National Sample Data Research Articles

Trends of Korean medicine service utilization for lumbar disc herniation and spinal stenosis: A 10-year analysis of the 2010 to 2019 data.

This retrospective, cross-sectional, and descriptive study aimed to analyze the trend of utilizing traditional Korean medicine services in patients with lumbar disc herniation (LDH) and/or lumbar spinal stenosis (LSS). In this study, based on the national patient sample data provided by Health Insurance Review and Assessment Service (HIRA), the trend of Korean medicine service utilization was investigated, including the following information: demographic characteristics of the patients, the total expenditure, number of claim statements per category, medical care expenditure per category, and routes of visiting traditional Korean medicine institutions. The study population comprised patients who visited Korean medicine institutions at least once from January 2010 to December 2019, with LSS and LDH as the primary diagnosis. LDH patients who used traditional Korean medicine services for treatment increased by about 1.36 times. LDH and LSS patients under 45 years of age were more likely to be males, but women accounted for a higher percentage among those over 45 years of age. Overall, women accounted for a slightly higher percentage than their counterparts for both diseases. From details of treatments received that were extracted from the claims data, acupuncture treatment accounted for the highest percentage for both disorders. Moreover, 50.7% of the patients who visited Korean medicine institutions to treat the two diseases also visited conventional Western medicine institutions. These patients, who were diagnosed with their condition at a Korean medicine institution, visited a conventional institution and then returned; the conventional institutions were primarily used for examination (40.5%). Increased utilization of traditional Korean medicine services was confirmed among patients with LDH and/or LSS; in particular, a sharp increase was noted among patients with LSS. The results of this study will be useful as basic research data for clinicians, researchers, and policy makers.

Impact of narcotics information management system on inappropriate benzodiazepine receptor agonist prescriptions: A quasi-experimental analysis in South Korea.

The South Korean government implemented the narcotics information management system (NIMS) on 18 May 2018 to manage benzodiazepine receptor agonists (BzRAs) and narcotics effectively and establish a reporting mechanism for these drugs. This study assessed the effects of NIMS on inappropriate use of BzRAs. Using national patient sample data from 2016 to 2020, we analysed adult outpatients who were prescribed oral BzRAs. We conducted a time series and segmented regression analysis using selected indicators to analyse the monthly variations related to the inappropriate use of these medications. The study revealed no significant changes in the indicators of inappropriate BzRA use following the NIMS implementation. Contrary to expectations, there was a significant increase in the proportion of patients exceeding defined daily dose (DDD) and in those receiving concurrent prescriptions of multiple BzRAs, following the implementation of NIMS. The immediate impact of the COVID-19 pandemic was an increase in DDD exceedance; however, overall, this did not significantly affect BzRA use. The introduction of NIMS did not significantly enhance the management of BzRA misuse. Additional measures, including continuous monitoring, system improvements and comprehensive education for prescribers and patients, are recommended to ensure the appropriate use of psychotropic medications.

Quantification and forecasting of regional commercial traffic volumes based on aggregated national data

The increasing volume of traffic in agglomeration areas makes it necessary to take better account of commercial traffic in transport planning and traffic control and to implement new solutions for the sustainable handling of commercial traffic. For this purpose, commercial transport demand models are used, which in turn are attributed with empirical data. However, the determination of key figures of economic traffic in a planning region is very complex and time-consuming. This article therefore presents a method for quantifying and forecasting regional commercial traffic volumes based on aggregated national data. It is applied exemplarily for the Munich Metropolitan Region. The method comprises the extrapolation of national sample data, the updating of outdated national behavioral data, the forecast for a target year and the cutting out of the quantity structure for the planning region. The data used are freely available. They include vehicle diaries, demographic statistics, vehicle registration statistics and employment statistics. Three categories are considered in the data: Economic sectors, vehicle types and settlement patterns. The modelling approach is validated by forecasting historical data and comparing it with verified data. Furthermore, the results are validated by reproducing key figures from independent data sources, whereby the deviations are mostly in the range of 0-10 %.

