The current study investigated the prevalence rates of eating disorders and patients’ use of medical care between 2010 and 2015, in addition to evaluating the economic burden of eating disorders in Korea in 2015.
The results of this study showed that the prevalence rates of eating disorders tended to increase from 2010 to 2013 and then decreased slightly from 2014 to 2015 (Table 1 and Figure 1). The medical expenditure of eating disorders consistently increased from USD 1 229 724 in 2010 to USD 1 843 706 in 2015. Cases of bulimia nervosa increased from 2010 to 2015. In addition, a gender differential was observed in the economic burden of eating disorders from 2010 to 2015; the discrepancy was higher in female patients than in to male patients.
Table 1. Prevalence of eating disorders in Korea from 2010 to 2015 by gender (per 100 000).
|
Eating disorders Number of patients Prevalence
|
Anorexia nervosa
Number of patients Prevalence
|
Bulimia nervosa
Number of patients Prevalence
|
Other eating disorders
Number of patients Prevalence
|
Medical expenditure of eating disorders
|
Year
|
Sub total
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Male
|
Female
|
Total cost
|
|
2010
|
6 074
|
1 010
|
5 064
|
1 511
|
376
|
1 135
|
1 399
|
72
|
1 327
|
3 366
|
572
|
2 794
|
131 770
|
1 097 954
|
1 229 724
|
|
|
12.02
|
3.99
|
20.09
|
2.99
|
1.49
|
4.50
|
2.77
|
0.28
|
5.26
|
6.66
|
2.26
|
11.08
|
|
|
|
|
2011
|
6 694
|
1 070
|
5 624
|
1 570
|
405
|
1 165
|
1 440
|
74
|
1 366
|
3 888
|
607
|
3 281
|
135 824
|
1 298 591
|
1 434 415
|
|
|
13.19
|
4.21
|
22.21
|
3.09
|
1.59
|
4.60
|
2.84
|
0.29
|
5.39
|
7.66
|
2.39
|
12.95
|
|
|
|
|
2012
|
7 052
|
1 187
|
5 865
|
1 534
|
369
|
1 165
|
1 600
|
92
|
1 508
|
4 151
|
754
|
3 397
|
155 809
|
1 314 500
|
1 470 310
|
|
|
13.84
|
4.65
|
23.05
|
3.01
|
1.45
|
4.58
|
3.14
|
0.36
|
5.93
|
8.15
|
2.96
|
13.35
|
|
|
|
|
2013
|
7 388
|
1 301
|
6 087
|
1 905
|
478
|
1 427
|
1 597
|
111
|
1 486
|
4 099
|
727
|
3 372
|
123 037
|
1 506 356
|
1 629 394
|
|
|
14.45
|
5.08
|
23.82
|
3.72
|
1.87
|
5.58
|
3.12
|
0.43
|
5.82
|
8.02
|
2.84
|
13.20
|
|
|
|
|
2014
|
7 364
|
1 204
|
6 160
|
1 793
|
457
|
1 336
|
1 681
|
93
|
1 588
|
4 110
|
680
|
3 430
|
175 329
|
1 631 515
|
1 806 843
|
|
|
14.35
|
4.69
|
24.01
|
3.49
|
1.78
|
5.21
|
3.28
|
0.36
|
6.19
|
8.01
|
2.65
|
13.37
|
|
|
|
|
2015
|
6 845
|
1 129
|
5 716
|
1 604
|
397
|
1 207
|
1 832
|
123
|
1 709
|
3 614
|
630
|
2 984
|
138 939
|
1 704 767
|
1 843 706
|
|
|
13.28
|
4.38
|
22.18
|
3.11
|
1.54
|
4.68
|
3.56
|
0.48
|
6.63
|
7.01
|
2.45
|
11.58
|
|
|
|
|
Note. Data sources from Healthcare Bigdata Hub (https://opendata.hira.or.kr/) and Korean Statistical Information Service (KOSIS); size of population = 50,515,666 (female 25 205 281; 2010); 50 734 284 (female 25 327 350; 2011); 50 948 272 (female 25 444 212; 2012); 51 141 463 (female 25 553 127; 2013); 51 327 916 (female 25 658 620; 2014); 51 529 338 (female 25 771 152; 2015); Exchange rate US dollar: 1 Korean won = 1 132 US dollar (2015); 1 053 (2014); 1 095 (2013); 1 127 (2012); 1 108 (2011); 1 156 (2010); from the Bank of Korea (http://ecos.bok.or.kr/).
Table 2 shows the medical care use of eating disorders, including anorexia nervosa, bulimia nervosa, and OED, from 2010 to 2015. There was an inconsistent increase in the number of outpatient visits of patients afflicted with different types of eating disorders. The number of inpatient admissions decreased for patients with bulimia nervosa but increased in the cases with anorexia nervosa and OED. Hospitalization days per patient inconsistently decreased in anorexia nervosa and bulimia nervosa, but increased in OED.
