Korean Classification Of Disease Research Articles

Trends in nationwide incidence of uveitis in South Korea using the National Health Insurance claims database from 2010 to 2021.

To investigate the population-based incidence of uveitis and the differences between anterior and non-anterior uveitis using the comprehensive Korean National Health Insurance Service (NHIS) database. We extracted data of patients who visited the clinic and were diagnosed with uveitis (based on Korean Classification of Diseases) from 2010 to 2021. The incidence of uveitis, differences between the demographics, and the underlying co-morbidities of anterior uveitis, non-anterior uveitis, and control groups were investigated. We identified 919,370 cases with uveitis (anterior: 800,132; non-anterior: 119,238). The average incidences (per 10,000 persons) of anterior and non-anterior uveitis were 13.0 (95% confidence interval [CI], 12.9-13.0), and 1.9 (95% CI, 1.9-1.9), respectively. The incidence increased (2010: 13.0; 2019: 16.5) but decreased during the coronavirus disease (COVID-19) pandemic (2020: 15.5; 2021: 15.4). The non-anterior group was significantly associated with sex (female, odds ratio [OR]: 1.09, p < 0.0001), specific age range (40-69 years, p < 0.0001), high Charlson Comorbidity Index (p < 0.0001), high household income (p < 0.0001), and various immunologic diseases (antiphospholipid antibody syndrome, OR: 1.79, p < 0.0001; systemic lupus erythematosus, OR: 1.22, p < 0.0001; psoriasis, OR: 1.13, p < 0.0001; ulcerative colitis, OR: 1.11, p = 0.0013; tuberculosis, OR: 1.09, p < 0.0001; rheumatoid arthritis, OR: 1.05, p < 0.0001) compared with the anterior group. Using the NHIS database, we conducted the largest population-based epidemiological study on uveitis in South Korea to estimate its increasing incidence in the past decade (including changes during COVID-19 pandemic) as well as its anatomical distribution. Our results may be beneficial for estimating the national burden of uveitis.

Incidence, Disability, and Mortality in Patients With Guillain-Barré Syndrome in Korea: A Nationwide Population-Based Study.

Background and PurposeThis study aimed to identify the epidemiological features of Guillain-Barré syndrome (GBS) in the Korean population.MethodsPatients with GBS were defined as those who were hospitalized with a primary diagnostic code of G61.0 on the Korean Classification of Disease in a department of neurology, rehabilitation medicine, or pediatrics. We evaluated the incidence and prevalence of GBS as well as physical disability, mortality, and cause of death in patients with GBS from 2002 to 2018 in the Korean population using the Korean National Health Insurance Service database.ResultsWe identified 11,146 patients with GBS. The ratio of males to females was 1.48. The age-adjusted incidence rate per 100,000 persons increased steadily from 0.84 in 2002 to 1.68 in 2018, as did the age-adjusted prevalence rate per 100,000 persons, from 0.77 to 15.62. The incidence and prevalence of GBS increased with age, peaking at 70–79 years. Among 10,114 patients without physical disability at the time of GBS being diagnosed, 502 (5.0%) patients had moderate disability and 526 (5.2%) had severe disability by the end of the study period. A total of 1,221 (11.0%) patients with GBS died during the mean follow-up period of 17 years (2002–2019). There were 144 (1.3%) in-hospital deaths.ConclusionsThis was the first nationwide epidemiological study of patients with GBS covering the entire population including patients of all ages in the Republic of Korea. We have revealed the seasonality of admissions, disability, and long-term mortality rates in patients with GBS.

Improved oral hygiene is associated with decreased risk of new-onset diabetes: a nationwide population-based cohort study.