Development and validation of a machine learning-based fall-related injury risk prediction model using nationwide claims database in Korean community-dwelling older population

BackgroundFalls impact over 25% of older adults annually, making fall prevention a critical public health focus. We aimed to develop and validate a machine learning-based prediction model for serious fall-related injuries (FRIs) among community-dwelling older adults, incorporating various medication factors.MethodsUtilizing annual national patient sample data, we segmented outpatient older adults without FRIs in the preceding three months into development and validation cohorts based on data from 2018 and 2019, respectively. The outcome of interest was serious FRIs, which we defined operationally as incidents necessitating an emergency department visit or hospital admission, identified by the diagnostic codes of injuries that are likely associated with falls. We developed four machine-learning models (light gradient boosting machine, Catboost, eXtreme Gradient Boosting, and Random forest), along with a logistic regression model as a reference.ResultsIn both cohorts, FRIs leading to hospitalization/emergency department visits occurred in approximately 2% of patients. After selecting features from initial set of 187, we retained 26, with 15 of them being medication-related. Catboost emerged as the top model, with area under the receiver operating characteristic of 0.700, along with sensitivity and specificity rates around 65%. The high-risk group showed more than threefold greater risk of FRIs than the low-risk group, and model interpretations aligned with clinical intuition.ConclusionWe developed and validated an explainable machine-learning model for predicting serious FRIs in community-dwelling older adults. With prospective validation, this model could facilitate targeted fall prevention strategies in primary care or community-pharmacy settings.

Trends of Surgical Service Utilization for Lumbar Spinal Stenosis in South Korea: A 10-Year (2010-2019) Cross-Sectional Analysis of the Health Insurance Review and Assessment Service-National Patient Sample Data.

Background and Objectives: This retrospective, cross-sectional, and descriptive study used claims data from the Korean Health Insurance Review and Assessment Service (HIRA) between 2010 and 2019 to analyze the trend of surgical service utilization in patients with lumbar spinal stenosis (LSS). Materials and Methods: The national patient sample data provided by the HIRA, which consisted of a 2% sample of the entire Korean population, was used to assess all patients who underwent decompression or fusion surgery at least once in Korea, with LSS as the main diagnosis from January 2010 to December 2019. An in-depth analysis was conducted to examine the utilization of surgical services, taking into account various demographic characteristics of patients, the frequency of claims for different types of surgeries, reoperation rates, the specific types of inpatient care associated with each surgery type, prescribed medications, and the overall expense of healthcare services. Results: A total of 6194 claims and 6074 patients were analyzed. The number of HIRA claims for patients increased from 393 (2010) to 417 (2019) for decompression, and from 230 (2010) to 244 (2019) for fusion. As for the medical expenses of surgery, there was an increase from United States dollar (USD) 867,549.31 (2010) to USD 1,153,078.94 (2019) for decompression and from USD 1,330,440.37 (2010) to USD 1,780,026.48 (2019) for fusion. Decompression accounted for the highest proportion (65.8%) of the first surgeries, but more patients underwent fusion (50.6%) than decompression (49.4%) in the second surgery. Across all sex and age groups, patients who underwent fusion procedures experienced longer hospital stays and incurred higher medical expenses for their inpatient care. Conclusion: The surgical service utilization of patients with LSS and the prescribing rate of opioids and non-opioid analgesics for surgical patients increased in 2019 compared to 2010. From mid-2010 onward, claims for fusion showed a gradual decrease, whereas those for decompression showed a continuously increasing trend. The findings of this study are expected to provide basic research data for clinicians, researchers, and policymakers.

Osteoporosis Associated with Breast Cancer Treatments Based on Types of Hormonal Therapy: A Cross-Sectional Study Using Korean National Sample Data.

Background and Objectives: This study aimed to investigate osteoporosis-related treatments and the overall anticancer drug treatment tendencies, with a focus on selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs), in Korean patients with breast cancer from 2010 to 2019. Materials and Methods: Data were obtained from the Health Insurance Review and Assessment Service. Patients with breast cancer (International Classification of Diseases, 10th Revision code: C50) as a principal diagnosis at least once from 2010 to 2019 were included. Those with osteoporosis (M80, M81, or M82) as a principal or sub-diagnosis or those who received osteoporosis treatment at least once were categorized as the osteoporosis-related treatment group, and others as the non-osteoporosis-related treatment group. The trends of drug prescriptions and treatment costs in patient groups were evaluated using descriptive statistics. Results: Among all included patients, those aged 45-54 years (40.20%) without osteoporosis treatment and those aged 55-64 years (34.11%) with osteoporosis treatment were the most common. SERM was the most commonly prescribed anticancer drug (29.20%) in the entire patient group, followed by AIs (20.83%). Patients without osteoporosis treatment had the highest prescription rate of SERM (31.48%), and those with osteoporosis treatment had a higher prescription rate of AIs (34.28%). Additionally, SERM and AIs were prescribed most frequently before and after the age of 55 years, respectively, regardless of the presence of treatment. Conclusions: This study found that osteoporosis-related treatment and patient age were associated with anticancer drug prescriptions. The present findings would help clinicians and researchers in the clinical diagnosis and treatment of breast cancer.

