search for




 

Health Characteristics of Elderly North Korean Defectors: 2006-2016 at National Medical Center
Korean J Clin Geri 2019 Jun;20(1):31-37
Published online June 30, 2019;  https://doi.org/10.15656/kjcg.2019.20.1.31
Copyright © 2019 The Korean Academy of Clinical Geriatrics.

Jong Yun Lee1, Im Seok Koh1, So Hee Lee2, Sung Soo Eun3

1Department of Neurology, National Medical Center, Seoul, Korea; 2Department of Psychiatry, National Medical Center, Seoul, Korea;
3Department of Counseling Psychology, Yongmoon Graduate School of Counseling Psychology, Seoul, Korea
Received October 27, 2018; Revised January 2, 2019; Accepted January 30, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background: The number of North Korean defectors (NKDs) exceeded 30,000 in 2016. Although the majority of NKDs is young adults, the number of elderly NKDs is growing and accounts for 4% of total NKDs in 2016. Little is known about health characteristics of elderly NKDs.
Methods: Using the Korean Standard Classification of Diseases, we categorized health characteristics of elderly NKDs between January 2006 and February 2016 at the National Medical Center.
Results: A total of 4,032 NKDs was observed and 11.4% (516 individuals) was ages of 60 year-old and above. In population of ages of 60 year-old and above, diseases of oesophagus, stomach and duodenum were the most common category (27.7%), followed by categories of headache (18.4%), dorsopathies (16.9%), arthrosis (10.7%), diseases of oral cavity, salivary glands and jaws (14.5%), spondylopathies (14.3%), ischemic heart diseases (10.7%), cerebrovascular diseases (10.1%) and mood disorders (9.3%). Compared to the counterpart of ages of less than 60 year-old, the elderly NKDs population utilized frequent office visits and hospitalizations as well as longer hospital stay per hospitalization (all P<0.001). Highest health expenditures were spent in the subgroup of male and ages of 70 and above than any other subgroups (P<0.001).
Conclusion: The elderly NKDs using the National Medical Center had health burdens of digestive, cardiovascular and musculoskeletal system diseases. Mood disorder burdens were also common. Health expenditures were concentrated in the elderly NKDs, especially, male elderly subgroup.
Keywords : Defector, Elderly health, Electronic medical records, North Korea, Practice pattern
References
  1. Policy on North Korean defectors [Internet]. Ministry of Unification; c2013. [cited 2019 Jan]. Available form: https://www.unikorea.go.kr/eng_unikorea/relations/statistics/defectors/.
  2. Nishiura H, Lee H, Yuan B, Endo A, Akhmetzhanov AR, Chowell G. Infectious disease risks among refugees from North Korea. Int J Infect Dis 2018;66:22-5.
    Pubmed CrossRef
  3. Ann SY, Ryou SH, Kim SB. Clinical characteristics of defectors from North Korea visiting a single tertiary hospital in South Korea. Korean J Med 2015;89:54-63.
    CrossRef
  4. Choi HR, Kim BS, Won CW, Ahn HC. HBsAg and anti-HBs prevalence in North Korean defectors. J Korean Acad Fam Med 1999;20:1778-83.
  5. Lee Y, Lee M, Park S. Mental health status of North Korean refugees in South Korea and risk and protective factors: A 10-year review of the literature. Eur J Psychotraumatol 2017;8 supppl 2:1369833.
    Pubmed KoreaMed CrossRef
  6. Lee Y, Lee MK, Chun KH, Lee YK, Yoon SJ. Trauma experience of North Korean refugees in China. Am J Prev Med 2001;20:225-9.
    Pubmed CrossRef
  7. Shin HY, Lee H, Park SM. Mental health and its associated factors among North Korean defectors living in South Korea. Asia Pac J Public Health 2016;28:592-600.
    Pubmed CrossRef
  8. Jeon BH, Kim MD, Hong SC, Kim NR, Lee CI, Kwak YS, et al. Prevalence and correlates of depressive symptoms among North Korean defectors living in South Korea for more than one year. Psychiatry Investig 2009;6:122-30.
    Pubmed KoreaMed CrossRef
  9. Kim HH, Lee YJ, Kim HK, Kim JE, Kim SJ, Bae SM, et al. Prevalence and correlates of psychiatric symptoms in North Korean defectors. Psychiatry Investig 2011;8:179-85.
    Pubmed KoreaMed CrossRef
