scholarly journals Statin Therapy and the Risk of COVID-19: A Cohort Study of the National Health Insurance Service in South Korea

2021 ◽  
Vol 11 (2) ◽  
pp. 116
Author(s):  
Tak Oh ◽  
In-Ae Song ◽  
Young-Tae Jeon
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Confidence Interval ◽  
South Korea ◽  
Hospital Mortality ◽  
Statin Therapy ◽  
National Health Insurance ◽  
Odds Ratio ◽  
Therapy Group ◽  
Control Group

We aimed to investigate whether statin therapy is associated with the incidence of coronavirus disease 2019 (COVID-19) among the South Korean population. In addition, we examined whether statin therapy affects hospital mortality among COVID-19 patients. The National Health Insurance Service (NHIS)-COVID-19 database in South Korea was used for data extraction for this population-based cohort study. A total of 122,040 adult individuals, with 22,633 (18.5%) in the statin therapy group and 101,697 (91.5%) in the control group, were included in the analysis. Among them, 7780 (6.4%) individuals were diagnosed with COVID-19 and hospital mortality occurred in 251 (3.2%) COVID-19 cases. After propensity score matching, logistic regression analysis showed that the odds of developing COVID-19 were 35% lower in the statin therapy group than in the control group (odds ratio: 0.65, 95% confidence interval: 0.60 to 0.71; p < 0.001). Regarding hospital mortality among COVID-19 patients, the multivariable model indicated that there were no differences between the statin therapy and control groups (odds ratio: 0.74, 95% confidence interval: 0.52 to 1.05; p = 0.094). Statin therapy may have potential benefits for the prevention of COVID-19 in South Korea. However, we found that statin therapy does not affect the hospital mortality of patients who are diagnosed with COVID-19.

Risk of infection following colonoscopy and sigmoidoscopy in symptomatic patients

Endoscopy ◽  
2017 ◽  
Vol 49 (08) ◽  
pp. 754-764 ◽  
Author(s):  
Jiun-Nong Lin ◽  
Chang-Bi Wang ◽  
Chih-Hui Yang ◽  
Chung-Hsu Lai ◽  
Hsi-Hsun Lin
Keyword(s):  
Health Insurance ◽  
Retrospective Study ◽  
Confidence Interval ◽  
National Health Insurance ◽  
Control Group ◽  
Research Database ◽  
Concordance Index ◽  
Risk Of Infection ◽  
Increased Risk ◽  
Common Infections

Abstract Background and study aims Previous studies describing the incidence of infection after colonoscopy and sigmoidoscopy are limited. The aim of this study was to determine the incidence of infection, and to propose a nomogram to predict the probability of infection following colonoscopy and sigmoidoscopy in symptomatic patients. Patients and methods A nationwide retrospective study was conducted by analyzing the National Health Insurance Research Database of Taiwan. The incidence of infection within 30 days after colonoscopy and sigmoidoscopy was assessed and compared with a control group matched at a ratio of 1:1 based on age, sex, and the date of examination. Results  In all, 112 543 patients who underwent colonoscopy or sigmoidoscopy and 112 543 matched patients who did not undergo these procedures were included. The overall incidence of infection within 30 days after colonoscopy and sigmoidoscopy was 0.37 %, which was significantly higher than that of the control group (0.04 %; P < 0.001). Diverticulitis, peritonitis, and appendicitis were the most common infections. Patients who underwent colonoscopy or sigmoidoscopy had a 9.38-fold risk of infection (95 % confidence interval, 6.81 – 12.93; P < 0.001) compared with the control group. The predicted infection-free rates of the nomogram were closely aligned with the actual infection-free rates, with a bootstrapping concordance index of 0.763. Conclusions Colonoscopy and sigmoidoscopy are associated with an increased risk of infection, which may occur after these procedures. Our nomogram may provide clinicians with an easy tool to evaluate the risk of infection after colonoscopy and sigmoidoscopy in symptomatic patients.

scholarly journals Dementia Risk among Coronavirus Disease Survivors: A Nationwide Cohort Study in South Korea

2021 ◽  
Vol 11 (10) ◽  
pp. 1015
Author(s):  
Hye-Yoon Park ◽  
In-Ae Song ◽  
Tak-Kyu Oh
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
South Korea ◽  
Cox Regression ◽  
Control Group ◽  
Dementia Diagnosis ◽  
Dementia Risk ◽  
History Of ◽  
New Onset