Healthcare usage and cost for plantar fasciitis: a retrospective observational analysis of the 2010–2018 health insurance review and assessment service national patient sample data

BackgroundPlantar fasciitis (PF) is the most common cause of heel pain in adults, and the number of patients and medical expenses are increasing annually. However, studies on this condition are lacking. There is a need to investigate universally administered PF treatment and the associated costs. Therefore we analyzed the South Korean Health Insurance Review and Assessment Service data to investigate the distribution and healthcare usage of patients with PF.MethodsA cross-sectional retrospective observational design was used in this study. Patients diagnosed with PF (ICD-10 code M72.2) between January 2010 and December 2018 in South Korea, of whom 60,079 had used healthcare at least once, were included in the study. We assessed healthcare usage and cost due to PF, treatment method, and visit route. All statistical analyses were performed with descriptive statistics using SAS 9.4 version.ResultsThe number of treated cases of PF and patients with PF was 11,627 cases and 3,571 patients in 2010, respectively, which increased annually to 38,515 cases and 10,125 patients by 2018, respectively. The 45-54-year-old age group had the highest number of patients; the patient population was predominantly women. Physical therapy was used frequently in Western medicine (WM) institutions, where > 50% of the medicines prescribed to outpatients were analgesics. In contrast, acupuncture therapy was most commonly used in Korean medicine (KM) institutions. A high percentage of patients who visited a KM institution, followed by a WM institution, and then returned to the same KM institution had visited the WM institution for radiological diagnostic examination.ConclusionThis study analyzed nine years of period data from a patient sample of claims data from the Health Insurance Review and Assessment Service to examine the current status of health service use for PF in Korea. We obtained information on the status of WM/KM institution visits for PF treatment, which could be useful for health policymakers. Study findings regarding treatments often used in WM/KM, the frequency of treatments, and their costs could be used as basic data by clinicians and researchers.

Intimate partner violence perpetration and mental health service use in England: analysis of nationally representative survey data.

Intimate partner violence perpetration (IPVP) is associated with psychiatric disorders, but an association with mental health service use has not been fully established and is relevant for policy. Mental health service contact by perpetrators of intimate partner violence presents an opportunity for reducing harmful behaviours. To examine the association between IPVP and mental health service use. Analysis of national probability sample data from the 2014 Adult Psychiatric Morbidity Survey, testing for associations between lifetime IPVP and mental health service use. We assessed the impact of missing data with multiple imputation and examined misreporting using probabilistic bias analysis. The prevalence of reported lifetime IPVP was similar for men (8.0%) and women (8.6%). Before adjustments, IPVP was associated with mental health service use (odds ratio (OR) for any mental health service use in the past year for men: 2.8 (95% CI: 1.8-4.2), for women: 2.8 (95% CI: 2.1-3.8)). Adjustments for intimate partner violence victimisation and other life adversities had an attenuative influence. Associations remained on restricting comparisons with those without criminal justice involvement (OR for any mental health service use in the past year for men: 2.9 (95% CI: 1.7-4.8), for women: 2.3 (95% CI: 1.7-3.2)). The strong association of IPVP with mental health service use is partly attributable to the concurrent presence of intimate partner violence victimisation and other life adversities. Efforts to improve the identification and assessment of IPVP in mental health services could benefit population health.

우리나라 국민의 반기업정서 현황과 영향요인

Using a national representative sample data collected in 2022, this article explores the current state of negative attitudes towards Korean companies in Korea and its antecedents. This study finds that, contrary to the past survey results, respondents to the current survey are more favorable to large companies and their founders than to small and medium-sized companies and their founders. It also shows that ideological orientation, respondents’ trust in Korean social institutions, and the depth of their direct and indirect experiences in or with Korean companies significantly affect their attitudes towards Korean companies. Based on the results, implications and directions for future research are discussed.

