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Sohn W, Park SY, Lee TH, Chon YE, Kim IH, Lee BS, Yoon KT, Jang JY, Lee YR, Yu SJ, Choi WM, Kim SG, Jun DW, Jeong J, Kim JH, Jang ES, Kim HY, Cho SB, Jang BK, Park JG, Lee JW, Seo YS, Lee JI, Song DS, Kim MY, Yim HJ, Sinn DH, Ahn SH, Kim YS, Jang H, Kim W, Han S, Kim SU. Effect of direct-acting antivirals on disease burden of hepatitis C virus infection in South Korea in 2007-2021: a nationwide, multicentre, retrospective cohort study. EClinicalMedicine 2024; 73:102671. [PMID: 38881570 PMCID: PMC11176940 DOI: 10.1016/j.eclinm.2024.102671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 06/18/2024] Open
Abstract
Background It is unclear whether direct-acting antivirals (DAAs) treatment improves the disease burden in hepatitis C virus (HCV) infection. This study aimed to investigate the effect of DAA treatment on the reduction of disease burden in patients with HCV infection using individual participant data. Methods This nationwide multicentre retrospective cohort study recruited patients with HCV infection from 29 tertiary institutions in South Korea. The data collection was done from medical records in each institution. The study included the untreated patients and the DAAs-treated patients and excluded those with a history of interferon-based treatments. Disease burden was the primary outcome, as represented by disability-adjusted life years (DALYs). Improvement in fibrosis after DAA treatment was assessed using APRI, FIB-4 index, and liver stiffness (LS) as assessed by transient elastography. Clinical outcomes were hepatocellular carcinoma (HCC), decompensation, and mortality. Findings Between January 1, 2007, and February 17, 2022, data from 11,725 patients with HCV infection, 8464 (72%) of whom were treated with DAAs, were analysed. DAA treatment significantly improved APRI- (median 0.64 [interquartile range (IQR), 0.35-1.31]-0.33 [0.23-0.52], p < 0.0001), FIB-4- (median 2.42 [IQR, 1.48-4.40]-1.93 [1.31-2.97], p < 0.0001), and liver LS-based fibrosis (median 7.4 [IQR, 5.3-12.3]-6.2 [4.6-10.2] kPa, p < 0.0001). During the median follow-up period of 27.5 months (IQR, 10.6-52.4), 469 patients died (4.0%), 586 (5.0%) developed HCC, and 580 (4.9%) developed decompensation. The APRI-based DALY estimate was significantly lower in the DAA group than in the untreated group (median 4.55 vs. 5.14 years, p < 0.0001), as was the FIB-4-based DALY estimate (median 5.43 [IQR, 3.00-6.44] vs. 5.79 [3.85-8.07] years, p < 0.0001). The differences between the untreated and DAA groups were greatest in patients aged 40-60 years. In multivariable analyses, the DAA group had a significantly reduced risk of HCC, decompensation, and mortality compared with the untreated group (hazard ratios: 0.41 [95% confidence interval (CI), 0.34-0.48], 0.31 [95% CI, 0.30-0.38], and 0.22 [95% CI, 0.17-0.27], respectively; p < 0.0001). Interpretation Our findings suggest that DAA treatment is associated with the improvement of liver-related outcomes and a reduction of liver fibrosis-based disease burden in patients with HCV infection. However, further studies using liver biopsy are needed to clarify the effect of DAA treatment on the reduction in the exact fibrosis-based disease burden beyond noninvasive tests. Funding The Korea Disease Control and Prevention Agency.
