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Oral health of high-cost patients and evaluation of oral health measures as predictors for high-cost patients in South Korea: a population-based cohort study.

ABSTRACT: OBJECTIVE:To examine the oral health conditions and oral health behaviour of high-cost patients and evaluate oral health measures as predictors of future high-cost patients. DESIGN:A retrospective, population-based cohort study using administrative healthcare records. SETTING:The National Health Insurance Service (NHIS) medical check-up database (a.k.a. NHIS-national health screening cohort database) in South Korea. PARTICIPANTS:131 549 individuals who received biennial health check-ups including dental check-ups in 2011 or 2012, aged 49-88. PRIMARY OUTCOME MEASURES:Current and subsequent year high-cost patient status. RESULTS:High-cost patients, on average, incur higher dental costs, suffer more from periodontal disease, brush their teeth less and use secondary oral hygiene products less. Some of the self-reported oral health behaviours and oral symptom variables show statistically significant associations with subsequent year high-cost patient indicators, even after adjusting for demographic, socioeconomic, medical conditions, and prior healthcare cost and utilisation. CONCLUSIONS:We demonstrate that oral health measures are associated with an increased risk of becoming a high-cost patient.

SUBMITTER: Kim YJ

PROVIDER: S-EPMC6747678 | biostudies-other | 2019 Sep

REPOSITORIES: biostudies-other

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Oral health of high-cost patients and evaluation of oral health measures as predictors for high-cost patients in South Korea: a population-based cohort study.

Kim Yeonkook Joseph YJ

BMJ open 20190912 9

<h4>Objective</h4>To examine the oral health conditions and oral health behaviour of high-cost patients and evaluate oral health measures as predictors of future high-cost patients.<h4>Design</h4>A retrospective, population-based cohort study using administrative healthcare records.<h4>Setting</h4>The National Health Insurance Service (NHIS) medical check-up database (a.k.a. NHIS-national health screening cohort database) in South Korea.<h4>Participants</h4>131 549 individuals who received bienn ...[more]

PMID: 31515435

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Project description:IntroductionThe proportion of neck injuries due to traffic accidents is increasing. Little is known about high-cost patients with acute whiplash-associated disorder (WAD). The present study aimed to investigate whether time to first visit for conventional medicine, multiple doctor visits, or alternative medicine could predict high-cost patients with acute WAD in Japan.MethodsData from a compulsory, no-fault, government automobile liability insurance agency in Japan between 2014 and 2019 were used. The primary economic outcome was the total cost of healthcare per person. Treatment-related variables were assessed based on the time to first visit for conventional and alternative medicine, multiple doctor visits, and visits for alternative medicine. Patients were categorized according to total healthcare cost (low, medium, and high cost). The variables were subjected to univariate and multivariate analysis to compare high-cost and low-cost patients.ResultsA total of 104,911 participants with a median age of 42 years were analyzed. The median total healthcare cost per person was 67,366 yen. The cost for consecutive medicine, for consecutive and alternative medicine, and total healthcare costs were significantly associated with all clinical outcomes. Female sex, being a homemaker, a history of WAD claim, residential area, patient responsibility in a traffic accident, multiple doctor visits, and visits for alternative medicine were identified as independent predictive factors for a high cost in multivariate analysis. Multiple doctor visits and visits for alternative medicine showed large differences between groups (odds ratios 2673 and 694, respectively). Patients with multiple doctor visits and visits for alternative medicine showed a significantly high total healthcare cost per person (292,346 yen) compared to those without (53,587 yen).ConclusionsA high total healthcare cost is strongly associated with multiple doctor visits and visits for alternative medicine in patients with acute WAD in Japan.

Project description:Countries around the world have taken control measures to mitigate the spread of COVID-19, including Korea. Social distancing is considered an essential strategy to reduce transmission in the absence of vaccination or treatment. While interventions have been successful in controlling COVID-19 in Korea, maintaining the current restrictions incurs great social costs. Thus, it is important to analyze the impact of different polices on the spread of the epidemic. To model the COVID-19 outbreak, we use an extended age-structured SEIR model with quarantine and isolation compartments. The model is calibrated to age-specific cumulative confirmed cases provided by the Korea Disease Control and Prevention Agency (KDCA). Four control measures-school closure, social distancing, quarantine, and isolation-are investigated. Because the infectiousness of the exposed has been controversial, we study two major scenarios, considering contributions to infection of the exposed, the quarantined, and the isolated. Assuming the transmission rate would increase more than 1.7 times after the end of social distancing, a second outbreak is expected in the first scenario. The epidemic threshold for increase of contacts between teenagers after school reopening is 3.3 times, which brings the net reproduction number to 1. The threshold values are higher in the second scenario. If the average time taken until isolation and quarantine reduces from three days to two, cumulative cases are reduced by 60% and 47% in the first scenario, respectively. Meanwhile, the reduction is 33% and 41%, respectively, for rapid isolation and quarantine in the second scenario. Without social distancing, a second wave is possible, irrespective of whether we assume risk of infection by the exposed. In the non-infectivity of the exposed scenario, early detection and isolation are significantly more effective than quarantine. Furthermore, quarantining the exposed is as important as isolating the infectious when we assume that the exposed also contribute to infection.

Dataset Information

Oral health of high-cost patients and evaluation of oral health measures as predictors for high-cost patients in South Korea: a population-based cohort study.

Publications

Oral health of high-cost patients and evaluation of oral health measures as predictors for high-cost patients in South Korea: a population-based cohort study.

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