Trends in potentially inappropriate opioid prescribing and associated risk factors among Korean noncancer patients prescribed non-injectable opioid analgesics.

Introduction:The aim of this study was to investigate trends in the prevalence of potentially inappropriate opioid prescribing (PIOP) and identify potential risk factors among Korean noncancer patients.Methods:We conducted a cross-sectional study of annual national patient sample data from the Korean Health Insurance Review and Assessment Service (HIRA-NPS) for the period 2012–2018. Noncancer patients who were prescribed non-injectable opioid analgesics (NIOAs) at least once were included. The proportion of patients with at least one PIOP in terms of concurrent use of benzodiazepines or gabapentinoids, substance use disorder, treatment duration, and dosage was evaluated. Multivariable logistic regression was performed to identify the risk factors associated with PIOP.Results:Of the 9,772,503 noncancer patients, 1,583,444 (16.2%) were prescribed NIOAs at least once. Among them, 15.7% were exposed to PIOP, and the prevalence was much higher (31.6%) in the elderly group (age: ⩾65 years). The prevalence of PIOP increased 1.1-fold over 7 years (14.8–16.8%) among the total NIOA users and was more pronounced in non-tramadol NIOA users (a 1.5-fold increase, from 13.2% to 19.4%). Multivariable logistic regression indicated that older age, beneficiaries of medical aid or national meritorious service, exposure to polypharmacy, psychological disorder, chronic pain indication, and concomitant sedative use were independently associated with higher odds of PIOP.Discussion and Conclusion:We found that the prevalence of PIOP was 15.7% among Korean noncancer patients, and it increased over the 7-year study period. This increasing trend is alarming because it was more drastic with non-tramadol NIOAs compared with that with tramadol. Several patient-level risk factors associated with PIOP would be useful in targeted management strategies for the safe use of opioids.Plain Language Summary Potentially inappropriate opioid prescribing and related risk factors among noncancer patients prescribed non-injectable opioids in Korea In Korea, the prevalence of non-injectable opioid analgesic (NIOA) use in noncancer patients steadily increased from 15.3% in 2012 to 17.1% in 2018.Also, the prevalence of potentially inappropriate opioid prescribing (PIOP) increased from 14.8% in 2012 to 16.8% in 2018.The following factors were associated with a markedly increased risk of PIOP: age, beneficiaries of medical aid or national meritorious service, polypharmacy, psychological disorder, chronic pain, and concomitant medications.

Factors associated with postoperative complications and costs for adrenalectomy in benign adrenal disorders

BackgroundThe incidence of adrenal incidentaloma has been increasing, and indications of and approaches to adrenalectomy are diverse. Drivers of complications and costs are not well identified. MethodsThe 2016 National Inpatient Sample data were used to identify patients who underwent adrenalectomy for benign adrenal disorders, such as Cushing syndrome, primary hyperaldosteronism, pheochromocytoma, and other benign neoplasms defined using the 10th Revision of the International Classification of Diseases. The primary outcome was determining the factors associated with clinical outcomes, perioperative complications, and hospitalization costs. ResultsUsing weighted estimates of the national sample data, 5,140 patients were identified. The mean age was 55 years. The majority of adrenalectomies were performed laparoscopically (48.5%) followed by a robotic approach (32.7%). The postoperative complication rate was 7.6%. In adjusted multivariable analyses, independent risk factors for perioperative complications included Hispanic race (odds ratio, 2.5; P = .01), and perioperative comorbid heart failure (odds ratio, 6.3; P < .001) and respiratory failure (odds ratio, 9.9; P < .001). The mean cost was $18,122. Independent risk factors associated with decrease of cost were female sex and primary hyperaldosteronism; factors associated with increased cost were pheochromocytoma, intraoperative complications, perioperative underlying comorbid respiratory failure and heart failure, and postoperative complications (P < .001). ConclusionAmong patients undergoing adrenalectomy for benign adrenal disorders, underlying comorbidities, including heart and respiratory failure, should be considered when recommending adrenalectomy, as these may increase the postoperative complication rates and hospitalization costs.