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Affiliation(s)
- Won Sohn
- Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, South Korea
| | - Soo Young Park
- Kyungpook National University Hospital, Kyungpook National University, Daegu, South Korea
| | - Tae Hee Lee
- Konyang University College of Medicine, Daejeon, South Korea
| | - Young Eun Chon
- CHA Bundang Medical Centre, CHA University, Seongnam, South Korea
| | - In Hee Kim
- Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, South Korea
| | - Byung-Seok Lee
- Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Ki Tae Yoon
- Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Yangsan, South Korea
| | - Jae Young Jang
- Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine, Seoul, South Korea
| | - Yu Rim Lee
- Kyungpook National University Chilgok Hospital, Kyungpook National University, Daegu, South Korea
| | - Su Jong Yu
- Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Won-Mook Choi
- Liver Centre, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sang Gyune Kim
- Soonchunhyang University Hospital Bucheon, Soonchunhyang University College of Medicine, Bucheon, South Korea
| | - Dae Won Jun
- Hanyang University Hospital, Hanyang University College of Medicine, Seoul, South Korea
| | - Joonho Jeong
- Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, South Korea
| | - Ji Hoon Kim
- Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Eun Sun Jang
- Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Hwi Young Kim
- College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Sung Bum Cho
- Chonnam National University Hospital, Chonnam National University, Hwasun, South Korea
| | | | - Jung Gil Park
- Yeungnam University College of Medicine, Daegu, South Korea
| | - Jin-Woo Lee
- Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - Yeon Seok Seo
- Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Jung Il Lee
- Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Do Seon Song
- St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, South Korea
| | - Moon Young Kim
- Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Hyung Joon Yim
- Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea
| | - Dong Hyun Sinn
- Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sang Hoon Ahn
- Yonsei University College of Medicine, Seoul, South Korea
- Yonsei Liver Centre, Severance Hospital, Seoul, South Korea
| | - Young Seok Kim
- Soonchunhyang University Hospital Bucheon, Soonchunhyang University College of Medicine, Bucheon, South Korea
| | - Heejoon Jang
- Seoul Metropolitan Government Seoul National University Boramae Medical Centre, Seoul National University College of Medicine, Seoul, South Korea
| | - Won Kim
- Seoul Metropolitan Government Seoul National University Boramae Medical Centre, Seoul National University College of Medicine, Seoul, South Korea
| | - Seungbong Han
- Department of Biostatistics, Korea University College of Medicine, Seoul, South Korea
| | - Seung Up Kim
- Yonsei University College of Medicine, Seoul, South Korea
- Yonsei Liver Centre, Severance Hospital, Seoul, South Korea
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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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Jo Y, Kim SB, Jung J. A Model-Based Cost-Effectiveness Analysis of Long-Acting Monoclonal Antibody (Tixagevimab and Cilgavimab: Evusheld) Preventive Treatment for High-Risk Populations Against SARS-CoV-2 in Korea. J Korean Med Sci 2023; 38:e250. [PMID: 37582500 PMCID: PMC10427216 DOI: 10.3346/jkms.2023.38.e250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/07/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Tixagevimab and cilgavimab (Evusheld) administration is a recommended strategy for unvaccinated patients with immunocompromised conditions and severe allergic reaction conditions to protect high-risk individuals and control the coronavirus disease 2019 (COVID-19) epidemic. We estimated the cost-effectiveness of Evusheld in key risk populations: 1) immunocompromised (vaccinated/unvaccinated), 2) severe allergic reaction, and 3) unvaccinated elderly high-risk groups. METHODS Based on the estimated target risk group population, we used a model of COVID-19 transmission to estimate the size of the risk group population for whom Evusheld treatment may help prevent symptomatic COVID-19 (and deaths) in 2022. We projected Evusheld intervention costs, quality-adjusted life year (QALY) lost, cost averted and QALY gained by reduced COVID-19 incidence, and incremental cost-effectiveness (cost per QALY gained) in each modeled population from the healthcare system perspective. RESULTS Our study demonstrated that Evusheld treatment for COVID-19 infection in South Korea is highly cost-effective for unvaccinated risk groups ($18,959 per QALY gained for immunocompromised and $23,978 per QALY gained for high-risk elderly groups) and moderately cost-effective among individuals who are vaccinated immunocompromised ($46,494 per QALY gained), or have severe allergic reactions ($45,996 per QALY gained). Evusheld's cost-effectiveness may be subject to risk-group-specific COVID-19 disease progression and Evusheld efficacy and cost, which may change in future epidemic scenarios. CONCLUSION As the COVID-19 variants and risk group-specific durable efficacy, toxicity (and/or resistance) and optimal dosing of Evusheld remain uncertain, better empirical estimates to inform these values in different epidemiological contexts are needed. These results may help decision-makers prioritize resources toward more equitable and effective COVID-19 control efforts.
