Estimating the Burden of Irritable Bowel Syndrome: Analysis of a Nationwide Korean Database

BACKGROUND/AIMS: Management of irritable bowel syndrome (IBS) imposes a heavy economic burden. This study was to estimate the epidemiologic features of IBS and to report the IBS burden for the first time in the Korean population. METHODS: A cross-sectional study was conducted using the National Health Insurance (NHI) system database, which covers the entire population of Korea. IBS was defined as diagnostic code -10 in adults with any outpatient clinic visits or hospitalization related to IBS. We excluded diseases that mimic IBS symptoms. RESULTS: A total of 2.42 million (58.2% female) individuals were identified as patients with IBS, yielding an age- and gender-adjusted prevalence of 5.1% in males and 6.9% in females. The prevalence of IBS increased proportionally with age, with higher medical costs in middle-aged patients. Outpatient clinics were visited by 98.6% of IBS patients, and 1.9% were treated upon admission. Of these patients, 87.6% were given a prescription. Co-morbidities that commonly accompanied IBS included upper gastrointestinal (36.1%), respiratory (12.3%), musculoskeletal (8.0%) disease, somatoform (4.3%) and depression/anxiety disorders (3.1%). The NHI costs of IBS, which include the NHI covered cost and beneficiary copayment charges, were estimated to be 155 million USD, which accounts for 0.46% of the total NHI costs for the entire Korean population. CONCLUSIONS: According to the Korean national claims database, about 6% of the Korean population seeks medical care for IBS at least once per year. This high prevalence places a large economic burden on the Korean healthcare system, accounting for 0.46% of overall national medical expenditure.

Health Care Costs of Digestive Diseases in Korea / 대한소화기학회지

BACKGROUND/AIMS: Gastrointestinal (GI) diseases impose a heavy economic burden. We aimed to provide the first report on the health care utilization and costs of GI diseases in Korea. METHODS: We collected the data from all insurance claims database of National Health Insurance Corporation in Korea and the cause of death database in 2007 of Korea National Statistical Office. We compiled information about all digestive disease as a primary diagnosis on clinic visits, hospitalization, and cause of death from these databases. RESULTS: Seventeen million people (35.6%) had a diagnosis of GI diseases during the year 2007. Among them, the proportion of patients with upper GI diseases was prevalent in 54.9% (9.5 million patients/year). The 1/4 patients in out-patients clinic had any one of gastroesophageal reflux disease, irritable bowel syndrome and constipation. Thirteen percent of the total direct cost in 2007 was attributed to all GI diseases, which was 3,649 billion won (0.4% of GDP). The patients with hospitalization occupied by 5% of all patients with GI diseases, however, attributed to 58.9% of GI-related direct costs. GI malignancy was the major cause of medical expenses in hospitalization. Stomach cancer continues to be the leading cause of GI-related death in Korea. CONCLUSIONS: GI diseases causes a heavy socioeconomic burden with high morbidity of functional GI disorders in outpatients care and high mortality of GI malignancy in inpatient care. This report highlights the healthcare utilization burden of GI diseases for researchers and public health policy maker to create new directions of integrated researches and health care plan.

Effect of Job Stress and Coping Strategy on Job Satisfaction in a Hospital Works / 대한산업의학회지

OBJECTIVE: The purpose of this study was to find out the effect of job stress, and the coping strategy of hospital workers on job satisfaction. METHODS: 468 self-administered questionnaires, were obtained from 120 doctors, 194 nurses, 45pharmacists and 109 administrators at a university hospital located in Seoul. The sociodemographic characteristics, personality types, degree of social support, job stresses, coping strategies, and job satisfaction were all assessed from the questionnaires. RESULTS: The analysis of job stress, according to occupation, showed that the most important job-related stress-inducing factors were: for doctors, role overload, and poor advancement opportunity; for nurses, role overload, and career development and wages; for pharmacists, role overload and lack of recognition from other health professionals; and for administrators, career development and wages, and organizational inefficiency. Job satisfaction had a significant positive correlation with control strategy, and a negative correlation with role ambiguity, career development and wages, personal relationship, role overload, and symptom management strategy. Job satisfaction was significantly influenced by control strategy, occupation, role ambiguity, person with an 'A' type personality and gender, from a multiple regression analysis. CONCLUSION: The results of this study suggested that to increase the job satisfaction for hospital workers, they need to be encouraged to use control strategies; create a supportive hospital atmospheres for social supports; re-evaluation, structuring and a new job design are all required to reduce role ambiguity.