"The COVID-19 fatality rate for medical benefits is 5.8 times higher, and the mortality rate is 4.7 times higher."
Jul 30, 2024
A research team led by Professor Lee Hye-jin of the Department of Family Medicine at Seoul National University Bundang Hospital (Professor Lee Jin-yong of Seoul National University Hospital's Public Medical Center, Nam Hyun-woo of Seoul National University College of Medicine) has released the results of a study to investigate the gap according to social and economic conditions and identify risk factors for hospitalization and death during the COVID-19 pandemic.
According to the research team's paper 'Worsening of Health Disparities cross COVID-19 pandemic stages in Korea' published in 'Epidemiology & Health', medical benefit recipients had a lower incidence of COVID-19 than those with higher incomes, but hospitalization, mortality, and fatality rates were higher, and these differences widened toward the second half of the epidemic. Medical benefits are a system in which the state provides medical services to vulnerable groups such as recipients of the National Basic Livelihood Security.
The study was conducted using the big data of the National Health Insurance Corporation of 51,984,158 people from January 1, 2020 to December 31, 2022.
According to the change in the government's quarantine policy, the research team divided the ▲1 period (2020.1.1.2.28), ▲2 period (2021.3.1.-2021.10.31), ▲3 period (2021.11.1.-2022.5.31) and investigated the incidence, hospitalization, mortality, and fatality of COVID-19 by period.
As a result of the study, a total of 21,105,865 people (40.6% and 40,601 per 100,000) were infected more than once, and most of them occurred in the third and fourth periods (24,457 per 100,000) (17,529 per 100,000). The total number of deaths was 54,638 (0.11%, 105 per 100,000) and the fatality rate was 259 per 100,000. The mortality rate was higher in the second half of the year, with 65 deaths per 100,000 in the third and 35 deaths per 100,000 in the fourth, but the fatality rate was higher in the first half, with 1,800 deaths per 100,000 in the first half and 593 deaths per 100,000 in the second.
The incidence of COVID-19 was slightly lower for those eligible for medical benefits and health insurance, but the hospitalization rate was about 2.6 times higher, the mortality rate was about 4.7 times higher, and the fatality rate was about 5.8 times higher, and the gap widened toward the second half.
The incidence of COVID-19 among those eligible for medical benefits during the entire period was 32,737 per 100,000, lower than the average (40.601 per 100,000). However, while the average number of medical benefits occurred at 186 per 100,000 people in the first period, 328 per 100,000 people were eligible for medical benefits, and the incidence rate at that time was somewhat higher for those eligible for medical benefits. The hospitalization rate was 5,663 per 100,000 people, higher than the average (2,106 per 100,000) of those eligible for medical benefits, and 3,628 per 100,000 people in the third period. The mortality rate was higher on average (105 per 100,000) than the average (498 per 100,000) of medical benefits recipients, especially at 335 per 100,000 in the third period, higher than the average (65 per 100,000). The fatality rate was also significantly higher than the average (259 per 100,000) of medical benefits recipients per 100,000, and it was 5,374 per 100,000 in the first period, a significant difference from the average (1800 per 100,000).
In addition, the research team conducted a logistic regression analysis to confirm the relationship between socio-economic conditions and hospitalization and death from COVID-19. As a result of the analysis, it was confirmed that the risk of hospitalization and death was low in low economic levels, disability, comorbidities, men, the elderly, and non-metropolitan residents outside Seoul and metropolitan cities, and low in vaccination.
The risk of hospitalization for those eligible for medical benefits was 2.55 times higher than for health insurance subscribers, and 1.85 times higher for those with disabilities. Vaccination lowered the risk of hospitalization by 0.4 times. The risk of death was 1.92 times higher for those eligible for medical benefits and 1.65 times higher for those with disabilities.
Lee Jin-yong, professor at Seoul National University Hospital's Public Medical Center, the corresponding author, said "This study is meaningful in that it encompasses the health effects of COVID-19 in Korea, which have been analyzed fragmentarily. In the future, when there are various health crisis situations, a better response will be possible based on the lessons learned from the COVID-19 period."