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Affiliation(s)
- Youngji Jo
- Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, USA.
| | - Sun Bean Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jaehun Jung
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea.
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Im D, Mahmudah NA, Yoon SJ, Kim YE, Lee DH, Kim YH, Jung YS, Ock M. Updating Korean Disability Weights for Causes of Disease: Adopting an Add-on Study Method. J Prev Med Public Health 2023; 56:291-302. [PMID: 37551067 PMCID: PMC10415644 DOI: 10.3961/jpmph.23.192] [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: 04/19/2023] [Accepted: 06/13/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVES Disability weights require regular updates, as they are influenced by both diseases and societal perceptions. Consequently, it is necessary to develop an up-to-date list of the causes of diseases and establish a survey panel for estimating disability weights. Accordingly, this study was conducted to calculate, assess, modify, and validate disability weights suitable for Korea, accounting for its cultural and social characteristics. METHODS The 380 causes of disease used in the survey were derived from the 2019 Global Burden of Disease Collaborative Network and from 2019 and 2020 Korean studies on disability weights for causes of disease. Disability weights were reanalyzed by integrating the findings of an earlier survey on disability weights in Korea with those of the additional survey conducted in this study. The responses were transformed into paired comparisons and analyzed using probit regression analysis. Coefficients for the causes of disease were converted into predicted probabilities, and disability weights in 2 models (model 1 and 2) were rescaled using a normal distribution and the natural logarithm, respectively. RESULTS The mean values for the 380 causes of disease in models 1 and 2 were 0.488 and 0.369, respectively. Both models exhibited the same order of disability weights. The disability weights for the 300 causes of disease present in both the current and 2019 studies demonstrated a Pearson correlation coefficient of 0.994 (p=0.001 for both models). This study presents a detailed add-on approach for calculating disability weights. CONCLUSIONS This method can be employed in other countries to obtain timely disability weight estimations.
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Affiliation(s)
- Dasom Im
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan,
Korea
| | - Noor Afif Mahmudah
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan,
Korea
- Department of Family and Community Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta,
Indonesia
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul,
Korea
| | - Young-Eun Kim
- Big Data Department, National Health Insurance Service, Wonju,
Korea
| | - Don-Hyung Lee
- Research & Statistics Team, Korean Health Promotion Institute, Seoul,
Korea
| | - Yeon-hee Kim
- Research & Statistics Team, Korean Health Promotion Institute, Seoul,
Korea
| | - Yoon-Sun Jung
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon,
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
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Liu X, Guo Y, Wang F, Yu Y, Yan Y, Wen H, Shi F, Wang Y, Wang X, Shen H, Li S, Gong Y, Ke S, Zhang W, Jin Q, Zhang G, Wu Y, Zhou M, Yu C. Disability weight measurement for the severity of different diseases in Wuhan, China. Popul Health Metr 2023; 21:5. [PMID: 37143047 PMCID: PMC10157574 DOI: 10.1186/s12963-023-00304-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/16/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Measurement of the Chinese burden of disease with disability-adjusted life-years (DALYs) requires disability weight (DW) that quantify health losses for all non-fatal consequences of disease and injury. The Global Burden of Disease (GBD) 2013 DW study indicates that it is limited by lack of geographic variation in DW data and by the current measurement methodology. We aim to estimate DW for a set of health states from major diseases in the Wuhan population. METHODS We conducted the DW measurement study for 206 health states through a household survey with computer-assisted face-to-face interviews and a web-based survey. Based on GBD 2013 DW study, paired comparison (PC) and Population health equivalence (PHE) method was used and different PC/PHE questions were randomly assigned to each respondent. In statistical analysis, the PC data was analyzed by probit regression. The probit regression results will be anchored by results from the PHE data analyzed by interval regression on the DW scale units between 0 (no loss of health) and 1 (loss equivalent to death). RESULTS A total of 2610 and 3140 individuals were included in the household and web-based survey, respectively. The results from the total pooled data showed health state "mild anemia" (DW = 0.005, 95% UI 0.000-0.027) or "allergic rhinitis (hay fever)" (0.005, 95% UI 0.000-0.029) had the lowest DW and "heroin and other opioid dependence, severe" had the highest DW (0.699, 95% UI 0.579-0.827). A high correlation coefficient (Pearson's r = 0.876; P < 0.001) for DWs of same health states was observed between Wuhan's survey and GBD 2013 DW survey. Health states referred to mental symptom, fatigue, and the residual category of other physical symptoms were statistically significantly associated with a lower Wuhan's DWs than the GBD's DWs. Health states with disfigurement and substance use symptom had a higher DW in Wuhan population than the GBD 2013 study. CONCLUSIONS This set of DWs could be used to calculate local diseases burden for health policy-decision in Wuhan population. The DW differences between the GBD's survey and Wuhan's survey suggest that there might be some contextual or culture factors influencing assessment on the severity of diseases.