Inflammation plays an important role in the development of diabetes, a major global health problem. Periodontal disease is also common in the general population. Because periodontal disease and poor oral hygiene can provoke transient bacteraemia and systemic inflammation, we hypothesised that periodontal disease and oral hygiene indicators would be associated with the occurrence of new-onset diabetes. In this study we analysed data collected between 2003 and 2006 on 188,013 subjects from the National Health Insurance System-Health Screening Cohort (NHIS-HEALS) in Korea who had no missing data for demographics, past medical history, oral hygiene indicators or laboratory findings. The presence of periodontal disease was defined on the basis of a modified version of ICD-10 codes (Korean Classification of Disease, sixth edition), if claims for treatment for acute periodontitis (K052), chronic periodontitis (K053) and periodontosis (K054) were made more than two times by a dentist, or if, according to medical records, subjects received treatment by a dentist for periodontal disease with ICD-10 codes K052, K053 or K054. Oral hygiene behaviours (number of tooth brushings, a dental visit for any reason and professional dental cleaning) were collected as self-reported data of dental health check-ups. Number of missing teeth was ascertained by dentists during oral health examination. The incidence of new-onset diabetes was defined according to ICD-10 codes E10-E14. The criterial included at least one claim per year for both visiting an outpatient clinic and admission accompanying prescription records for any glucose-lowering agent, or was based on a fasting plasma glucose ≥7mmol/l from NHIS-HEALS. Of the included subjects, 17.5% had periodontal disease. After a median follow-up of 10.0years, diabetes developed in 31,545 (event rate: 16.1%, 95% CI 15.9%, 16.3%) subjects. In multivariable models, after adjusting for demographics, regular exercise, alcohol consumption, smoking status, vascular risk factors, history of malignancy and laboratory findings, the presence of periodontal disease (HR 1.09, 95% CI 1.07, 1.12, p < 0.001) and number of missing teeth (≥15 teeth) remained positively associated with occurrence of new-onset diabetes (HR 1.21, 95% CI 1.09, 1.33, p < 0.001, p for trend <0.001). Frequent tooth brushing (≥3 times/day) was negatively associated with occurrence of new-onset diabetes (HR 0.92, 95% CI 0.89, 0.95, p < 0.001, p for trend <0.001). Frequent tooth brushing may be an attenuating factor and the presence of periodontal disease and an increased number of missing teeth may be augmenting factors for the occurrence of new-onset diabetes. Improving oral hygiene may be associated with a decreased risk of occurrence of new-onset diabetes.

Epidemiology of Antiphospholipid Syndrome in Korea: a Nationwide Population-based Study.

BackgroundAntiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by arterial and venous thrombosis or pregnancy morbidity in patients with persistent antiphospholipid antibodies. However, nationwide population-based epidemiology studies regarding APS are still unavailable.MethodsWe analyzed claims data extracted from the Korean Health Insurance and Review Agency (HIRA) covering more than 52 million Koreans, between January 1, 2008, and December 31, 2017. Patients diagnosed with APS, as determined by the Korean Classification of Disease, 7th edition (D68.6), and a rare intractable disease program (V253), were identified in HIRA.ResultsA total of 3,088 newly diagnosed incident cases of 1,215 men and 1,873 women were identified during 2009–2016. The mean age was 44.6 ± 16.6 (men, 47.4 ± 16.3; women, 42.8 ± 16.6) years. The incidence was 0.75 per 105 person-year (95% confidence interval, 0.73–0.78). The prevalence in 2016 was 6.19 per 105 people. For incident cases, women showed incidence peak at ages of 30–39 years and 70–79 years, whereas for men, it was highest at ages of 70–79 years only. Of all patients, 1,766 (57%, 810 men and 956 women) had primary APS, 1,322 (43%, 405 men and 917 women) had secondary APS, and 845 (27%, 216 men and 629 women) were associated with systemic lupus erythematosus (SLE).ConclusionThe incidence of APS differs according to age groups and gender. The incidence of primary APS was higher than that of secondary APS in both gender. Furthermore, as already reported, secondary APS is highly associated with SLE; however, we observed that rheumatoid arthritis is also highly related.

Incidence and risk factors for retinal detachment after cataract surgery in Korea: a nationwide population-based study from 2011 to 2015.

