Boram Sim, Hyun Joo Kim
Pediatric endocrine care burden increased despite a declining pediatric population, with condition-specific post-2020 patterns. Continued surveillance is needed to monitor emerging trends and potential care gaps.
OBJECTIVES: This study examined national trends in diagnosed patient counts, claims-based annual prevalence, and healthcare expenditures for pediatric diabetes, obesity, and precocious puberty in South Korea from 2017 to 2023 using National Health Insurance (NHI) claims data.
METHODS: Aggregated Health Insurance Review and Assessment Service claims data for individuals aged 0-19 years with a primary diagnosis of diabetes (E10-E14), obesity (E66), or precocious puberty (E30.1) were included. Diagnosed patient counts, claims-based annual prevalence, and expenditures were calculated for each condition. Exploratory segmented negative binomial regression assessed changes around 2020.
RESULTS: Diagnosed patient counts increased for diabetes (12,839 to 16,747), obesity (2,253 to 3,468), and precocious puberty (106,238 to 206,251); among males aged 5-9 years with precocious puberty, counts increased 5.5-fold. Claims-based annual prevalence increased for diabetes (0.13% to 0.21%) and precocious puberty (1.11% to 2.60%), whereas obesity peaked at 0.09% in 2021 before declining to 0.04% in 2023. All conditions showed significant pre-2020 upward trends. Diabetes showed no significant level or slope change; obesity showed no significant immediate level change but a significant downward slope change relative to the pre-2020 trend; and precocious puberty showed a significant level increase in 2020 without a significant subsequent slope change. Total NHI-covered expenditures increased by 58.0%.
CONCLUSION: Pediatric endocrine care burden increased despite a declining pediatric population, with condition-specific post-2020 patterns. Continued surveillance is needed to monitor emerging trends and potential care gaps.