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Affiliation(s)
- Xiaoxue Liu
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
- Global Health Research Division, Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Yan Guo
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Fang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, China
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, 442000, Hubei, China
| | - Yaqiong Yan
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Haoyu Wen
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Fang Shi
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Yafeng Wang
- Global Health Research Division, Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Xuyan Wang
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Hui Shen
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Shiyang Li
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Yanyun Gong
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Sisi Ke
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Wei Zhang
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Qiman Jin
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Gang Zhang
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Yu Wu
- Global Health Research Division, Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Nanwei Road 27, Xicheng District, Beijing, 100050, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China.
- Global Health Institute, Wuhan University, Wuhan, 430072, Hubei, China.
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He Q, Zhou M, Yin P, Jiang B, Qi J, Liu Y, Liu J, You J, Zhou Y, Long Z, Xing X, Cheng Q, Chen Y, Wang H, Liu Z. Can global or national disability weights represent provincial level? BMC Public Health 2023; 23:461. [PMID: 36899365 PMCID: PMC9999537 DOI: 10.1186/s12889-022-14347-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 10/11/2022] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND A universal set of disability weights(DWs) is mainly based on the survey of North America, Australia and Europe, whereas the participants in Asia was limited. The debate hasn't yet settled whether a universal DW is desirable or useful.The focus of the debate is its representativenes-s.After all, the DWs come from people's subjective evaluation of pain, and they may vary according to cultural background.The differences of the DWs could have implications for the magnitude or ranking of disease burdens.The DWs of Anhui Province has not been completely presented.This paper aims to obtain the DWs suitable for the general population of Anhui Province of China, and attempts to explore the differences between different DWs by comparing the DWs with the similar-cultural background and the DWs with cross-cultural background. METHODS A web-based survey was conducted to estimate the DWs for 206 health states of Anhui province in 2020. Paired comparison (PC) data were analyzed and anchored by probit regression and fitting loess model. We compared the DWs in Anhui with other provinces in China and those in Global burden of disease (GBD) and Japan. RESULTS Compared with Anhui province, the proportion of health states which showed 2 times or more differences ranged from 1.94% (Henan) to 11.17% (Sichuan) in China and domestic provinces. It was 19.88% in Japan and 21.51% in GBD 2013 respectively. In Asian countries or regions, most of the health states with top 15 DWs belonged to the category of mental, behavioral, and substance use disorders. But in GBD, most were infectious diseases and cancer. The differences of DWs in neighboring provinces were smaller than other geographically distant provinces or countries. CONCLUSION PC responses were largely consistent across very distinct settings,but the exceptions do need to be faced squarely.The differences of DWs among similar-cultural regions were smaller than cross-cultural regions. There is an urgent need for relevant gold standards.