Impacts of statin and metformin on neuropathy in patients with type 2 diabetes mellitus: Korean Health Insurance data

BACKGROUNDNeuropathy is a common chronic complication in type 2 diabetes mellitus (T2DM). Statin and metformin are commonly used medications in T2DM patients, and some studies showed statin- or metformin-induced neuropathy.AIMTo evaluate the incidence of neuropathy among patients with T2DM associated with statin and metformin therapies. METHODSKorean Health Insurance Review and Assessment national patient sample data from 2016 and 2017 were used. Patients with T2DM and no complications were divided into statin/metformin/statin + metformin users and non-users. Neuropathy incidence was defined by International Statistical Classification of Diseases and Related Health Problems, 10th revision codes and concomitant prescriptions for anticonvulsants or antidepressants. Logistic regression analyses were conducted to examine the associations between statin/metformin/statin + metformin therapies and the incidence of neuropathy. Propensity score (PS) matching was performed on the basis of age, sex and comorbidities.RESULTSOverall, 34964 and 35887 patients with T2DM and no complications were included in the Korean Health Insurance Review and Assessment national patient sample datasets from 2016 and 2017, respectively. Statin therapy was associated with increased risks of neuropathy in 2016 and 2017 [PS-matched odds ratio (OR) = 1.22, 95% confidence interval (CI): 1.08-1.38; PS-matched OR = 1.17, 95%CI: 1.03-1.33, respectively]. Metformin therapy was associated with reduced risks of neuropathy in 2016 and 2017 (PS-matched OR = 0.30, 95%CI: 0.21-0.42; PS-matched OR = 0.44, 95%CI: 0.32-0.60, respectively). Combined statin + metformin therapy was not significantly associated with neuropathy in 2016 or 2017 (PS-matched OR = 0.85, 95%CI: 0.61-1.19; PS-matched OR = 0.95, 95%CI: 0.66-1.38, respectively). CONCLUSIONStatin therapy was associated with enhanced risk of new-onset neuropathy in patients with T2DM, but metformin therapy showed the opposite association.

Living with grandparents: Multi-generational families and the academic performance of grandchildren in China

Previous studies on social stratification and intergenerational mobility have mostly focused on the effects of parents on their children’s socioeconomic status (SES) attainment, but less attention has been paid to the important role played by grandparents in the life chances of their grandchildren, and its underlying mechanism. By analyzing a national survey sample data of junior high school students in China, this study examines the influence factors of living with grandparents and their effect on the academic performance of adolescents, and the intermediate mechanism. The study finds that (a) three-generation cohabitation occurs when there is a functional need for the nuclear family, and children with lower SES, working mothers, or single-parent families are more likely to experience cohabitation between grandparents and grandchildren; (b) living with grandparents has significant positive effects on adolescents’ academic performance after controlling for other factors; (c) the effect of living with grandparents is moderated by the family’s SES and family structure, and students from lower-SES or single-parent families benefit more from living with grandparents; and (d) living with grandparents to a certain extent benefits grandchildren’s academic performance by enhancing family social capital investment. Households in which grandparents cohabit invest significantly more in the social capital of children than those who do not have grandparents cohabiting. The results of this study show that in modern society, family kinship networks still play a very important role in the status attainment and social mobility of individuals. Therefore, scholars should pay more attention to the important role of extended families in social stratification and mobility and its micro-mechanisms.

Obesity Is Associated With Higher odds of Hepatorenal syndrome in Patients Admitted With Alcoholic Hepatitis: Analysis of the National Inpatient Sample (2016–2017)

Introduction: Obesity is a significant independent risk factor for the development of liver disease. There is some available data suggesting worse outcomes of alcoholic hepatitis (AH) in obese patients however, national sample data supporting these findings are scarce. The aim of our study was to study the severity of AH in patients with concurrent obesity thus we analyzed data from the national inpatient sample. Methods: We queried the National Inpatient Sample (NIS) 2016 and 2017 database. The NIS was searched for hospitalization of adult patients with alcoholic hepatitis as a principal diagnosis with and without Obesity (BMI = 30 and above) as a secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality while the secondary outcomes were severe sepsis with shock, hospital length of stay (LOS), NSTEMI, hepatorenal syndrome (HRS) and bleeding esophageal varices (BEV) development. STATA software was used for analysis. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. Results: There were over 71 million discharges in the combined 2016 and 2017 NIS database. Out of 32,584 adult AH hospitalizations, 3,720 (11.4%) had a concomitant diagnosis of obesity. There were no differences between mean age, sex and race in both groups of patients. Patients with AH and concurrent obesity had no significant difference in inpatient mortality (aOR= 0.74, P = 0.272, CI = 0.438 -1.261) however, they were found to have higher odds of developing HRS (aOR = 1.54, P= 0.020, CI= 1.069 -2.209) and lower odds of developing BEV(aOR 0.22, P= 0.008, CI= 0.070 -0.670). Patients with AH and concurrent obesity were also found to have similar odds of developing NSTEMI (aOR = 2.29, P= 0.180, CI= 0.680 - 7.762), severe sepsis with shock (aOR = 0.97%, P= 0.945, CI= 0.486 -1.954) and a 0.5 day mean increase in LOS (P =0.045, CI = 0.011 - 0.987) when compared to those without obesity. Conclusion: In conclusion, patients with obesity admitted with AH have higher odds of developing HRS, lower odds of developing BEV and no statistically significant difference in mortality, development of NSTEMI and severe sepsis with septic shock. It is important to identify these patients at higher risk and provide better surveillance to prevent the development of HRS.

