Development of an Algorithm for Stroke Prediction: A National Health Insurance Database Study in Korea

2018 ◽  
Vol 79 (3-4) ◽  
pp. 214-220 ◽  
Author(s):  
Seung Nam Min ◽  
Se Jin Park ◽  
Dong Joon Kim ◽  
Murali Subramaniyam ◽  
Kyung-Sun Lee
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Stroke Prevention ◽  
Normal Subjects ◽  
Control Group ◽  
Modifiable Risk Factors ◽  
Stroke Patients

Background: Stroke is the second leading cause of death worldwide and remains an important health burden both for the individuals and for the national healthcare systems. Potentially modifiable risk factors for stroke include hypertension, cardiac disease, diabetes, and dysregulation of glucose metabolism, atrial fibrillation, and lifestyle factors. Objects: We aimed to derive a model equation for developing a stroke pre-diagnosis algorithm with the potentially modifiable risk factors. Methods: We used logistic regression for model derivation, together with data from the database of the Korea National Health Insurance Service (NHIS). We reviewed the NHIS records of 500,000 enrollees. For the regression analysis, data regarding 367 stroke patients were selected. The control group consisted of 500 patients followed up for 2 consecutive years and with no history of stroke. Results: We developed a logistic regression model based on information regarding several well-known modifiable risk factors. The developed model could correctly discriminate between normal subjects and stroke patients in 65% of cases. Conclusion: The model developed in the present study can be applied in the clinical setting to estimate the probability of stroke in a year and thus improve the stroke prevention strategies in high-risk patients. The approach used to develop the stroke prevention algorithm can be applied for developing similar models for the pre-diagnosis of other diseases.

scholarly journals The Associations of Tonsillectomy with Adenoidectomy with Pneumonia and Appendicitis Based on National Sample Cohort Data from the Korean National Health Insurance Service

2021 ◽  
Author(s):  
Junhui Jeong ◽  
Jung Kyu Choi ◽  
Hyun Seung Choi ◽  
Chang Eui Hong ◽  
Hyang Ae Shin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Significant Risk ◽  
National Sample ◽  
Population Based ◽  
Control Group ◽  
Number Of Patients ◽  
Korean National Health Insurance

Abstract Introduction The association between tonsillectomy with adenoidectomy (T&A) with appendicitis is controversial, and the association of T&A with pneumonia has not been investigated. Objective To investigate the associations of T&A with pneumonia and appendicitis using data from the Korean National Health Insurance Service National Sample Cohort. Methods We selected patients between the ages of 3 and 10 years who had undergone T&A in 2005 and were monitored since the performance of the T&A until 2013. The control group was established to have similar propensities for demographic characteristics compared to the T&A group. For eight years after the T&A, the number of patients with a diagnosis of pneumonia, patients who were admitted due to pneumonia, and those who underwent appendectomy were analyzed. The risk factors for pneumonia and appendectomy were analyzed. Results The number of pneumonia diagnoses was significantly higher in the T&A group than in the control group (p = 0.023), but there were no significant differences in the number of admissions due to pneumonia between the 2 groups (p = 0.155). Younger age and T&A were significant risk factors for the development of pneumonia. There were no significant differences in the number of appendectomies between the T&A and the control groups (p = 0.425), neither were there significant risk factors for appendectomy. Conclusion Tonsillectomy with adenoidectomy was associated with an increase in pneumonia diagnoses, but it was not associated with the number of appendectomies. The associations of T&A with pneumonia and appendicitis were analyzed in this population-based study.