To evaluate the incidence and risk factors for retinal detachment (RD) after cataract surgery in the years 2011 to 2015 in Korea. A nationwide retrospective cohort study was performed using health claim data from the Korean National Health Insurance Service (KNHIS) database. Patients over 40years of age who underwent cataract surgery from 2011 and 2015 in Korea were retrospectively identified using Korean Electronic Data Interchange (KEDI) code and Korean Classification of Diseases (KCD)-7 code. A total of 2,191,510 eyes in 1,455,968 patients (58.63% female; mean age, 69.19 ± 9.82years) underwent cataract surgery from 2011 to 2015 in Korea and 17,351 patients experienced RD (45.4% female; mean age, 60.89 ± 10.21years). The 5-year cumulative risk of RD after cataract surgery was 1.19%, and 80.9% of RD occurred within 1year after cataract surgery. In multivariate analysis, adjusted hazard ratio (HR) of RD was 1.335 [95% confidence interval (CI), 1.293-1.378] for male gender, 1.422 [95% CI, 1.371-1.475] for preoperative myopia, and 2.596 [95% CI, 2.367-2.849] for anterior vitrectomy during cataract surgery. Younger age was one of the factors highly associated with RD after cataract surgery, with HR [95% CI], 5.873 [5.527-6.240] in 40 to 54years of age, 4.037 [3.811-4.277] in 55 to 64years, and 2.026 [1.911-2.147] in 65 to 74years. Adjusted HR of RD for surgery in secondary and primary healthcare centers were 0.495 [95% CI, 0.477-0.513] and 0.108 [95% CI, 0.104-0.113], respectively. Residence in non-metropolitan area and lower household income was associated with higher risk of RD. Younger age, anterior vitrectomy for posterior capsule rupture, preoperative myopia, male gender, surgery in tertiary referral centers, residence in non-metropolitan area, and lower household income were associated with an increased risk of RD after cataract surgery. The optimal timing of cataract surgery should be determined considering patient's risk factors, and appropriate pre- and postoperative evaluation is needed to prevent RD in patients with higher risks.

Incidence-Based versus Prevalence-Based Approaches on Measuring Disability-Adjusted Life Years for Injury.

BackgroundInjury represents an important aspect of disease that affects everyone at some point in their lives. To better understand and prevent these injuries, various analytical methods have been developed to assess both the magnitude and features of injury burden. In this study, we attempted to estimate the injury burden of Korea in 2014 by comparing the prevalence-based approach used by the Global Burden of Diseases (GBD) team and the World Health Organization against an alternative incidence-based approach, and to assess the different implications of these measurements.MethodsThe 10th Korean National Hospital Discharge survey data and causes of death statistics in 2014 were used as data sources. Years of life lost (YLL), years lived with disability (YLD) and disability-adjusted life years (DALYs) were calculated using both the incidence- and prevalence-based approaches. The Korean Classification of Diseases (KCD) version 5 diagnostic codes were used to classify the mechanism of injury.ResultsThe prevalence-based injury burden tended to be higher (1,670,229 DALYs) than the incidence-based injury burden (1,544,467 DALYs). The elderly population exhibited a higher prevalence-based YLD and DALY relative to incidence-based outcomes. In order of significance, the three most common causes of injury as calculated using an incidence-based approach were road injury, fall, and self-harm, compared with a prevalence-based method, which identified self-harm, road injury, and falls as the most common injuries.ConclusionAn appropriate prevention program is needed for injuries with potential to cause long-lasting morbidity. Accordingly, a tailored injury-prevention strategy should be developed for each high-risk group.