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Affiliation(s)
- Qin He
- Anhui Provincial Center for Disease Control and Prevention, Shushan District, Hefei, 230601, China
| | - Maigeng Zhou
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, Beijing, 100050, China
| | - Peng Yin
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, Beijing, 100050, China
| | - Bo Jiang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, Beijing, 100050, China
| | - Jinlei Qi
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, Beijing, 100050, China
| | - Yunning Liu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, Beijing, 100050, China
| | - Jiangmei Liu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, Beijing, 100050, China
| | - Jinling You
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, Beijing, 100050, China
| | - Yuchang Zhou
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, Beijing, 100050, China
| | - Zheng Long
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, Beijing, 100050, China
| | - Xiuya Xing
- Anhui Provincial Center for Disease Control and Prevention, Shushan District, Hefei, 230601, China
| | - Qianyao Cheng
- Anhui Provincial Center for Disease Control and Prevention, Shushan District, Hefei, 230601, China
| | - Yeji Chen
- Anhui Provincial Center for Disease Control and Prevention, Shushan District, Hefei, 230601, China
| | - Huadong Wang
- Anhui Provincial Center for Disease Control and Prevention, Shushan District, Hefei, 230601, China
| | - Zhirong Liu
- Anhui Provincial Center for Disease Control and Prevention, Shushan District, Hefei, 230601, China.
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Won P, Celie KB, Rutter C, Gillenwater TJ, Yenikomshian HA. Burn Patient Perspectives on Disability Weights and the Philosophy of Disability: A Gap in the Literature. EUROPEAN BURN JOURNAL 2023; 4:363-372. [PMID: 38528989 PMCID: PMC10961916 DOI: 10.3390/ebj4040037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Background Disability-adjusted life years (DALY) have a ubiquitous presence in academic global health, including attempts to understand the global burden of burn injuries. Objective The present scoping review aimed to examine whether disability weights (DWs) were informed by burn patient perspectives and secondarily to determine whether literature indicates which of the three most common philosophical models of disability best aligns with burn patient experiences. Methods A review of six databases was conducted and The Critical Appraisal Skills Program (CASP) checklist was utilized. Results Out of a total of 764 articles, zero studies solicited patient perspectives of DWs. Four articles contained data that could be extrapolated to patient perspectives on disability. All articles utilized semi-structured interviews of burn survivors and reported thematic elements including return to work, self-image, and social integration. Patients reported similar themes that burn injuries were disabling injuries and instrumentally detrimental, with modulation based on the patient's social circumstances. Conclusions This scoping review highlights a significant gap in literature. First, no studies were found directly investigating burn patient perspectives on burn DWs. Current DWs have been derived from expert opinions with limited input from patients. Second, the limited primary patient data gleaned from this review suggest patients consider their injuries as instrumentally detrimental, which aligns most closely with the welfarist view of disability. More explicit investigations into the philosophical model of disability best aligning with burn patient experiences are needed to ground the health economics of burns in sound theory.
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Affiliation(s)
- Paul Won
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Karel-Bart Celie
- Uehiro Center for Practical Ethics, University of Oxford, Oxford OX1 1PT, UK
- Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, CA 90033, USA
| | - Cindy Rutter
- Independent Researcher, Los Angeles, CA 90033, USA
| | - T. Justin Gillenwater
- Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, CA 90033, USA
| | - Haig A. Yenikomshian
- Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, CA 90033, USA
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Cho SK, Choi S, Kim H, Song YJ, Jung SY, Jang EJ, Sung YK. COX-2 Inhibitor Use as an Early Treatment Option for Knee Osteoarthritis Patients in Korea: A Population-Based Cross-Sectional Study. J Korean Med Sci 2022; 37:e148. [PMID: 35535375 PMCID: PMC9091425 DOI: 10.3346/jkms.2022.37.e148] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 02/09/2022] [Accepted: 04/05/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND To investigate the use of cyclooxygenase-2 (COX-2) inhibitors as an initial drug treatment for knee osteoarthritis (OA) patients. METHODS From 2013 to 2015, patients with knee OA were identified from the Korean nationwide claims database. Among them, we extracted incident cases of knee OA to identify the initial drug treatment. Trends in the use of non-steroid anti-inflammatory drugs (NSAIDs) including COX-2 inhibitors were analyzed during the first year after their diagnosis. Associated factors for COX-2 inhibitor use were examined using a multivariate logistic regression model. RESULTS We identified 2,857,999 incident knee OA patients (955,259 in 2013, 981,314 in 2014, and 921,426 in 2015). The mean ± standard deviation age of patients was 64.2 ± 9.8 years. The frequency of COX-2 inhibitor use as initial treatment increased from 3.5% in 2013 to 7.2% in 2015 (P < 0.01). In patients taking the medication regularly for one year after diagnosis (medication possession ratio ≥ 50%), COX-2 inhibitor use also rapidly increased from 5.5% in 2013 to 11.1% in 2015 (P < 0.01). However, the frequencies of non-selective NSAID and analgesic use did not decrease remarkably. Factors associated with patients using COX-2 inhibitors on initial drug treatment were older age (odds ratio [OR], 1.08), female (OR, 1.24), and comorbidity (OR, 1.03). Type of institution, physician speciality, and insurance type of patients were also associated. CONCLUSION In Korea, COX-2 inhibitors have rapidly increased as an initial treatment for knee OA patients, but it has not appeared to reduce the use of non-selective NSAIDs and analgesics.