Risk Factors of Recurrent Ischemic Events after Acute Noncardiogenic Ischemic Stroke

2020 ◽  
Vol 25 (45) ◽  
pp. 4827-4834 ◽  
Author(s):  
Limin Zhang ◽  
Xingang Li ◽  
Dongzhi Wang ◽  
Hong Lv ◽  
Xuezhong Si ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Operating Characteristic ◽  
Control Group ◽  
Case Group ◽  
Stroke Patients ◽  
Clopidogrel Therapy ◽  
Ischemic Events

Background: A considerable proportion of acute noncardiogenic ischemic stroke patients continue to experience recurrent ischemic events after standard therapy. Aim: We aimed to identify risk factors for recurrent ischemic event prediction at an early stage. Methods : 286 non-cardioembolic ischemic stroke patients with the onset of symptoms within 24 hours were enrolled. Vascular risk factors, routine laboratory data on admission, thromboelastography test seven days after clopidogrel therapy and any recurrent events within one year were assessed. Patients were divided into case group (patients with clinical adverse events, including ischemic stokes, transient ischemic attack, myocardial infarction and vascular related mortality) and control group (events-free patients). The risk of the recurrent ischemic events was determined by the receiver operating characteristic curve and multivariable logistic regression analysis. Results: Clinical adverse events were observed in 43 patients (case group). The mean levels of Mean Platelet Volume (MPV), Platelet/Lymphocyte Ratio (PLR), Lymphocyte Count (LY) and Fibrinogen (Fib) on admission were significantly higher in the case group as compared to the control group (P<0.001). Seven days after clopidogrel therapy, the ADP-induced platelet inhibition rate (ADP%) level was lower in the case group, while the Maximum Amplitude (MA) level was higher in the case group as compared to the control group (P<0.01). The Area Under the Curve (AUC) of receiver operating characteristic(ROC) curve of LY, PLR, , Fib, MA, ADP% and MPV were 0.602, 0.614, 0.629, 0.770, 0.800 and 0.808, respectively. The logistic regression analysis showed that MPV, ADP% and MA were indeed predictive factors. Conclusion: MPV, ADP% and MA were risk factors of recurrent ischemic events after acute noncardiogenic ischemic stroke. Urgent assessment and individual drug therapy should be offered to these patients as soon as possible.

Prediagnosis Smoking, Obesity, Insulin Resistance, and Second Primary Cancer Risk in Male Cancer Survivors: National Health Insurance Corporation Study

2007 ◽  
Vol 25 (30) ◽  
pp. 4835-4843 ◽  
Author(s):  
Sang Min Park ◽  
Min Kyung Lim ◽  
Kyu Won Jung ◽  
Soon Ae Shin ◽  
Keun-Young Yoo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Health Insurance ◽  
Cancer Survivors ◽  
National Health Insurance ◽  
National Health ◽  
Smoking History ◽  
Second Primary ◽  
Primary Cancer ◽  
Second Primary Cancer

Purpose Smoking, obesity, and insulin resistance are well-known risk factors for cancer, yet few epidemiology studies evaluate their role as risk factors for a second primary cancer (SPC). Patients and Methods We identified 14,181 men with a first cancer from the National Health Insurance Corporation Study cohort. We obtained data on fasting glucose level, body mass index (BMI), and smoking history from an enrollment interview (1996). We obtained SPC incidence data for 1996 through 2002 from the Korean Central Cancer Registry. We used the standard Poisson regression model to estimate the age- and multivariate-adjusted relative risk (RR) for SPCs in relation to smoking history, BMI, and insulin resistance before diagnosis. Results We observed 204 patients with SPC. The overall age-standardized incidence rate of SPC was 603.2 occurrences per 100,000 person-years, which was about 2.3 times higher than that of first cancer in the general male population. Multivariate regression revealed that lung (RR, 3.69; 95% CI, 1.35 to 10.09) and smoking-related (RR, 2.02; 95% CI, 1.02 to 4.03) SPCs were significantly associated with smoking. Obese patients (BMI ≥ 25 kg/m2) had significantly elevated RRs for colorectal (RR, 3.45; 95% CI, 1.50 to 7.93) and genitourinary (RR, 3.61; 95% CI, 1.36 to 9.54) SPCs. Patients with a fasting serum glucose concentration ≥ 126 mg/dL had a higher RR for hepatopancreatobiliary (RR, 3.33; 95% CI, 1.33 to 8.37) and smoking-related (1.93; 95% CI, 1.01 to 3.68) SPCs. Conclusion Prediagnosis smoking history, obesity, and insulin resistance were risk factors for several SPCs. These findings suggest that more thorough surveillance and screening for SPCs is needed for the cancer survivors with these risk factors.