PSY41 - The Economic Burden of Sphingolopidosis in Korea

The aim of this study is to identify the prevalence and of sphingolipidosis using Korean National Health Insurance claim database from 2010 to 2016 in Korea. We analysed nationwide data collected between 2010 and 2016 from the Korean Health Insurance Review and Assessment (HIRA) database. Patients with sphingolipidosis were defined by the E75.2 Other sphingolipidosis code of the Korean Classification of Disease (KCD). E75.2 includes fabry’s disease, gaucher’s disease, krabbe’s disease, niemann-Pick’s disease, farber’s syndrome, and metachromatic leukodystrophy. The prevalence and economic burden of sphingolipidosis was assessed on the basis of age, sex, admission, and geographical distribution. The overall prevalence of sphingolipidosis was dramatically increased from 3.5 to 6.3 per 1,000,000 populations over the study period. The male to female ratio of sphingolipidosis was 1.16:1 in 2016, revealing a male predominance. The economic burden from sphingolipidosis was significantly increased from 6,473,208 KRW to 31,793,867 KRW (approx. 5,500 USD to 27,100 USD) from 2010 to 2016. The patients are being mainly treated in institution above hospital. Among five districts in Korea, the prevalence in the Seoul Metropolitan district was the highest as 64.5% of total patients, accounting for about 56.7% of total economic burden in 2016. This study found that the overall prevalence of sphingolipidosis is dramatically 1.8 fold increased from 2010 to 2016, with male predominance, and also dramatically 4.9 fold increased economic burden of sphingolipidosis in Korea. Among above sphingolipidosis, only Fabry’s disease and Gaucher’s disease has approved and available treatments in Korea. Further analysis for finding association with treatment availability is needed.

Abstract P173: Target Blood Pressure in Elderly Hypertensive Patients: A Korean National Health Insurance Service Health Examinee Cohort Study

Background: We aimed to investigate the benefits of strict blood pressure control and determine the optimal blood pressure in elderly hypertensive subjects. Methods: This study used the National Health Insurance Service Health examinee Sample Cohort. We selected subjects who were over the age of 60 years and who had received a newly diagnosis of hypertension (Korean Classification of Disease [KCD] codes I10–I13) from 2003 to 2006. Subjects who had previous major cardiovascular (CV) events, such as heart failure, ischemic heart disease, stroke, or end stage renal disease (ESRD) were excluded. The remaining 25,858 individuals were divided into three groups; 1) mean systolic blood pressure (SBP) &lt; 130mmHg (N = 7,494), 2) mean SBP 130 to 140 mmHg (N = 9,272), 3) mean SBP above 140mmHg (N = 9,092). The primary outcome of the study was to compare all-cause mortality and CV mortality in each group. Results: Compared to mean SBP ≥140 mmHg group, mean SBP 130 to 140 mmHg group had significantly lower rate of all-cause mortality (HR=0.63, 95% CI= 0.58-0.69, p&lt;0.001) and CV mortality (HR=0.58, 95% CI= 0.48-0.69, p&lt;0.001). The diastolic blood pressure (DBP) between 80 to 90 mmHg group also had lower risk of all-cause death (HR=0.51, 95% CI= 0.47-0.56, p&lt;0.001) and CV death (HR=0.44, 95% CI= 0.37-0.53, p&lt;0.001) in comparison with DBP ≥90 mmHg group. However, the SBP below 130 mmHg subjects and the DBP below 80 mmHg subjects did not have significant lower rate of all-cause and CV mortality compared to SBP 130 to 140 mmHg and DBP 80 to 90mmHg subjects, respectively. In subgroup analysis, mean SBP &lt;120 mmHg subjects were associated with higher risk of all-cause death (HR=1.47, 95% CI= 1.27-1.72, p&lt;0.001) and CV death (HR=1.57, 95% CI= 1.15-2.14, p=0.004) than SBP 130 to 140 mmHg subjects. Conclusion: Mean SBP between 130 to 140 mmHg and mean DBP below 90 mmHg for elderly hypertensives without previous major CV disease was beneficial in reducing all-cause and CV mortality. However, mean SBP below 120mmHg was associated with a raised risk of all-cause mortality and CV mortality.

The Trends of Atrial Fibrillation-Related Hospital Visit and Cost, Treatment Pattern and Mortality in Korea: 10-Year Nationwide Sample Cohort Data.

