on non-communicable diseases because of their increasing incidence, with fewer studies investigating communicable diseases. Therefore, we estimated the burden of communicable diseases in Korea using national representative 2012 data. To estimate the disability-adjusted life years (DALY), we used cause of death data from the Statistics Korea to estimate the years of life lost (YLL), applied the Korean garbage code algorithm, and used national claims data from the National Health Insurance Service (NHIS) to estimate years lived with disability (YLD). In 2012, the total DALYs of communicable disease were 445 per 100,000, with 129 YLLs per 100,000 and 316 YLDs per 100,000. The total DALYs in men were 468 per 100,000, greater than the 422 per 100,000 DALYs seen in women. The DALYs of lower respiratory infections were the highest value among communicable diseases at 143/100,000 DALYs followed by tuberculosis and upper respiratory infections. The 40-49 years old age group had the largest number of total DALYs. In contrast, the over 80 years old age group had the largest number of total DALYs per 100,000 followed by the 70-79 and 0-9 years old age groups. These results enable the prioritization of interventions related to communicable diseases and can be used for evidence-based public health policies.
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Affiliation(s)
- Ye Rin Lee
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Kanghee Moon
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Young Ae Kim
- Cancer Policy Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - So Youn Park
- Department of Medical Education and Humanities, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Chang Mo Oh
- Cancer Registration and Statistic Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Kyung Suk Lee
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - In Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.
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29
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Yoon J, Seo H, Oh IH, Yoon SJ. The Non-Communicable Disease Burden in Korea: Findings from the 2012 Korean Burden of Disease Study. J Korean Med Sci 2016; 31 Suppl 2:S158-S167. [PMID: 27775253 PMCID: PMC5081297 DOI: 10.3346/jkms.2016.31.s2.s158] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 07/10/2016] [Indexed: 11/20/2022] Open
Abstract
In recognition of Korea's rising burden of non-communicable diseases (NCDs), we investigated the nation's NCD status and extracted detailed information from the 2012 Korean Burden of Disease study. Consistent with that study, we used disability-adjusted life year (DALY) as a metric. Using national data sources and disability weights specific to the Korean population, we analyzed 116 disaggregated NCDs from the study's four-level disease and injury hierarchy for both sexes and nine age groups. Per 100,000 population, 21,019 DALYs were lost to 116 NCDs. Of those, 13.97% were due to premature death (death prior to the standard life expectancy for a subject's age) and 86.03% to non-fatal health outcomes. Based on traditional statistics, the main causes of health loss were mortality of neoplasms; cardiovascular and circulatory diseases; diabetes, urogenital, blood, and endocrine diseases; and chronic respiratory diseases. When combined with analyses of premature death and non-fatal outcomes, however, a substantially different view emerged: the main causes of health loss were diabetes mellitus, low back pain, chronic obstructive pulmonary disease, ischemic heart disease, ischemic stroke, cirrhosis of the liver, osteoarthritis, asthma, gastritis and duodenitis, and periodontal disease (in that order), collectively causing 49.20% of DALYs. Thus, burden of disease data using DALYs rather than traditional statistics brings a new perspective to characterization of the population's health that provides practical information useful for developing and targeting national NCD control programs to better meet national needs.
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Affiliation(s)
- Jihyun Yoon
- Department of Public Health, Graduate School, Korea University, Seoul, Korea
| | - Hyeyoung Seo
- Department of Public Health, Graduate School, Korea University, Seoul, Korea
| | - In Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Seok Jun Yoon
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.
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30
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Yoon J, Yoon SJ. Quantifying Burden of Disease to Measure Population Health in Korea. J Korean Med Sci 2016; 31 Suppl 2:S101-S107. [PMID: 27775246 PMCID: PMC5081290 DOI: 10.3346/jkms.2016.31.s2.s101] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 09/03/2016] [Indexed: 02/06/2023] Open
Abstract
Quantitative assessments of the health status of a population are essential to make decisions and set priorities in the field of public health. Changing epidemiologic patterns increase the demand for comprehensive estimates of population health across the full health spectrum, including non-communicable diseases and injuries. Burden of disease (BoD) analysis has helped meet this need. With the success of the Global Burden of Disease (GBD) Study, the BoD technique has become predominantly associated with the GBD approach and its methodology using disability-adjusted life year (DALY) has been rapidly disseminated and generally accepted over the last several years. The first Korean BoD study using the DALY metric was presented in 2002. Various BoD studies have since been conducted, but the DALY concept has remained primarily academic and has not yet been actively utilized in the health policy arena. Here, we review the DALY metric and population-based Korean BoD studies using national health data, with the intent of increasing the understanding of their value and their potential role in strengthening future assessments of the Korean population's health status.