Table 2. Patient’s medical care use for eating disorders from 2010 to 2015.
Year
|
Eating disorders
|
Anorexia nervosa
|
Bulimia nervosa
|
Other eating disorders
|
|
Number of outpatient visits (per patient)
|
Number of inpatient admissions (per patient)
|
Hospitalization days (per patient)
|
Number of outpatient visits (per patient)
|
Number of inpatient admissions (per patient)
|
Hospitalization days (per patient)
|
Number of outpatient visits (per patient)
|
Number of inpatient admissions (per patient)
|
Hospitalization days (per patient)
|
Number of outpatient visits (per patient)
|
Number of inpatient admissions (per patient)
|
Hospitalization days (per patient)
|
2010
|
3.27
|
1.72
|
31.16
|
2.43
|
1.51
|
28.32
|
4.03
|
1.67
|
37.62
|
3.19
|
1.33
|
17.76
|
2011
|
3.07
|
1.80
|
30.40
|
2.30
|
1.93
|
34.26
|
4.20
|
1.77
|
32.95
|
2.92
|
1.13
|
14.65
|
2012
|
3.54
|
1.79
|
30.48
|
2.73
|
1.97
|
35.17
|
4.57
|
1.63
|
29.07
|
3.25
|
1.24
|
17.58
|
2013
|
3.49
|
1.82
|
29.83
|
2.49
|
1.90
|
35.11
|
4.44
|
1.78
|
22.76
|
3.42
|
1.40
|
17.97
|
2014
|
3.51
|
1.71
|
28.69
|
2.71
|
1.65
|
29.42
|
4.16
|
1.66
|
25.78
|
3.15
|
1.34
|
17.14
|
2015
|
3.86
|
1.65
|
27.01
|
2.86
|
1.62
|
27.26
|
4.52
|
1.63
|
28.25
|
3.40
|
1.47
|
22.05
|
Note. Data source from Healthcare Bigdata Hub (https://opendata.hira.or.kr/).
Table 3 shows the economic burden of eating disorders including anorexia nervosa, bulimia nervosa, and OED by gender in 2015. The economic cost of eating disorders was 5 455 626 USD. Total costs were approximately 6 times higher in female patients than male patients. Direct costs were higher than indirect costs-2 in all types of eating disorders. OED were the highest contributor to the economic burden among anorexia nervosa, bulimia nervosa, and OED.
Table 3 Economic cost of eating disorders in 2015.
|
Eating disorders
|
Anorexia nervosa
|
Bulimia nervosa
|
Other eating disorders
|
Classification
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
Direct costs
|
|
|
|
|
|
|
|
|
|
|
|
|
Direct medical costs
|
246 792
|
2 572 075
|
2 818 867
|
91 585
|
1 037 569
|
1 129 154
|
31 420
|
737 817
|
769 237
|
123 786
|
796 690
|
920 476
|
Direct non-medical costs
|
|
|
|
|
|
|
|
|
|
|
|
|
Transportation cost for hospital visits
|
11 492
|
84 283
|
95 776
|
4 402
|
20 806
|
25 208
|
1 275
|
27 047
|
28 322
|
5 815
|
36 430
|
42 245
|
Caregiver cost
|
79 798
|
405 167
|
484 965
|
44 865
|
213 194
|
258 059
|
5 964
|
67 603
|
73 568
|
28 969
|
124 370
|
153 339
|
Total direct costs
|
338 082
|
3 061 526
|
3 399 608
|
140 852
|
1 271 569
|
1 412 421
|
38 660
|
832 467
|
871 127
|
158 570
|
957 490
|
1 116 060
|
Indirect costs-2
|
453 177
|
1 602 841
|
2 056 018
|
132 185
|
353 510
|
485 694
|
18 772
|
328 218
|
346 991
|
302 220
|
921 113
|
1 223 333
|
Total costs
|
791 259
|
4 664 367
|
5 455 626
|
273 037
|
1 625 078
|
1 898 115
|
57 432
|
1 160 686
|
1 218 118
|
460 790
|
1 878 602
|
2 339 393
|
Note. Exchange rate US dollar: 1 Korean won = 1 132 US dollar from the Bank of Korea (http://ecos.bok.or.kr/); For indirect costs-2, productivity loss from the absence from work due to hospital admission and outpatient visits were included.
Table 4 shows the results of the sensitivity analysis for the economic burden of eating disorders in 2015. OED were the highest contributor to the economic burden and females were a higher contributor to the economic burden than males in indirect costs-1.
Table 4. Sensitivity analysis of indirect costs for economic cost of eating disorders in 2015.
|
Eating disorders
|
Anorexia nervosa
|
Bulimia nervosa
|
Other eating disorders
|
Classification
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
Indirect costs-1
|
920 012
|
3 064 617
|
3 984 629
|
157 353
|
638 689
|
796 043
|
24 599
|
552 534
|
577 132
|
738 060
|
1 873 394
|
2 611 454
|
Note. Indirect costs-1 is different from indirect costs-2. Indirect costs-1 was estimated for the purpose of sensitivity analysis without the employment-to-population ratio (i.e., proportion of the population employed). Indirect costs-1 was not included in the total costs.
