Showing papers by "Myoung-Hee Kim published in 2020"

Estimation of the number of working population at high-risk of COVID-19 infection in Korea.

Abstract: OBJECTIVES: We aimed to identify occupational groups at high risk of COVID-19 infection, estimate the number of such workers, and examine the prevalence of protective resources by employment status in Korea METHODS: Based on the 6th Standard Occupational Classification codes, the 2015 census data was linked with the 5th Korean Working Conditions Survey data, which measures how frequently workers directly contact with people other than fellow employees in the workplace RESULTS: A total of 30 occupational groups, including seven occupations from healthcare and welfare sectors and 23 from other sectors, are classified as high-risk occupational groups to have frequent contact with people other than fellow employees in the workplace (more than half of the working hours) Approximately 1 4 million (women, 79 1%) and 10 7 million workers (46 3%) are employed respectively in the high-risk occupations of healthcare and welfare and other sectors Occupations with a larger share of women are more likely to be at higher risk of infection and paid less Among the wage-earners in the high-risk occupations, protective resources to deal with COVID-19 such as trade union and health and safety committee are less prevalent in temporary or daily workers than those in permanent employment CONCLUSION: Given the large number of Korean workforces employed in high-risk occupations and inequality within the working population, the workplace needs to be the key locus for the governments' action to control the COVID-19, and special consideration for vulnerable workers should be warranted

Recalibration and validation of the Charlson Comorbidity Index in an Asian population: the National Health Insurance Service-National Sample Cohort study.

Abstract: Weights assigned to comorbidities in predicting mortality may vary based on the type of index disease and advances in the management of comorbidities. We aimed to develop a modified version of the Charlson Comorbidity Index (CCI) using an Asian nationwide database (mCCI-A), enabling the precise prediction of mortality rates in this population. The main data source used in this study was the National Health Insurance Service-National Sample Cohort (NHIS-NSC) obtained from the National Health Insurance database, which includes health insurance claims filed between January 1, 2002, and December 31, 2013, in Korea. Of the 1,025,340 individuals included in the NHIS-NSC, 570,716 patients who were hospitalized at least once were analyzed in this study. In total, 399,502 patients, accounting for 70% of the cohort, were assigned to the development cohort, and the remaining patients (n = 171,214) were assigned to the validation cohort. The mCCI-A scores were calculated by summing the weights assigned to individual comorbidities according to their relative prognostic significance determined by a multivariate Cox proportional hazard model. The modified index was validated in the same cohort. The Cox proportional hazard model provided reassigned severity weights for 17 comorbidities that significantly predicted mortality. Both the CCI and mCCI-A were correlated with mortality. However, compared with the CCI, the mCCI-A showed modest but significant increases in the c statistics. According to the analyses using continuous net reclassification improvement, the mCCI-A improved the net mortality risk reclassification by 44.0% (95% confidence intervals (CI), 41.6–46.5; p < 0.001). The mCCI-A facilitates better risk stratification of mortality rates in Korean inpatients than the CCI, suggesting that the mCCI-A may be a preferable index for use in clinical practice and statistical analyses in epidemiological studies.