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Affiliation(s)
- Soo-Kyung Cho
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
- Hanyang University Institute for Rheumatology Research, Seoul, Korea
| | - Seongmi Choi
- Department of Statistics, Kyungpook National University, Daegu, Korea
| | - Hyoungyoung Kim
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
- Hanyang University Institute for Rheumatology Research, Seoul, Korea
| | - Yeo-Jin Song
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
- Hanyang University Institute for Rheumatology Research, Seoul, Korea
| | | | - Eun Jin Jang
- Department of Information Statistics, Andong National University, Andong, Korea.
| | - Yoon-Kyoung Sung
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
- Hanyang University Institute for Rheumatology Research, Seoul, Korea.
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Charalampous P, Polinder S, Wothge J, von der Lippe E, Haagsma JA. A systematic literature review of disability weights measurement studies: evolution of methodological choices. Arch Public Health 2022; 80:91. [PMID: 35331325 PMCID: PMC8944058 DOI: 10.1186/s13690-022-00860-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/18/2022] [Indexed: 12/13/2022] Open
Abstract
Background The disability weight is an essential factor to estimate the healthy time that is lost due to living with a certain state of illness. A 2014 review showed a considerable variation in methods used to derive disability weights. Since then, several sets of disability weights have been developed. This systematic review aimed to provide an updated and comparative overview of the methodological design choices and surveying techniques that have been used in disability weights measurement studies and how they evolved over time. Methods A literature search was conducted in multiple international databases (early-1990 to mid-2021). Records were screened according to pre-defined eligibility criteria. The quality of the included disability weights measurement studies was assessed using the Checklist for Reporting Valuation Studies (CREATE) instrument. Studies were collated by characteristics and methodological design approaches. Data extraction was performed by one reviewer and discussed with a second. Results Forty-six unique disability weights measurement studies met our eligibility criteria. More than half (n = 27; 59%) of the identified studies assessed disability weights for multiple ill-health outcomes. Thirty studies (65%) described the health states using disease-specific descriptions or a combination of a disease-specific descriptions and generic-preference instruments. The percentage of studies obtaining health preferences from a population-based panel increased from 14% (2004–2011) to 32% (2012–2021). None of the disability weight studies published in the past 10 years used the annual profile approach. Most studies performed panel-meetings to obtain disability weights data. Conclusions Our review reveals that a methodological uniformity between national and GBD disability weights studies increased, especially from 2010 onwards. Over years, more studies used disease-specific health state descriptions in line with those of the GBD study, panel from general populations, and data from web-based surveys and/or household surveys. There is, however, a wide variation in valuation techniques that were used to derive disability weights at national-level and that persisted over time. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00860-z.