Risk factors of chronic opioid use after surgical procedures in noncancer patients: A nationwide case-control study.

Surgery is an indication for opioid prescription in noncancer patients, and chronic use of opioids is associated with overdose and abuse. We aimed to evaluate the prevalence and risk factors associated with chronic opioid use (COU) following surgery among noncancer patients. A nationwide case-control study. Retrospective analysis of the annual national patient sample data from 2012 to 2018 in South Korea. Adults without cancer who had undergone surgery and received noninjectable opioids during hospital stay. COU during 3 months following surgery. A total of 15 543 participants were included, and the prevalence overall and in opioid-naïve users was 8.1 and 5.7%, respectively. Prior exposure patterns of opioids [intermittent user, adjusted odds ratio (aOR) 2.35; 95% CI, 2.00 to 2.77, and continuous user, aOR 8.58; 95% CI, 6.54 to 11.24] and concomitant use of benzodiazepine (in continuous user, aOR 18.60; 95% CI 11.70 to 29.55) were strongly associated with COU compared with naïve users. Morphine milligram equivalent, type of opioid strength at discharge and prescription of nonopioid analgesics at discharge were also associated with COU. Compared with minor surgery, knee (aOR 1.49; 95% CI 1.17 to 1.89), spine (aOR 1.65; 95% CI 1.33 to 2.06) and shoulder (aOR 2.54; 95% CI 1.97 to 3.27) procedures showed a significantly positive association with COU. Sensitivity analysis in opioid-naïve patients showed similar results. About 8.1% of noncancer patients who had undergone surgery and were prescribed noninjectable opioids became chronic opioid users in Korea. Identified risk factors could be used to derive strategies for safe opioid use in noncancer patients in the future.

Contextualizing the relationship between Gender and Computer Self-efficacy: An Empirical study from India

In this study, by considering household, societal, and institutional contextual factors, we attempt to theorize the relationship between gender and digital divide with the help of social learning theory (SLT) and the literature on computer self-efficacy (CSE). Then, using a large-scale national representative sample data from India, we empirically evaluate these relationships. Our empirical analysis corroborates anecdotal evidence that gender-based digital divide exists and is severe. Caste, household size, marriage, and presence of digitally literate women in the family are found to be influencers of women’s CSE, which, in turn, impact gender-level digital divide.

Heavy drug use in young adulthood

ABSTRACT Background: For some, substance use changes over the life course, but not for others. Because of the devastation caused to individual lives and to society by drug use, the issue of who among young adults continues drug use into early adulthood is one of importance. Several factors have been identified in the prior literature, but studies of long term drug use are relatively rare in examination of whether these characteristics of people continue to lead to heavy drug use. Our focus in this paper is on who the problem drug users are in young adulthood, and what factors are associated with this maintenance of drug use over time. Methods: Using National sample data from the U.S., we examine factors known to be of importance in their association with adolescent substance use and note if they are important in substance use over the young life course. Data are drawn from the National Longitudinal Study of Adolescent Health (ADD Health). The final sample consisted of approximately 15,000 cases from waves 1, 3 and 4. Results: Multivariate analyses indicate that the predictors of heavy drug use in young adulthood vary by the drug used. However, the most general influences on heavy drug use in young adulthood are age, gender, race-ethnicity, and the prior use of drugs. Conclusions: Results of the study shed light on long term substance use among adolescents and young adults.