Table 5 and Figures 2 and 3 show the economic burden of eating disorders in Korea in 2015 by age and gender. The economic burden of eating disorders was higher in patients aged between 20 years and 29 years than other age ranges. Anorexia nervosa was higher in patients aged between 10 years and 19 years than other age ranges. Bulimia nervosa was higher in patients aged between 20 years and 29 years than other age ranges. OED were higher in patients aged 50 years and 59 years than other age ranges. In general, female patients showed higher economic burden than male patients. In addition, younger generations showed a higher economic burden than older generations, except for in the case of OED.
Table 5 Economic cost of disease due to eating disorders in Korea in 2015 by age group.
|
Eating disorders
|
Anorexia nervosa
|
Bulimia nervosa
|
Other eating disorders
|
Direct cost
|
Indirect cost
|
Direct cost
|
Indirect cost
|
Direct cost
|
Indirect cost
|
Direct cost
|
Indirect cost
|
Age range
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
Male
|
Female
|
Sub total
|
|
0-9
|
29 659
|
41 561
|
71 220
|
-
|
-
|
-
|
16 507
|
20 429
|
36 936
|
-
|
-
|
-
|
-
|
1 253
|
1 253
|
-
|
-
|
-
|
13 152
|
19 879
|
33 031
|
-
|
-
|
-
|
|
10-19
|
58 076
|
766 065
|
824 141
|
-
|
-
|
-
|
29 904
|
507 441
|
537 345
|
-
|
-
|
-
|
15 145
|
130 128
|
145 273
|
-
|
-
|
-
|
13 027
|
128 496
|
141 523
|
-
|
-
|
-
|
|
20-29
|
59 903
|
913 172
|
973 075
|
22 652
|
390 672
|
413 324
|
12 388
|
274 955
|
287 343
|
5 134
|
126 763
|
131 897
|
13 288
|
388 018
|
401 306
|
5 231
|
152 803
|
158 034
|
34 227
|
250 199
|
284 427
|
12 287
|
111 105
|
123 392
|
|
30-39
|
42 248
|
688 260
|
730 507
|
126 348
|
427 966
|
554 314
|
26 783
|
237 700
|
264 483
|
105 300
|
166 309
|
271 609
|
6 174
|
198 800
|
204 974
|
8 619
|
106 144
|
114 763
|
9 290
|
251 760
|
261 050
|
12 429
|
155 513
|
167 941
|
|
40-49
|
16 621
|
293 279
|
309 900
|
30 714
|
200 841
|
231 555
|
4 100
|
118 678
|
122 778
|
7 081
|
42 819
|
49 901
|
2 130
|
75 690
|
77 820
|
3 705
|
56 011
|
59 716
|
10 391
|
98 911
|
109 302
|
19 927
|
102 011
|
121 938
|
|
50-59
|
16 330
|
89 894
|
106 224
|
23 474
|
574 452
|
597 925
|
7 170
|
25 813
|
32 984
|
10 143
|
13 574
|
23 717
|
286
|
25 356
|
25 641
|
1 014
|
12 263
|
13 277
|
8 874
|
38 725
|
47 599
|
12 317
|
548 614
|
560 931
|
|
60-69
|
27 404
|
34 994
|
62 398
|
240 666
|
4 301
|
244 967
|
5 041
|
10 934
|
15 975
|
1 894
|
1 321
|
3 215
|
19
|
8 126
|
8 145
|
27
|
892
|
919
|
22 344
|
15 934
|
38 278
|
238 745
|
2 088
|
240 833
|
|
70-79
|
47 007
|
98 324
|
145 331
|
4 483
|
3 213
|
7 697
|
24 946
|
45 507
|
70 453
|
2 544
|
1 555
|
4 099
|
1 618
|
4 200
|
5 818
|
176
|
103
|
279
|
20 444
|
48 617
|
69 061
|
1 764
|
1 555
|
3 319
|
|
80-89
|
40 834
|
135 978
|
176 812
|
4 840
|
1 395
|
6 236
|
14 013
|
30 113
|
44 125
|
88
|
1 167
|
1 255
|
-
|
897
|
897
|
-
|
1
|
1
|
26 821
|
104 968
|
131 790
|
4 752
|
227
|
4 979
|
|
Total
|
338 082
|
3 061 526
|
3 399 608
|
453 177
|
1 602 841
|
2 056 018
|
140 852
|
1 271 569
|
1 412 421
|
132 185
|
353 510
|
485 694
|
38 660
|
832 467
|
871 127
|
18 772
|
328 218
|
346 991
|
158 570
|
957 490
|
1 116 060
|
302 220
|
921 113
|
1 223 333
|
|
Note. Exchange rate US dollar: 1 Korean won = 1 132 US dollar from the Bank of Korea (http://ecos.bok.or.kr/).