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Affiliation(s)
- Periklis Charalampous
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Jördis Wothge
- German Environment Agency, Section Noise Abatement of Industrial Plants and Products, Noise Impact, Wörlitzer Pl. 1, 06844, Dessau-Roßlau, Germany
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitorin, Robert Koch Institute, Berlin, Germany
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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10
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Jung YS, Kim YE, Park H, Oh IH, Jo MW, Ock M, Go DS, Yoon SJ. Measuring the Burden of Disease in Korea, 2008-2018. J Prev Med Public Health 2021; 54:293-300. [PMID: 34649391 PMCID: PMC8517373 DOI: 10.3961/jpmph.21.478] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/22/2021] [Indexed: 12/03/2022] Open
Abstract
The study aims to examine the current status and differences in the burden of disease in Korea during 2008-2018. We calculated the burden of disease for Koreans from 2008 to 2018 using an incidence-based approach. Disability adjusted life years (DALYs) were expressed in units per 100 000 population by adding years of life lost (YLLs) and years lived with disability (YLDs). DALY calculation results were presented by gender, age group, disease, region, and income level. To explore differences in DALYs by region and income level, we used administrative district and insurance premium information from the National Health Insurance Service claims data. The burden of disease among Koreans showed an increasing trend from 2008 to 2018. By 2017, the burden of disease among men was higher than that among women. Diabetes mellitus, low back pain, and chronic lower respiratory disease were ranked high in the burden of disease; the sum of DALY rates for these diseases accounted for 18.4% of the total burden of disease among Koreans in 2018. The top leading causes associated with a high burden of disease differed slightly according to gender, age group, and income level. In this study, we measured the health status of Koreans and differences in the population health level according to gender, age group, region, and income level. This data can be used as an indicator of health equity, and the results derived from this study can be used to guide community-centered (or customized) health promotion policies and projects, and for setting national health policy goals.
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Affiliation(s)
- Yoon-Sun Jung
- Department of Public Health, Graduate School, Korea University, Seoul, Korea
| | - Young-Eun Kim
- Department of Big Data Strategy, National Health Insurance Service, Wonju, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Graduate Program in System Health Science and Engineering, Ewha Womans University College of Medicine, Seoul, Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, Kyung Hee University 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, University of Ulsan College of Medicine, Seoul, Korea.,Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Dun-Sol Go
- Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong, Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
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11
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Kim CB, Ock M, Jung YS, Kim KB, Kim YE, Kim KA, Yoon SJ. Estimation of Years Lived with Disability Using a Prevalence-Based Approach: Application to Major Psychiatric Disease in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9056. [PMID: 34501645 PMCID: PMC8431236 DOI: 10.3390/ijerph18179056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 11/16/2022]
Abstract
To help develop policies concerning the prevention of psychiatric disease in Korea, we reviewed the literature on this topic in different countries and used a prevalence-based approach to estimate the years lived with disability (YLDs) in Korean patients with major psychiatric diseases. We calculated YLDs by extracting data on the number of patients with mild, moderate, and severe cases of schizophrenia, bipolar disorder, and major depressive disorder, as classified by International Statistical Classification of Disease (ICD) codes. YLDs were highest for patients with major depressive disorder (1190.6; 73.9%), schizophrenia (303.3; 18.8%) and bipolar disorder (117.9; 7.3%). Men had higher YLDs for schizophrenia, 2502 (20-24 years); bipolar disorder, 477 (40-44 years); and major depressive disorder, 2034 (75-79 years). Women had higher YLDs for schizophrenia, 484 (45-49 years); bipolar disorder, 214 (≥80 years); and major depressive disorder, 3541 (75-79 years). The prevalence-based approach and severity distribution is useful for estimating long-term psychiatric disease burden and YLDs. However, YLD-estimation studies must compensate for the shortcomings of the ICD-10 by referencing the Diagnostic and Statistical Manual of Mental Disorders 5th edition, as well as updating the disability weight score according to disease severity.
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Affiliation(s)
- Chae-Bong Kim
- Department of Public Health, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea; (C.-B.K.); (Y.-S.J.); (K.-B.K.)
