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Published on: December 15, 2023
Nationwide Data on the Characteristics of Linked-to-Care Chronic Hepatitis B in Korea
Young Cheol Ju1, Dae Won Jun1,2, Eileen L Yoon2
1Department of Translational Medicine, Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul 04763, Korea.
Insights
Only 35.8% of chronic hepatitis B (CHB) patients in Korea linked to care, with lower rates in men and younger adults. Targeted interventions are needed for males in urban areas to improve CHB care linkage.
Area of Science:
- Hepatology
- Public Health
- Epidemiology
Background:
- Linkage-to-care rates for chronic hepatitis B (CHB) are not well understood.
- Effective CHB management requires timely linkage to ongoing medical care.
- Understanding patient characteristics associated with linkage is crucial for public health interventions.
Purpose of the Study:
- To determine the proportion and characteristics of CHB patients linked to care in Korea.
- To identify demographic and geographic factors influencing linkage-to-care rates.
- To analyze the long-term outcomes of CHB patients who are linked to care.
Main Methods:
- Retrospective analysis of Korean National Health Insurance Service claims data (2002-2018).
- Inclusion criteria: CHB patients with at least two diagnostic visits between 2002-2006, without prior malignancy.
- Follow-up until 2018 to assess linkage status and outcomes.
Main Results:
- A total of 553,085 CHB patients were analyzed, with a linkage-to-care rate of 35.8%.
- Linkage rates were lower in men (35.7%) vs. women (36.0%) and lowest in the 20s age group (29.4%).
- Higher linkage rates were observed in rural areas compared to metropolitan areas (p < 0.0001).
Conclusions:
- Two-thirds of CHB patients in Korea are not linked to care, highlighting a significant public health gap.
- Interventions should target males, urban dwellers, and individuals not in life transition periods to improve CHB care linkage.
- Linked CHB patients had a 15-year cumulative incidence of hepatocellular carcinoma of 18.2% and overall survival of 93.8%.
Abstract:
Linkage-to-care rate of chronic hepatitis B (CHB) is less well characterized. We aimed to evaluate the proportion, characteristics of CHB patients who are linked to care. We retrospectively analyzed insurance reimbursement claims data provided by the Korean National Health Insurance Service. CHB patients who had at least two clinic or hospital visits that were associated with a CHB diagnostic code during 2002-2006 were included. Those without a history of malignancy at baseline were followed up until 2018. Mean follow-up period was 14.5 ± 2.9 years. Among the participants, 553,085 patients (35.8%) were found to be linked to care. The rates were lower in men than women (35.7% vs. 36.0%, p = 0.006). By age, it was highest for the 40's age group at 44.8% and lowest at 29.4% for the 20's age group (All p < 0.0001). The linkage-to-care rate was higher in rural area than metropolitan area (p < 0.0001). The 15-year cumulative incidence of hepatocellular carcinoma and overall survival rates among linked-to-care CHB patients were 18.2% and 93.8%, respectively. Two thirds of CHB patients were not linked to care. Those who are male, dwelling in metropolitan areas, and not in life transition periods need to be targeted to improve the linkage-to-care rate in Korea.
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