Professor Lee Hye-jin of the Department of Family Medicine at Seoul National University Bundang Hospital, the first author of the paper, said "Korea has maintained a low fatality rate of COVID-19 at all income levels compared to other countries. But in detail, vulnerable groups, such as low-income families and people with disabilities, were more vulnerable to COVID-19, and the gap widened as the pandemic progressed. In the future, it is necessary to establish a response strategy and social safety net to prevent vulnerable groups from experiencing health inequality in the event of an infectious disease epidemic," he added.
According to the research team's paper 'Worsening of Health Disparities cross COVID-19 pandemic stages in Korea' published in 'Epidemiology & Health', medical benefit recipients had a lower incidence of COVID-19 than those with higher incomes, but hospitalization, mortality, and fatality rates were higher, and these differences widened toward the second half of the epidemic. Medical benefits are a system in which the state provides medical services to vulnerable groups such as recipients of the National Basic Livelihood Security.
The study was conducted using the big data of the National Health Insurance Corporation of 51,984,158 people from January 1, 2020 to December 31, 2022.
According to the change in the government's quarantine policy, the research team divided the ▲1 period (2020.1.1.2.28), ▲2 period (2021.3.1.-2021.10.31), ▲3 period (2021.11.1.-2022.5.31) and investigated the incidence, hospitalization, mortality, and fatality of COVID-19 by period.
As a result of the study, a total of 21,105,865 people (40.6% and 40,601 per 100,000) were infected more than once, and most of them occurred in the third and fourth periods (24,457 per 100,000) (17,529 per 100,000). The total number of deaths was 54,638 (0.11%, 105 per 100,000) and the fatality rate was 259 per 100,000. The mortality rate was higher in the second half of the year, with 65 deaths per 100,000 in the third and 35 deaths per 100,000 in the fourth, but the fatality rate was higher in the first half, with 1,800 deaths per 100,000 in the first half and 593 deaths per 100,000 in the second.
The incidence of COVID-19 was slightly lower for those eligible for medical benefits and health insurance, but the hospitalization rate was about 2.6 times higher, the mortality rate was about 4.7 times higher, and the fatality rate was about 5.8 times higher, and the gap widened toward the second half.
The incidence of COVID-19 among those eligible for medical benefits during the entire period was 32,737 per 100,000, lower than the average (40.601 per 100,000). However, while the average number of medical benefits occurred at 186 per 100,000 people in the first period, 328 per 100,000 people were eligible for medical benefits, and the incidence rate at that time was somewhat higher for those eligible for medical benefits. The hospitalization rate was 5,663 per 100,000 people, higher than the average (2,106 per 100,000) of those eligible for medical benefits, and 3,628 per 100,000 people in the third period. The mortality rate was higher on average (105 per 100,000) than the average (498 per 100,000) of medical benefits recipients, especially at 335 per 100,000 in the third period, higher than the average (65 per 100,000). The fatality rate was also significantly higher than the average (259 per 100,000) of medical benefits recipients per 100,000, and it was 5,374 per 100,000 in the first period, a significant difference from the average (1800 per 100,000).
In addition, the research team conducted a logistic regression analysis to confirm the relationship between socio-economic conditions and hospitalization and death from COVID-19. As a result of the analysis, it was confirmed that the risk of hospitalization and death was low in low economic levels, disability, comorbidities, men, the elderly, and non-metropolitan residents outside Seoul and metropolitan cities, and low in vaccination.
The risk of hospitalization for those eligible for medical benefits was 2.55 times higher than for health insurance subscribers, and 1.85 times higher for those with disabilities. Vaccination lowered the risk of hospitalization by 0.4 times. The risk of death was 1.92 times higher for those eligible for medical benefits and 1.65 times higher for those with disabilities.
Lee Jin-yong, professor at Seoul National University Hospital's Public Medical Center, the corresponding author, said "This study is meaningful in that it encompasses the health effects of COVID-19 in Korea, which have been analyzed fragmentarily. In the future, when there are various health crisis situations, a better response will be possible based on the lessons learned from the COVID-19 period."
Professor Lee Hye-jin of the Department of Family Medicine at Seoul National University Bundang Hospital, the first author of the paper, said "Korea has maintained a low fatality rate of COVID-19 at all income levels compared to other countries. But in detail, vulnerable groups, such as low-income families and people with disabilities, were more vulnerable to COVID-19, and the gap widened as the pandemic progressed. In the future, it is necessary to establish a response strategy and social safety net to prevent vulnerable groups from experiencing health inequality in the event of an infectious disease epidemic," he added.
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