Stroke is a leading public health problem in Korea in terms of the economic burden. The indirect costs were identified as the largest component of the overall cost.

BackgroundThe recently-observed trend towards younger stroke patients in Korea raises economic concerns, including erosion of the workforce. We compared per-person lifetime costs of stroke according to the age of stroke onset from the Korean societal perspective.MethodsA state-transition Markov model consisted of three health states ('post primary stroke event', 'alive post stroke', and 'dead') was developed to simulate the natural history of stroke. The transition probabilities for fatal and non-fatal recurrent stroke by age and gender and for non-stroke causes of death were derived from the national epidemiologic data of the Korean Health Insurance Review and Assessment Services and data from the Danish Monitoring Trends in Cardiovascular Disease study. We used an incidence-based approach to estimate the long-term costs of stroke. The model captured stroke-related costs including costs within the health sector, patients' out-of-pocket costs outside the health sector, and costs resulting from loss of productivity due to morbidity and premature death using a human capital approach. Average insurance-covered costs occurring within the health sector were estimated from the National Health Insurance claims database. Other costs were estimated based on the national epidemiologic data and literature. All costs are presented in 2008 Korean currency values (Korean won = KRW).ResultsThe lifetime costs of stroke were estimated to be: 200.7, 81.9, and 16.4 million Korean won (1,200 KRW is approximately equal to one US dollar) for men who suffered a first stroke at age 45, 55 and 65 years, respectively, and 75.7, 39.2, and 19.3 million KRW for women at the same age. While stroke occurring among Koreans aged 45 to 64 years accounted for only 30% of the total disease incidence, this age group incurred 75% of the total national lifetime costs of stroke.ConclusionsA higher lifetime burden and increasing incidence of stroke among younger Koreans highlight the need for more effective strategies for the prevention and management of stroke especially for people between 40 and 60 years of ages.

BackgroundIt is important to identify and quantify the factors that affect gender differences in high-risk drinking (HRD), from both an academic and a policy perspective. However, little is currently known about them. This study examines these factors and estimates the percentage contribution each makes to gender differences in HRD.MethodsThis study analyzed information on 23,587 adults obtained from the Korea National Health and Nutrition Surveys of 1998, 2001, and 2005. It found that the prevalence of HRD was about 5 times higher among men (0.37) than women (0.08). Using a decomposition approach extended from the Oaxaca-Blinder method, we decomposed the gender difference in HRD to an "overall composition effect" (contributions due to gender differences in the distribution of observed socio-economic characteristics), and an "overall HRD-tendency effect" (contributions due to gender differences in tendencies in HRD for individuals who share socio-economic characteristics).ResultsThe HRD-tendency effect accounted for 96% of the gender difference in HRD in South Korea, whereas gender differences in observed socio-economic characteristics explained just 4% of the difference. Notably, the gender-specific HRD-tendency effect accounts for 90% of the gender difference in HRD.ConclusionWe came to a finding that gender-specific HRD tendency is the greatest contributor to gender differences in HRD. Therefore, to effective reduce HRD, it will be necessary to understand gender differences in socioeconomic characteristics between men and women but also take notice of such differences in sociocultural settings as they experience. And it will be also required to prepare any gender-differentiated intervention strategy for men and women.

ObjectivesWe aimed to estimate the annual socioeconomic burden of coronary heart disease (CHD) in Korea in 2005, using the National Health Insurance (NHI) claims data.MethodsA prevalence-based, top-down, cost-of-treatment method was used to assess the direct and indirect costs of CHD (International Classification of Diseases, 10th revision codes of I20-I25), angina pectoris (I20), and myocardial infarction (MI, I21-I23) from a societal perspective.ResultsEstimated national spending on CHD in 2005 was $2.52 billion. The majority of the spending was attributable to medical costs (53.3%), followed by productivity loss due to morbidity and premature death (33.6%), transportation (8.1%), and informal caregiver costs (4.9%). While medical cost was the predominant cost attribute in treating angina (74.3% of the total cost), premature death was the largest cost attribute for patients with MI (66.9%). Annual per-capita cost of treating MI, excluding premature death cost, was $3183, which is about 2 times higher than the cost for angina ($1556).ConclusionsThe total insurance-covered medical cost ($1.13 billion) of CHD accounted for approximately 6.02% of the total annual NHI expenditure. These findings suggest that the current burden of CHD on society is tremendous and that more effective prevention strategies are required in Korea.

BackgroundNo previous study has explored the interactions between education and lifestyle in relation to obesity. This study hypothesized that education may be obesogenic through its interplay with lifestyle behaviors.MethodsData for a nationally representative sample (6937 men and 9333 women) from the Korea National Health and Nutrition Examination Survey (2010–2012) were analyzed. Multivariate logistic regressions were performed for three education levels and six lifestyle behaviors, each of which comprised two groups.ResultsInteractions between education and lifestyle behaviors in relation to obesity were observed for all lifestyle behaviors in women (p for interaction <0.001) and for three lifestyle behaviors in men. Education appeared obesogenic for three groups of lifestyle behaviors in men (p for trend <0.05), but was protective against obesity for 11 groups in women. Each one-unit increase in education level in men increased the odds of obesity by 1.29-fold among under-reported energy intake groups (95 % confidence interval: 1.16, 1.44).ConclusionsEducation may be a risk factor for obesity through its interplay with lifestyle behaviors. Further research is required to examine these findings in different socio-cultural settings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3776-4) contains supplementary material, which is available to authorized users.