Background and ObjectivesThe change of in-hospital and out-hospital treatments, and hospital costs for atrial fibrillation (AF) were not well known in rapidly aging Asian countries. This study is to examine the trends of AF management and outcomes in Korea.Subjects and MethodsIn the sample cohort from Korean National Health Insurance Data Sample Cohort (K-NHID-Sample Cohort) from 2004 through 2013, we identified patients with AF and hospital visit records using Korean Classification of Diseases, 6th Revision (KCD-6). Hospital cost, prescribed medications, radiofrequency catheter ablation (RFCA), morbidity and mortality were identified.ResultsAF-related hospitalization and outpatient clinic visits increased by 2.19 and 3.06-fold, respectively. While the total cost increased from 3.6 to 11.3 billion won (p<0.001), the mean cost per patient increased from 0.68 to 0.83 million won (p<0.001). Although the mean CHA2DS2-VASc score increased from 3.5 to 4.4 in the total AF population, the proportion of patients who receive anticoagulation therapy with warfarin showed no significant change for the decade. The proportion of hospitalization for RFCA was increased (0.4% to 1.1%, p<0.001). All-cause mortality (6.7% to 5.0%), cardiovascular mortality (1.4% to 1.1%) and stroke-related death (1.3% to 0.8%) showed a modest decrease from 2004 to 2013.ConclusionDuring the last decade, AF-related hospitalization and outpatient clinic visits have increased with the increase of many other comorbidities, whereas the rate of anticoagulation did not improved. Although mortality in patients with AF showed a modest decrease from 2004 to 2013, proper anticoagulation therapy is warranted for the improvement of public health.

Review on the Development State and Utilization of Pattern Identification Questionnaire in Korean Medicine by U Code of Korean Classification of Disease

Review on the Development State and Utilization of Pattern Identification Questionnaire in Korean Medicine by U Code of Korean Classification of Disease

Effective screening for the anti-hypertensive of selected herbs used in the traditional Korean medicines

In this study, Korean medicinal herb extracts were investigated for their in vitro effect on anti-hypertensive activities, including nitric oxide (NO) production in the human umbilical vein endothelial cell line EA.hy529 and angiotensin-converting enzyme (ACE) activity. Traditional remedies related to the treatment of hypertension were identified using DongUiBoGam, the most comprehensive source for Korean traditional pharmacopoeia. Herbal remedies were selected by translating the symptom terminology into westernized medicinal terms using the Korean classification of disease in Oriental medicine and Korea Traditional Knowledge Portal. Seven types of herb extracts were selected and screened for in vitro anti-hypertensive activities. Among the extracts, those of Evodiae fructus, Bambusae caulis in Taeniam, Sophorae fructus, Melonis calyx, and Schizonepeta rhizome produced significant increases in NO production, although their ability to inhibit ACE were weaker. Using Fourier transform ion cyclotron resonance mass spectrometry, the major flavonoids exhibiting anti-hypertensive activities were identified: quercetin, apigenin, and luteolin. Our results indicate that these medicinal herbs are potent natural anti-hypertensive agents that can be developed for clinical therapies. In addition, our systematic approach to identifying candidate herbal remedies in the traditional Korean pharmacopoeia can be used to search for additional traditional remedies, such as for hypoglycemia and obesity.

Translation of Korean Medicine Use to ICD-Codes Using National Health Insurance Service-National Sample Cohort.

Background. Korean medicine was incorporated into the Korean Classification of Diseases (KCD) 6 through the development of U codes (U20–U99). Studies of the burden of disease have used summary measures such as disability-adjusted life years. Although Korean medicine is included in the official health care system, studies of the burden of disease that include Korean medicine are lacking. Methods. A data-based approach was used with National Health Insurance Service-National Sample Cohort data for the year 2012. U code diagnoses for patients covered by National Health Insurance were collected. Using the main disease and subdisease codes, the proportion of U codes was redistributed into the related KCD 6 codes and visualized. U code and KCD code relevance was appraised prior to the analysis by consultation with medical professionals and from the beta draft version of the International Classification of Diseases-11 traditional medicine chapter. Results. This approach enabled redistribution of U codes into KCD 6 codes. Musculoskeletal diseases had the greatest increase in the burden of disease through this approach. Conclusion. This study provides a possible method of incorporating Korean medicine into burden of disease analyses through a data-based approach. Further studies should analyze potential yearly differences.