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Affiliation(s)
- Jihyun Yoon
- Department of Public Health, Korea University Graduate School, Seoul, Korea
| | - Seok Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.
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31
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Kim SH, Lee HJ, Ock M, Go DS, Kim HJ, Lee JY, Jo MW. Disability-Adjusted Life Years for Maternal, Neonatal, and Nutritional Disorders in Korea. J Korean Med Sci 2016; 31 Suppl 2:S184-S190. [PMID: 27775256 PMCID: PMC5081300 DOI: 10.3346/jkms.2016.31.s2.s184] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 06/26/2016] [Indexed: 12/22/2022] Open
Abstract
Maternal and child health is an important issue throughout the world. Given their impact on maternal and child health, nutritional issues need to be carefully addressed. Accordingly, the effect of maternal, child, and nutritional disorders on disability-adjusted life years (DALYs) should be calculated. The present study used DALYs to estimate the burden of disease of maternal, neonatal, and nutritional disorders in the Korean population in 2012. For this purpose, we used claim data of the Korean National Health Insurance Service, DisMod II, and death data of the Statistics Korea and adhered to incidence-based DALY estimation methodology. The total DALYs per 100,000 population were 376 in maternal disorders, 64 in neonatal disorders, and 58 in nutritional deficiencies. The leading causes of DALYs were abortion in maternal disorders, preterm birth complications in neonatal disorders, and iron-deficiency anemia in nutritional deficiencies. Our findings shed light on the considerable burden of maternal, neonatal, and nutritional conditions, emphasizing the need for health care policies that can reduce morbidity and mortality.
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Affiliation(s)
- Seon Ha Kim
- Department of Nursing, Dankook University College of Nursing, Cheonan, Korea
| | - Hyeon Jeong Lee
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Minsu Ock
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Dun Sol Go
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun Joo Kim
- Department of Nursing Science, Shinsung University, Dangjin, Korea
| | - Jin Yong Lee
- Public Health Medical Service, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
| | - Min Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea.
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32
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Gong YH, Yoon SJ, Jo MW, Kim A, Kim YA, Yoon J, Seo H, Kim D. The Burden of Cancer in Korea during 2012: Findings from a Prevalence-Based Approach. J Korean Med Sci 2016; 31 Suppl 2:S168-S177. [PMID: 27775254 PMCID: PMC5081298 DOI: 10.3346/jkms.2016.31.s2.s168] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 05/19/2016] [Indexed: 11/20/2022] Open
Abstract
Cancer causes a significant deterioration in health and premature death and is a national socioeconomic burden. This study aimed to measure the burden of cancer using the disability-adjusted life year (DALY) metric based on the newly adopted methodology from the Global Burden of Disease Study in 2010. This study was conducted based on data from the Korean National Cancer Registry. The DALYs were calculated using a prevalence-based method instead of the incidence-based method used by previous studies. The total burden of cancer in 2012 was 3,470.79 DALYs per 100,000 persons. Lung cancer was the most prevalent cancer burden, followed by liver, stomach, colorectal, and breast cancer. The DALYs for lung, liver, stomach, colon and rectum, and pancreatic cancer were high in men, whereas the DALYs for breast, lung, stomach, colorectal, and liver cancer were high in women. Health loss from leukemia and cancer of the brain and nervous system was prevalent for those younger than age 20; from stomach, breast, and liver for those aged 30-50; and from lung, colon and rectum, and pancreas for a large proportion of individuals over the age of 60. The most important differences were that the DALYs were calculated by prevalence and that other components of the DALYs were measured by a population-based perspective. Thus, prevalence-based DALYs could provide more suitable data for decision making in the healthcare field.
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Affiliation(s)
- Young Hoon Gong
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Seok Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.
| | - Min Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Arim Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young Ae Kim
- Cancer policy branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jihyun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyeyoung Seo
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Dongwoo Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
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