Contextualizing privacy on health-related use of information technology

Privacy amid rapid digitalization of medical records is a critical ingredient to the success of electronic-based health service. This paper explores the potential roles of privacy attitudes concerning medical data, based on a large set of a national sample data (n = 2638) from the U.S. Health Information National Trend Survey. We examine the ways in which privacy concern and confidence are (a) mediated through one's interest in sharing information with health professionals and (b) moderated by one's medical condition and the reliance on Internet. Evidence from this study provides insights into the factors shaping health-related engagement in information technologies, helping us argue that privacy is a key predictor. Discussion offers interpretations of how people's perceived need of medical data will mediate privacy concern, contextualizing the affordances of health technologies in future algorithmic applications.

PRS43 SOCIAL BURDEN AND MEDICAL COST OF COPD IN KOREA

to estimate the burden of disease due to Chronic obstructive pulmonary disease (COPD) in Korea. We investigated the prevalence of COPD in Korea using data from the National Health and Nutrition Examination Survey (KNHANES 2016). Using the bronchodilator responsiveness in population-based samples, we corrected the pre-bronchodilator testing results that can overestimate prevalence. We used national statistics and Korean-specific disability weights. Disability-adjusted life years (DALYs) was calculated using methodology employed in the GBD 2010. Medical cost and healthcare use were investigated using national patient sample data of Health Insurance Review and Assessment Service (HIRA-NPS 2016). Patients were identified by ICD-10 codes and COPD-related medications. 24,174 DALYs (per 100,000 population over age 40) were lost due to COPD. Of those, 60.8% came from male over 60s, and 20% from the female. 8% was due to premature death and 92% was computed from years lived with disability (YLDs) due to illness. The prevalence of COPD was 9.6%, which was 31.5% lower than that of the pre-bronchodilator test. Only 9.9% of estimated patients had been diagnosed or treated. The annual medical expenditure per person was 1,187 (SD: 3,568) USD. The cost per event was 961 (SD: 2,382) USD when acute exacerbation occurred. The most commonly prescribed drug was methylxanthines and the largest portion of the costs was LAMA and ICS / LABA. The burden of disease was estimated not only by the population using the health care service but also by the general population, and the economic burden was also investigated. Key Terms: burden, medical cost, chronic obstructive pulmonary disease Authors: Eunmi Bae (Korea University. College of Pharmacy), and Sang-Eun Choi (Korea University. College of Pharmacy).

PCN321 IMAGING SURVEILLANCE OF PATIENTS WITH OVARIAN CANCER AFTER SUCCEEDING EARLY TREATMENT: A CROSS-SECTIONAL ANALYSIS FROM REAL-WORLD DATA

Patients with ovarian cancer (OC) after succeeding early treatment have a long observation period to monitor recurrence. Clinical guidelines recommend that patients over 2-year of disease-free survival need less frequent monitoring. This study aims to investigate OC-related healthcare utilization (HCU) and costs according to the frequency of outpatient visit in OC patients on the observation period. We conducted a descriptive, cross-sectional study using the national claims sample data of 2017, containing 3% of the total population in South Korea. We included patients with OC, having no claims for OC-related hospitalization in 2017. They were categorized into the infrequent and the frequent based on their number of OC-related outpatient visits for monitoring: less than 4 or not. HCU, including outpatient visit and monitoring, and OC-related direct costs were compared between two groups with focusing on imaging surveillance; magnetic resonance imaging, computed tomography, x-ray, ultrasonography and positron-emission tomography. A total of 306 OC patients without OC-related hospitalization were identified. Those patients were classified as the frequent (N=47) and the infrequent group (N=259). The number of imaging for each visit were 1.139 and 1.135, respectively (p=0.882). The cost per visit for the frequent group (USD 458) was significantly higher than that of the infrequent group (USD 263, p<0.001). With focusing on imaging surveillance, computed tomography was preferred the most in both groups (58.5% of outpatient visits in the infrequent, 44.3% in the infrequent), and followed by X-rays for the frequent (37.7%) and ultrasonography, which is costly, for the infrequent group (30.4%), respectively. Use of costly imaging surveillance in the frequent group was higher than that in the infrequent group. Although a further study needs to investigate factors that contribute to the difference such as patients’ characteristics, proper management is required to avoid unnecessary HCU and to reduce the burden of OC.