HIV병 사망자 중 결핵 사망 분율과 관련 요인

본 연구는 HIV병 사망자 중 HIV병과 결핵이 동반사망한 분율을 조사하고 그 관련 요인을 분석하였다. 2002년부터 2010년까지 사이에 HIV병 사망자는 모두 774명으로 결핵이 동반사망한 분율은 10.1%로 나타났다. 그런데 이러한 분율은 2005년부터 2007년 사이에 16.3%까지 치솟았지만 2008년부터 2010년 사이에는 4%까지 감소하는 경향을 보였다. 또한 HIV-결핵 동반사망 분율은 젊은 계층에서 더 높았고 배우자가 있는 그룹과 교육을 잘 받은 그룹에서는 유의하게 낮은 경향을 보였다. 이처럼 활동성이 높은 젊은층에서 HIV-결핵 동반사망 분율이 높고 사회경제적 안정계층에서 HIV-결핵 동반사망 분율이 낮은 것은 비슷한 해외 연구에서도 유사하게 나타나고 있어 HIV-결핵 동반사망의 예방 가능성을 시사한다. 한국은 다행히 점차 HIV-결핵 동반사망 분율이 낮아지고 있어 HIV감염자에 대한 결핵 예방사업의 효과가 나타나고 있음을 시사하고 이후 이러한 지표의 지속적인 모니터링이 필요함을 보여주고 있다. Objectives: To identify the importance of preventing tuberculosis for HIV (Human Immunodeficiency Virus) infectees and to monitor their management of health, we investigated the proportion of HIV-TB (Tuberculosis) deaths among the HIV deaths and its related factors. Methods: Data for HIV deaths from 2002 to 2010 was acquired from Statistics Korea, after which the HIV deaths were reclassified into HIV-TB deaths or other deaths according to the KCD (Korean Classification of Diseases). We analyzed the proportion of HIV-TB deaths among HIV disease deaths and the relationship between HIV-TB deaths and related variables such as sex, age, educational level, marital status, etc. Results: There were 774 HIV deaths in South Korea between 2002 and 2010. TB was the main cause of death in 10.1% of all HIV deaths. The total proportion of HIV-TB deaths was 10.1% but its proportion reached 16.3% between 2005-2007 and then decreased to 4% in 2010. Also, the proportion of HIV-TB deaths was significantly high in the young age groups, but its proportion was significantly low in married groups and well educated groups (p<0.05). Conclusions: The result implies that the policy that takes care of HIV infectee regarding TB prevention has been getting systemized on a national scale. Also, HIV-TB deaths have been affected by social factors such as education and marriage status.

Stakeholder analysis for adopting a personal health record standard in Korea.

Interest in health information exchanges (HIEs) is increasing. Several countries have adopted core health data standards with appropriate strategies. This study was conducted to determine the feasibility of a continuity of care record (CCR) as the standard for an electronic version of the official transfer note and the HIE in Korean healthcare. A technical review of the CCR standard and analysis of stakeholders' views were undertaken. Transfer notes were reviewed and matched with CCR standard categories. The standard for the Korean coding system was selected. Stakeholder analysis included an online survey of members of the Korean Society of Medical Informatics, a public hearing to derive opinions of consumers, doctors, vendors, academic societies and policy makers about the policy process, and a focus group meeting with EMR vendors to determine which HIE objects were technically applicable. Data objects in the official transfer note form matched CCR standards. Korean Classification of Diseases, Korean Standard Terminology of Medicine, Electronic Data Interchange code (EDI code), Logical Observation Identifiers Names and Codes, and Korean drug codes (KD code) were recommended as the Korean coding standard.'Social history', 'payers', and 'encounters' were mostly marked as optional or unnecessary sections, and 'allergies', 'alerts', 'medication list', 'problems/diagnoses', 'results',and 'procedures' as mandatory. Unlike the US, 'social history' was considered optional and 'advance directives' mandatory.At the public hearing there was some objection from the Korean Medical Association to the HIE on legal grounds in termsof intellectual property and patients' personal information. Other groups showed positive or neutral responses. Focus group members divided CCR data objects into three phases based onpredicted adoption time in CCR: (i) immediate adoption; (ii) short-term adoption ('alerts', 'family history'); and (iii) long-term adoption ('results', 'advanced directives', 'functional status', 'medical equipment', 'vital signs', 'plan of care', 'social history'). There were no technical problems in generating the CCR standard document from EMRs. Matters of concern that arose from study results should be resolved with time and consultation.

