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      The Socioeconomic Burden of Coronary Heart Disease in Korea

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          Abstract

          Objectives

          We aimed to estimate the annual socioeconomic burden of coronary heart disease (CHD) in Korea in 2005, using the National Health Insurance (NHI) claims data.

          Methods

          A 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.

          Results

          Estimated 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).

          Conclusions

          The 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.

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          Most cited references36

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          Emerging epidemic of cardiovascular disease in developing countries.

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            Coronary heart disease mortality among young adults in the U.S. from 1980 through 2002: concealed leveling of mortality rates.

            The objective of our study was to examine age-specific mortality rates from coronary heart disease (CHD), particularly those among younger adults. Trends for obesity, diabetes, blood pressure, and metabolic syndrome among young adults raise concerns about the mortality rates from CHD in this group. We used mortality data from 1980 to 2002 to calculate age-specific mortality rates from CHD for U.S. adults age > or =35 years. Overall, the age-adjusted mortality rate decreased by 52% in men and 49% in women. Among women age 35 to 54 years, the estimated annual percentage change (EAPC) in mortality was -5.4% (95% confidence interval [CI] -5.8 to -4.9) from 1980 until 1989, -1.2% (95% CI -1.6 to -0.8) from 1989 until 2000, and 1.5% (95% CI -3.4 to 6.6) from 2000 until 2002. Among men age 35 to 54 years, the EAPC in mortality was -6.2% (95% CI -6.4 to -5.9) from 1980 until 1989, -2.3% (95% CI -2.6 to -2.1) from 1989 until 2000, and -0.5% (95% CI -3.7 to 2.9) from 2000 until 2002. Among women and men age > or =55 years, the estimated annual percentage decrease in mortality from CHD accelerated in more recent years compared with earlier periods. The mortality rates for CHD among younger adults may serve as a sentinel event. Unfavorable trends in several risk factors for CHD provide a likely explanation for the observed mortality rates.
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              Patterns of coronary heart disease morbidity and mortality in the sexes: a 26-year follow-up of the Framingham population.

              A population-based survey, using data from the Framingham study, assessed sex-specific patterns of coronary heart disease occurring over a 26-year period of time. Among subjects ages 35 to 84 years, men have about twice the total incidence of morbidity and mortality of women. The sex gap in morbidity tends to diminish during the later years of the age range, mainly because of a surge in growth of female morbidity after age 45 years, while by that age, the growth in the male rate begins to taper off. An approximate 10-year difference between the sexes persists in mortality rates throughout the life span. The relative health advantage that is possessed by women, however, is buffered by a case fatality rate from coronary attacks that exceeds the male rate (32% vs 27%). Coronary disease manifestations differ between the sexes. Myocardial infarction is more likely to be unrecognized in women than in men (34% vs 27%). Angina pectoris in women more frequently is uncomplicated (80%), whereas in men angina tends to evolve out of infarction (66%). Also, sudden death comprises a greater proportion of male deaths than female deaths (50% vs 39%). Because women maintain a lesser probability of the disease than do men at any level of the major cardiovascular risk factors, distinctions in their risk factor profiles do not explain completely the observed disease patterns.
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                Author and article information

                Journal
                J Prev Med Public Health
                J Prev Med Public Health
                JPMPH
                Journal of Preventive Medicine and Public Health
                The Korean Society for Preventive Medicine
                1975-8375
                2233-4521
                September 2012
                28 September 2012
                : 45
                : 5
                : 291-300
                Affiliations
                [1 ]Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
                [2 ]Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.
                [3 ]Health Insurance Policy Research Institute, National Health Insurance Corporation, Seoul, Korea.
                [4 ]Health Insurance Review and Assessment Services, Seoul, Korea.
                [5 ]College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, Korea.
                Author notes
                Corresponding author: Hye-Young Kang, PhD. 85 Songdogwahak-ro, Yeonsu-gu, Incheon 406-840, Korea. Tel: +82-32-749-4512, Fax: +82-2-392-7734, hykang2@ 123456yonsei.ac.kr
                Article
                10.3961/jpmph.2012.45.5.291
                3469811
                23091654
                fdc210f3-66bb-4a3f-82a6-18305c2d36b1
                Copyright © 2012 The Korean Society for Preventive Medicine

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 December 2011
                : 07 June 2012
                Categories
                Original Article

                Public health
                myocardial infarction,insurance claim,angina,coronary disease,cost of illness
                Public health
                myocardial infarction, insurance claim, angina, coronary disease, cost of illness

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