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan 44033, Korea;
| | - Yoon-Sun Jung
- Department of Public Health, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea; (C.-B.K.); (Y.-S.J.); (K.-B.K.)
| | - Ki-Beom Kim
- Department of Public Health, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea; (C.-B.K.); (Y.-S.J.); (K.-B.K.)
| | - Young-Eun Kim
- Department of Big Data Strategy, National Health Insurance Service, 32 Geongang-ro, Wonju 26464, Korea;
| | - Keun-A Kim
- School of Military Medicine, The Armed Force Medical Command, 90 Jaun-ro, Daejeon 34059, Korea;
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea
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12
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Nomura S, Yamamoto Y, Yoneoka D, Haagsma JA, Salomon JA, Ueda P, Mori R, Santomauro D, Vos T, Shibuya K. How do Japanese rate the severity of different diseases and injuries?-an assessment of disability weights for 231 health states by 37,318 Japanese respondents. Popul Health Metr 2021; 19:21. [PMID: 33892742 PMCID: PMC8063365 DOI: 10.1186/s12963-021-00253-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 04/08/2021] [Indexed: 12/03/2022] Open
Abstract
Background Disability weights (DWs) are weight factors that reflect the severity of health states for estimates of disability-adjusted life years. A new set of global DWs was published for the Global Burden of Diseases and Injuries (GBD) 2013 study, which relied on sampling from various world regions, but included little data for countries in East Asia. This study aimed to measure DWs in Japan using comparable methods, and compare the results with previous estimates from the GBD 2013 DW study. Methods We conducted a web-based survey in 2019 to estimate DWs for 231 health states for the Japanese population. The survey included five new health states but otherwise followed the method of the GBD DW measurement study. The survey consisted of 15 paired comparison (PC) questions and 3 population health equivalence questions (PHE) per respondent. We analyzed PC data using probit regression and rescaled results to DW units between 0 (equivalent to full health) and 1 (equivalent to death). Findings We considered 37,318 nationally representative respondents. The values of the resulting DWs ranged from 0.707 (95% uncertainty interval (UI) 0.527–0.842) for spinal cord injury at neck level (untreated) to 0.004 (UI 0.001–0.009) for mild anemia. High correlation between Japanese DW and GBD 2013 DW was observed, but there was considerable disagreement. Out of 226 comparable health states, 55 (24.3%) showed more than a factor-of-two difference, of which 41 (74.6%) had a higher value in Japanese DW. Many of the health states with higher DW in the Japan study were injuries, including amputation and fracture, and hearing and vision loss, while mental, behavioral, and substance use disorders generally tended to be lower. Conclusions This study has created an empirical basis for assessment of Japanese DWs of health status. The findings from this study based on the Japanese population suggest that there might be contextual differences in rating the severity of health states compared to previous surveys conducted elsewhere. Supplementary Information The online version contains supplementary material available at 10.1186/s12963-021-00253-4.
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Affiliation(s)
- Shuhei Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan. .,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | | | - Daisuke Yoneoka
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Division of Biostatistics and Bioinformatics, Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Joshua A Salomon
- Center for Primary Care and Outcomes Research, Stanford University School of Medicine, California, USA
| | - Peter Ueda
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Rintaro Mori
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Damian Santomauro
- School of Public Health, The University of Queensland, Queensland, Australia.,Queensland Centre for Mental Health Research, Queensland, Australia.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Kenji Shibuya
- Institute for Population Health, King's College London, London, UK
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13
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The Gaps in Health-Adjusted Life Years (HALE) by Income and Region in Korea: A National Representative Bigdata Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073473. [PMID: 33801588 PMCID: PMC8036311 DOI: 10.3390/ijerph18073473] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 11/16/2022]
Abstract
This study aims to calculate the health-adjusted life years (HALE) by using years lived with disability (YLD) from the national claims data, as well as to identify the differences and inequalities in income level and region. The study was carried out on total population receiving health insurance and medical benefits. We calculated incidence-based YLD for 260 disease groups, and used it as the number of healthy years lost to calculate HALE. We adopted the insurance premium to calculate the income as a proxy indicator. For the region classification, we chose 250 Korean municipal-level administrative districts. Our results revealed that HALE increased from 2008 to 2018. HALE in males increased faster than that in females. HALE was higher in higher income levels. In 2018, the gap in HALE between Q1 and Q2, the lower income group, was about 5.57 years. The gap in females by income level was smaller than that in males. Moreover, the gap in HALE by region was found to increase. Results suggest that there is an inequality in YLD in terms of income level in Korea. Therefore, we need intensive management for the low-income group to promote HALE at the national level.
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