We aimed to investigate whether coronavirus disease (COVID-19) survivors were at a higher risk of dementia diagnosis compared to controls at 6 months follow-up. Data pertaining to the period between 1 January and 4 June 2020, were extracted from the National Health Insurance Service (NHIS)-COVID-19 database in South Korea. Data on adults (≥20 years old) with no history of dementia, obtained from the NHIS-COVID-19 database, were included in the study. The endpoint of this study was the development of dementia, which was evaluated from 1 January to 1 December 2020. A total of 306,577 adults were included in the analysis, comprising 7133 COVID-19 survivors and 299,444 individuals in the control group. Among the subjects, new-onset dementia diagnosed in 2020 was recorded in 1.2% (3546 of 306,577). In the covariate-adjusted multivariable Cox regression model, the incidence of dementia among COVID-19 survivors was 1.39-fold higher (hazard ratio: 1.39, 95% confidence interval: 1.05–1.85; p = 0.023) than that in the control group. At approximately 6 months of follow-up, COVID-19 survivors were at a higher risk of dementia compared to other populations in South Korea.

scholarly journals Patterns of statin utilisation for new users and market dynamics in South Korea: a 13-year retrospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e026603 ◽  
Author(s):  
Kyung-Bok Son ◽  
SeungJin Bae
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
South Korea ◽  
National Health Insurance ◽  
National Health ◽  
Primary Healthcare ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Moderate Intensity ◽  
Market Dynamics

ObjectiveThis study analysed utilisation of statins for new statin users and assessed market dynamics of statins in South Korea.DesignThis study is a retrospective cohort study.SettingThe yearly claims data for statins were retrieved from the National Health Insurance Service-National Sample Cohort.Main outcome measureWe are interested in new statin users during 2003–2015 in Korea. Information on prescribed statins, including intensity of statins and entry of new and follow-on statins in the market, and healthcare institutions that prescribed the statins were also collected. In time series analysis, we estimated the effect of introduction of generics in the market, specifically for newly prescribed statin users.ResultsThis 13-year longitudinal study of a sample cohort provided by the National Health Insurance Service found that the incidence of new statin user increase from 838.1/100 000 persons in 2003 to 1626.9/100 000 persons in 2015. Most new users were initiated on a monotherapy that was prescribed at primary healthcare institutions. However, the statin market for new users were quite dynamic in Korea. First, the most commonly prescribed statin changed several times during the study period. Second, the use of moderate-intensity statins increased from 57% in 2003 to 92% in 2015. In line with this result, we could not observe substantial differences in prescription of statins in groups having selected diseases history. Lastly, we found market invasion or switch of statins among new statin users, specifically at primary healthcare institutions.ConclusionSimilar to other countries, the incidence of new statin users has been increased in Korea. However, the statin market in Korea is quite dynamic compared with other countries. Interestingly, discounted price of originals after the introduction of generics immediately expand markets or substitute the market particularly in primary healthcare institutions in Korea.

scholarly journals Prevalence of mental illness among COVID-19 survivors in South Korea: nationwide cohort

BJPsych Open ◽  
2021 ◽  
Vol 7 (6) ◽  
Author(s):  
Hye Yoon Park ◽  
In-Ae Song ◽  
So Hee Lee ◽  
Min young Sim ◽  
Hong Sang Oh ◽  
...  
Keyword(s):  
Mental Illness ◽  
Health Insurance ◽  
South Korea ◽  
Odds Ratio ◽  
Associated Factors ◽  
Specific Treatment ◽  
Control Group ◽  
Test Results ◽  
Important Health ◽  
Important Health Issue

Background Mental illness among survivors of coronavirus disease 2019 (COVID-2019) during the post-illness period is an emerging and important health issue. Aims We aimed to investigate the prevalence of mental illness and the associated factors for its development among COVID-2019 survivors. Method From 1 January to 4 June 2020, data were extracted from the National Health Insurance Service COVID-19 database in South Korea. Patients with COVID-19 were defined as those whose test results indicated that they had contracted the infection, regardless of disease severity. COVID-19 survivors were defined as those who recovered from the infection. The primary end-point was the development of mental illness, which was evaluated between 1 January and 1 December 2020. Results A total 260 883 individuals were included in this study, and 2.36% (6148) were COVID-19 survivors. The COVID-19 survivors showed higher prevalence of mental illness than the control group (12.0% in the COVID-19 survivors v. 7.7% in the control group; odds ratio (OR) = 2.40, 95% CI 2.21–2.61, P < 0.001). Additionally, compared with the control group, the no specific treatment for COVID-19 group (OR = 2.23, 95% CI 2.03–2.45, P < 0.001) and specific treatment for COVID-19 group (OR = 3.27, 95% CI 2.77–3.87, P < 0.001) showed higher prevalence of mental illness among survivors. Conclusions In South Korea, COVID-19 survivors had a higher risk of developing mental illness compared with the rest of the populations. Moreover, this trend was more evident in COVID-19 survivors who experienced specific treatment in the hospital.

scholarly journals Association between de Quervain syndrome and herpes zoster: a population-based cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e046891
Author(s):  
Chao-Yu Hsu ◽  
Der-Shin Ke ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Herpes Zoster ◽  
National Health Insurance ◽  
National Health ◽  
Population Based ◽  
Control Group ◽  
Research Database ◽  
Increased Risk ◽  
De Quervain

