Examining the Economic Perspective of Treatable Mortality: The Role of Health Care Financing and the Importance for Economic Prosperity

Health is an essential element of economic life and is therefore considered a source of comparative economic development of countries. The aim of the study was to examine the associations between health care financing, specific treatable mortality of males and females of working age, and economic prosperity, taking into account to the classification of health systems applied in the countries of the Organization for Economic Co-operation and Development (OECD). An insurance-based health system and a tax-based health system were identified in these countries, and data were collected for the period 1994–2016. Descriptive analysis, panel regression analysis and cluster analysis were used to achieve the aim. The analytical process included economic indicators [health expenditure, gross domestic product (GDP)] and health indicators (treatable mortality from circulatory system diseases and endocrine, nutritional and metabolic diseases). The results revealed significant negative associations of health care financing with treatable mortality from circulatory system diseases and endocrine, nutritional, and metabolic diseases in both health systems and both gender categories. There were also negative associations between treatable mortality in both diagnosis groups and economic prosperity. These results have shown that health care financing is linked to economic prosperity also through health variability in the working age population. In terms of assessing economic and health outcomes, less positive and more positive countries were identified using cluster analysis. Countries such as Latvia with a tax-based health system and Hungary, Lithuania, Estonia with an insurance-based health system were characterized by great potential for improvements. Although reducing treatable mortality is a great motivation for public health leaders to increase health care financing, the importance for economic prosperity may be a more compelling argument. Effective interventions should be considered in the light of their regional, social and economic contexts.

Investigating the Biomarkers of the Sasang Constitution via Network Pharmacology Approach

Sasang constitutional (SC) medicine classifies people into Soeum (SE), Soyang (SY), Taeeum (TE), and Taeyang (TY) types based on psychological and physical traits. However, biomarkers of these types are still unclear. We aimed to identify biomarkers among the SC types using network pharmacology methods. Target genes associated with the SC types were identified by grouping herb targets that preserve and strengthen the requisite energy (Bomyeongjiju). The herb targets were obtained by constructing an herb-compound-target network. We identified 371, 185, 146, and 89 target genes and their unique biological processes related to SE, SY, TE, and TY types, respectively. While the targets of SE and SY types were the most similar among the target pairs of the SC types, those of TY type overlapped with only a few other SC-type targets. Moreover, SE, SY, TE, and TY were related to “diseases of the digestive system,” “diseases of the nervous system,” “endocrine, nutritional, and metabolic diseases,” and “congenital malformations, deformations, and chromosomal abnormalities,” respectively. We successfully identified the target genes, biological processes, and diseases related to each SC type. We also demonstrated that a drug-centric approach using network pharmacology analysis provides a deeper understanding of the concept of Sasang constitutional medicine at a phenotypic level.

Multimorbidity among incident Finnish systemic lupus erythematosus patients during 2000–2017

The objective of the study was to examine the risk of other morbidities among patients with systemic lupus erythematosus (SLE). A total of 1006 adult new-onset SLE patients were identified during 1.1.2000- 31.12.2014 from the register of Social Insurance Institution. For each case three general population controls matched according to age, sex and place of residence at the index day were sampled from the population register. Both groups were followed up from the index date until the end of 2017 or until death. The national register on specialized care was explored to gather broadly their 12 organ-specific morbidities, which were found among 91.2% of SLE patients and 66.7% of comparators. The rate ratio (RR) was elevated in almost all disease groups. Musculoskeletal, cardiovascular and genitourinary conditions were the most common comorbidities with RRs of 1.82 (1.68 to 1.97), 1.91 (1.76 to 2.08) and 1.91 (1.73 to 2.09), respectively. Men with SLE had a significantly higher risk for diseases of the genitourinary system and endocrine, nutritional and metabolic diseases compared to women with SLE. The risk of concurrent morbidities is essential to note in the care of SLE patients.

Incidence, Cause of Death, and Survival of Amyloidosis in Korea

BackgroundWe sought to assess incidence and survival for amyloidosis.MethodsWe acquired data from newly diagnosed cases related to amyloidosis from the National Health Insurance Service in Korea from 2006 through 2017 (n=2,233; male 53.5%). We calculated the age-standardized incidence rate, analyzed the survival rate (SR) using the Kaplan-Meier method, and analyzed the death risk using Cox proportional hazards methods.ResultsThe mean age was 57.0 (±16.7) years in males and 56.8 (±15.6) years in females (p=non-significant). The proportion of death was 34.7%. The causes of death were endocrine, nutritional, and metabolic diseases (33.9%), malignant neoplasm (20.8%), diseases of the circulatory system (9.68%), and diseases of the genitourinary system (9.29%). The overall age-standardized incidence rate was 0.47 persons per 100,000 persons in 2017. Overall, the 10-year SR for amyloidosis was 57.7% (55.9% in males and 59.2% in females). Adjusted hazard ratios were 9.16 (95% confidence interval [CI] 2.23, 37.5) among 40-49 year-old, 16.1 (95% CI 4.00, 65.3) among 50-59 year-old, 30.3 (95% CI 7.53, 122.0) among 60-69 year-old, 48.7 (95% CI 12.1, 196.3) among 70-79 year-old, 80.1 (95% CI 19.6, 326.3) among people 80 years or older and 1.21 (95% CI 1.02, 1.44) in the medium-level socioeconomic position group. ConclusionsThe age-standardized incidence rate of amyloidosis was about 0.5 persons per 100,000 persons in 2017. The 10-year SR of amyloidosis was about 58%. The most common cause of death was endocrine, nutritional, and metabolic diseases. The risk of death from amyloidosis increased with age and medium socioeconomic position.

Multimorbidity Analysis of 13 Systemic Diseases in Northeast China

Background: Multimorbidity not only affects the quality of patients’ lives, but can also bring a heavy economic burden to individuals, families and society. The purpose of this study was to reveal the connections between diseases, especially the important role each disease played in the entire multimorbidity network. Methods: A total of 1,155,734 inpatients were enrolled through multistage stratified random sampling in Jilin Province in 2017. Categorical variables were compared using the Rao–Scott-χ2 test. Weighted networks were adopted to present the complex relationships of multimorbidity. Results: The distributions of the number of diseases differed significantly by gender, age and health insurance scheme (P < 0.001). Diseases of the respiratory system had the highest weight in multimorbidity in young people. Endocrine, nutritional and metabolic diseases and circulatory system diseases were often associated with other systemic diseases in middle aged and old people. Conclusions: Multimorbidity with respiratory system diseases in young people should not be overlooked. Additionally, effective prevention efforts that target endocrine, nutritional and metabolic diseases and circulatory system diseases are needed in middle aged and old people.