  10. Health Insurance Review and Assessment Service, National Health Insurance Service. 2016 national health insurance statistical yearbook. Wonju-si, Gangwon-do: Kim ST, Seong SC;2017.
  11. Korean standard statistical classification [Internet]. Statistics Korea; c1996 [cited 2018 May]. Available form: http://kssc.kostat.go.kr/ksscNew_web/ekssc/main/main.do#.
  12. Yin CS, Ko SG. Introduction to the history and current status of evidence-based Korean medicine: a unique integrated system of allopathic and holistic medicine. Evid Based Complement Alternat Med 2014;2014:740515.
    Pubmed KoreaMed CrossRef
  13. Schafer I, Hansen H, Schon G, Hofels S, Altiner A, Dahlhaus A, et al. The influence of age, gender and socio-economic status on multimorbidity patterns in primary care. First results from the multicare cohort study. BMC Health Serv Res 2012;12:89
    Pubmed KoreaMed CrossRef
  14. Wang BR, Yu S, Noh JW, Kwon YD. Factors associated with self-rated health among North Korean defectors residing in South Korea. BMC Public Health 2014;14:999.
    Pubmed KoreaMed CrossRef
  15. Jeon W, Hong C, Lee C, Kim DK, Han M, Min S. Correlation between traumatic events and posttraumatic stress disorder among North Korean defectors in South Korea. J Trauma Stress 2005;18:147-54.
    Pubmed CrossRef
  16. Ahn JH, Kim WH, Choi HJ, Jeon JY, Song IG, Bae JN. Stigma of mental illnesses as perceived by North Korean defectors living in South Korea. Psychiatry Investig 2015;12:9-15.
    Pubmed KoreaMed CrossRef
  17. Kim SJ, Park YS, Lee H, Park SM. Current situation of psychiatry in North Korean: from the viewpoint of North Korean medical doctors. Korean J Psychosom Med 2012;20:32-9.
    CrossRef
  18. Amnesty International. The crumbling state of health care in North Korea. London: Amnesty International Publication;2010.
  19. World Health Organization. Noncommunicable disease country profiles: Democratic people’s republic of Korea. Published 2014. [cited 2018 May]. Available form: http://www.who.int/entity/nmh/countries/prk_en.pdf?ua=1.
  20. Korean national health and nutrition examination survey [Internet]. Korean Centers for Disease Control and Prevention. [cited 2018 May]. Available form: https://knhanes.cdc.go.kr/knhanes/eng/index.do.
  21. World Health Organization. Noncommunicable disease country profiles: Republic of Korea. Published 2014. [cited 2017 May]. Available form: http://www.who.int/entity/nmh/countries/kor_en.pdf?ua=1.
  22. Cancer statistics [Internet]. National Cancer Information Center;c2017. [cited 2018 May]. Available form: https://www.cancer.go.kr/lay1/S1T654C655/contents.do.
  23. Park JH, Kim E, Chung IY, Park S, Park J, Youn Y, et al. Clinicopathologic characteristics of cancer of North Korean defectors. Korean J Clin Onco 2014;10:73-7.
    CrossRef
  24. Cole MG, Dendukuri N. Risk factors for depression among elderly community subjects: A systematic review and metaanalysis. Am J Psychiatry 2003;160:1147-56.
    Pubmed CrossRef
  25. Park JH, Lee JJ, Lee SB, Huh Y, Choi EA, Youn JC, et al. Prevalence of major depressive disorder and minor depressive disorder in an elderly Korean population: Results from the Korean longitudinal study on health and sging (KLoSHA). J Affect Disord 2010;125:234-40.
    Pubmed CrossRef
  26. Lee E. Impact of aging on elderly health care expenditure in Korea. Korea institue of public finance: Cho WD.; 2011.
  27. North Korean refugees protection and settlement support act [Internet]. Korea Legislation Research Institute; c2017. [cited 2018 May]. Available form: http://elaw.klri.re.kr/eng_service/lawView.do?hseq=40094&lang=ENG.
  28. Choi JP. The integration process of North Korean defector physicians into the South Korean medical system. J Korean Med Assoc 2013;56:383-8.
    CrossRef
  29. Jeon WT, Eom JS, Min SK. A 7-year follow-up study on the mental health of North Korean defectors in South Korea. J Trauma Stress 2013;26:158-64.
    Pubmed CrossRef
  30. Park K, Cho Y, Yoon IJ. Social inclusion and length of stay as determinants of health among North Korean refugees in South Korea. Int J Public Health 2009;54:175-82.
    Pubmed CrossRef

 

June 2019, 20 (1)