ObjectiveBoth physical diseases such as infection and chronic pain and psychological disorders such as depression have been associated with herpes zoster (HZ) reactivation. However, the relationship between de Quervain syndrome (DQS), a painful tenosynovitis and HZ remains unclear. We investigated whether DQS increases the risk of HZ reactivation.DesignA retrospective population-based cohort study.SettingTaiwan.ParticipantsWe used a subset of Taiwan’s National Health Insurance Research Database, the Longitudinal Health Insurance Database which contains the registration files and original claims data of 1 million randomly selected individuals from the National Health Insurance programme. The case group in this study comprised patients newly diagnosed with DQS between 2000 and 2012. Individuals without DQS comprised the control group. Cases and controls were 1:1 matched by age, sex and index year (defined as the year of DQS diagnosis).ResultsApproximately 55% of the participants were ≤49 years. Most participants were women (77%). The incidence rate of HZ in the DQS group was 8.39 per 1000 person years. After adjustments for age, sex and comorbidities, patients with DQS had a 1.30 times higher risk of HZ reactivation than the control group. Stratification analysis revealed taht DQS increases the HZ risk in individuals ≤64 years, women, and patients without comorbidities.ConclusionDQS is associated with an increased risk of HZ. Clinicians should be aware of this risk when dealing with patients with DQS, particularly in young adults.

scholarly journals Inequality of trauma care under a single-payer universal coverage system in Taiwan: a nationwide cohort study from the National Health Insurance Research Database

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032062 ◽  
Author(s):  
Ling-wei Kuo ◽  
Chih-Yuan Fu ◽  
Chien-An Liao ◽  
Chien-Hung Liao ◽  
Chi-Hsun Hsieh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Hospital Mortality ◽  
National Health Insurance ◽  
Low Income ◽  
Trauma Care ◽  
Trauma Patients ◽  
Research Database ◽  
Single Payer ◽  
Torso Trauma

​ObjectivesTo assess the impact of lower socioeconomic status on the outcome of major torso trauma patients under the single-payer system by the National Health Insurance (NHI) in Taiwan.​DesignA nationwide, retrospective cohort study.​SettingAn observational study from the NHI Research Database (NHIRD), involving all the insurees in the NHI.​ParticipantsPatients with major torso trauma (injury severity score ≥16) from 2003 to 2013 in Taiwan were included. International Classification of Disease, Ninth Revision, Clinical Modification codes were used to identify trauma patients. A total of 64 721 patients were initially identified in the NHIRD. After applying the exclusion criteria, 20 009 patients were included in our statistical analysis.​Primary and secondary outcome measuresThe primary outcome measure was in-hospital mortality, and we analysed patients with different income levels and geographic regions. Multiple logistic regression was used to control for confounding variables.​ResultsIn univariate analysis, geographic disparities and low-income level were both risk factors for in-hospital mortality for patients with major torso trauma (p=0.002 and <0.001, respectively). However, in multivariate analysis, only a low-income level remained an independent risk factor for increased in-hospital mortality (p<0.001).​ConclusionEven with the NHI, wealth inequity still led to different outcomes for major torso trauma in Taiwan. Health policies must focus on this vulnerable group to eliminate inequality in trauma care.

Unmet dental care needs in South Korea: how do they differ by insurance system?

2019 ◽  
Vol 24 (3) ◽  
pp. 164-171 ◽  
Author(s):  
Xianhua Che ◽  
Minsung Sohn ◽  
Hee-Jung Park
Keyword(s):  
Health Insurance ◽  
Confidence Interval ◽  
South Korea ◽  
National Health Insurance ◽  
National Health ◽  
Dental Care ◽  
Income Group ◽  
Care Needs ◽  
Medical Aid ◽  
Dental Care Needs

Objectives This study aimed to analyse and compare the influence of National Health Insurance and Medical Aid coverage on the persistency of unmet dental care needs in South Korea. Methods This study was based on a longitudinal sample of 4461 adults aged 19 years and older who participated in the South Korea Health Panel from 2011 to 2014, using weights to make the data nationally representative. Propensity score matching was used to adjust the demographic, socioeconomic and health status information of National Health Insurance and Medical Aid groups. Panel logistic regression analyses were conducted to examine the association between health insurance type and unmet dental needs for three consecutive years. Results The odds of the lowest income group reporting unmet dental care needs compared with the highest income group was 6.75 (confidence interval 5.94−7.67), which reduced to 4.19 (confidence interval 3.76−4.67) in the models including health insurance schemes. Additionally, Medical Aid recipients (odds ratio 2.49; 95% confidence interval 2.18−2.48) were more likely to have unmet needs than those covered by National Health Insurance. Conclusions The dental care needs of Medical Aid beneficiaries were not being met, unlike those of the National Health Insurance beneficiaries. Such evidence suggests that increasing health insurance coverage to include several essential dental services would improve the accessibility of dental care services for Medical Aid beneficiaries.

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