The Association of Adolescent Fatness and Fitness With Risk Factors for Adult Metabolic Syndrome: A 22-Year Follow-up Study

2014 ◽  
Vol 11 (4) ◽  
pp. 823-830 ◽  
Author(s):  
Yoonsuk Jekal ◽  
YoonMyung Kim ◽  
Ji Eun Yun ◽  
Eun Sung Kim ◽  
Masayo Naruse ◽  
...  
Keyword(s):  
Risk Factors ◽  
High School ◽  
Metabolic Syndrome ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Health Examination ◽  
Follow Up Study ◽  
Fitness Levels

Background:Few studies have been conducted to explore the associations of fatness and fitness during adolescence with risk factors of metabolic syndrome (MetS) during adulthood, particularly in Asians.Methods:Adolescent anthropometric and fitness data were collected during the participants’ high school years (N = 15,896) and their corresponding health examination data from adulthood were taken from the National Health Insurance Corporation (NHIC) in Korea. A total of 1,006 participants (6.3%) were analyzed in the study.Results:The odds ratios (ORs) for being overweight (BMI ≥ 25 kg/m2) during adulthood was 11.87 (95% CI: 4.19–33.59) in men and 8.44 (95% CI: 1.78–40.02) in women, respectively, in the fattest group vs. the leanest group during adolescence. Participants with low fitness levels during adolescence were more likely to be overweight and have abnormal MetS risk factors in adulthood vs. those with high fitness levels. Joint exposure analyses of fatness and fitness showed that male participants who were more fat and unfit during adolescence had 4.11 (95% CI: 1.19–14.14) and 3.04 (95% CI: 1.17–11.12) times higher risk of having abnormal glucose and MetS risks during adulthood, respectively.Conclusions:Fatness and fitness levels during adolescence appear to be significantly associated with the MetS risk factors and prevalence in adulthood in Koreans.

scholarly journals A Study on Risk Factors of the Incidence of Prostate Cancer Using National Health Insurance Service: Effects of BMI on Age

2019 ◽  
Vol 44 (4) ◽  
pp. 410-418 ◽  
Author(s):  
Hye Sim Kim ◽  
Tae Hwa Go ◽  
Dae Ryong Kang ◽  
Jae Hung Jung ◽  
Sung Won Kwon ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health

scholarly journals Targeting and Impact of National Health Insurance Program in Indonesia

2020 ◽  
Vol 9 (4) ◽  
pp. 468-481
Author(s):  
Galih Putri Yunistria
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Health Insurance ◽  
National Health Insurance ◽  
Logistic Regression Analysis ◽  
National Health ◽  
Health Care Facilities ◽  
National Health Insurance System ◽  
Care Facilities

National Health Insurance System (NHIS) program in Indonesia has been launched since 2014,and government spending to support the program has allocated nearly 40% of MoH budget,especially for the NHIS subsidies. This study examined the distribution of NHIS subsidizedbeneficiaries which associated with the household income distribution, and also studied about theutilization rate of health care facilities among the residents since the NHIS program has introducedto change citizens’ health seeking behaviour from traditional services to health facilities. Using the2016 Susenas data, this study employed the benefit incidence analysis method to measure thedistribution of NHIS-subsidized group, and logistic regression analysis to determine the health careseeking behavior. The result shows that households in higher income (quantile III-V) get benefitfrom government subsidy on NHIS program. It indicated there was a leakage on governmentbudget that not belong to the target (quantile I and II). Then, logistic regression analysis found thatpeople with higher income and having health insurance tend to visit health care facilities morefrequently than lower income group and uninsured people. This can be concluded that healthinsurance ownership is one of the important factors to influence people visiting health carefacilities.

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