CD4-1 Increasing incidence of Type 1 diabetes in Canterbury children and adolescents and spatial-temporal clustering

Aims: The prevalence of diabetes mellitus (DM) is increasing around the world. In the Republic of Korea, the prevalence of diabetes was 7.75% (2,690,000 persons) in 2005. The increasing prevalence of diabetes is also one of the most important medical issues, as the control of chronic complications of diabetes, the main causes of morbidity and mortality of diabetes, is not easy and is required over long periods of life. In this study, we attempted to analyze all causes of mortality in Type 2 DM (T2DM) and compared our findings with previously published data. Methods: All T2DM patients older than thirty and whose death certificates were issued in Dong-A University Hospital from 2000 through 2004, were evaluated. The patients were excluded if they already had clinically significant tuberculosis, liver, thyroid, renal, connective tissue diseases and cancers when T2DM was diagnosed. We classified the cause of death into several groups using the KCD (Korean Classification of Disease)-4. The results were compared with data that was collected from 1990 through 1994. Results: A total of 102 patients were included, 66 of whom were males. 37.4% and 34.3%of the study group were aged in their 60’s or 70’s, respectively. The mean duration of diabetes was 11.8 ± 8.2 years. The most common cause of death was infectious disease (39.2%), the second was ischemic heart disease (IHD)(24.5%). Other causes were cancer (12.8%), renal disease (6.9%), liver disease (4.9%), cerebrovascular accident (CVA) (3.9%), congestive heart failure (CHF) (2.9%), DM itself (2.0%). However, in the 1990s, the most common cause of death was cardiovascular disease (IHD+CVD) with others being infectious disease, DM, liver disease, cancer and renal disease, in that order. The proportion of infectious disease was increased and that of cardiovascular disease decreased in current causes of mortality of diabetes compared with past mortality of diabetes. Conclusions: The prevalence of cardiovascular mortality in university hospital based T2DM patients decreased during the past ten years.

약의 허가시점분포가 사망률에 매치는 영향 : 신약의 거시경제적 효과

Technological innovation has been regarded as the core competence for the economic growth of individual, as well as organization and country. Pharmaceutical innovation, what we call new medicines, influence people's longevity and productivity by increasing output per hour worked. Therefore, using claims data on virtually all the drugs and diseases of over 550,000 people enrolled in National Health Insurance Program in Korea, we examined the impact of the vintage (original FDA and KFDA approval year) of drugs used to treat a patients from July 1st to December 31st in 2002 on the patient's mortality at the end of 2004, controlling for demographic characteristics(age and sex), utilization of medical services, and the nature and complexity of illness. We found that people using newer drugs are less likely to die at the end of 2004, conditional on covariates. The estimated mortality rates were declining with respect to drug vintage for 1970s, 1980s and 1990s and highly significant. In addition to estimating the model for the entire sample, we estimated the model separately for several disease categories classified by Korean Classification of Disease. Estimates of three drug vintage variables for subgroups of people with (1)neoplasms, (2)endocrine, nutritional and metabolic diseases, and (3)the diseases of circulatory system displayed similar patterns.