Journal of Preventive Medicine and Public Health July, Vol. 43, No. 4, 34-35 doi:.396/jpmph..43.4.34 Estimating the Socioeconomic Costs of Alcohol Drinking Among Adolescents in Korea Jaeyeun Kim, Woojin Chung,3, Sunmi Lee 3, Chongyon Park 3 Department of Public Health, Yonsei University Graduate School; Graduate School of Public Health, Yonsei University; 3 Health Insurance Policy Research Institute, National Health Insurance Corporation Objectives: The purpose of this study was to estimate the socioeconomic costs resulting from alcohol drinking among adolescents as of 6 from a societal perspective. Methods: The costs were classified into direct costs, indirect costs, and other costs. The direct costs consisted of direct medical costs and direct non-medical costs. The indirect costs were computed by future income losses from premature death, productivity losses from using medical services and reduction of productivity from drinking and hangover. The other costs consisted of property damage, public administrative expenses, and traffic accident compensation. Results: The socioeconomic costs of alcohol drinking among adolescents as of 6 were estimated to be 387.5 billion won (.5% of GDP). In the case of the former, the amount included 48.5% for reduction of productivity from drinking and hangover, 39.38% for future income losses from premature death, and 6.7% for hangover costs. Conclusions: The results showed that the socioeconomic costs of alcohol drinking among adolescents in Korea were a serious as compared with that of the United States. Therefore, the active interventions such as a surveillance system and a prevention program to control adolescents drinking by government and preventive medicine specialist are needed. Key words: Alcohol drinking, Costs, Adolescent, Korea J Prev Med Public Health ;43(4):34-35
Table. The types of costs and sources Types of costs Direct costs Medical costs Health insurance / Medical aid Industrial accident compensation insurance Automobile insurance Non-medical costs Transportation Care giver Hangover Indirect costs Future income losses from premature death Reduction of productivity from hangover and productivity losses from sick leave Other costs Property damages Public administrative expenses Traffic accidents compensation Sources - 6 National Health Insurance Statistical Yearbook, National Health Insurance Corporation - 6 Yearbook of Labor Statistics, Ministry of Labor - Status for occurrence of traffic accidents caused by intoxication, Korean National Police Agency - Estimation and assessment the costs of road traffic accident in 6, Road Traffic Authority - The Third Korea National Health and Nutrition Examination Survey, Korea Institute for Health and Social Affairs - Annual report on the consumer price index, Korea National Statistical Office. - Medicare service, Korea Care Worker Education Center - The Third Korea National Health and Nutrition Examination Survey, Korea Institute for Health and Social Affairs - Annual report on the cause of death statistics, Korea National Statistical Office - Life table, Korea National Statistical Office - Annual report on the survey of economically active population, Korea National Statistical Office - Annual report on the consumer price index, Korea National Statistical Office - 6 Report on Wage Structure Survey, Ministry of Labor - Survey report on the Wages and Working Hours at Establishments, Ministry of Labor - 6 National Health Insurance Statistical Yearbook, National Health Insurance Corporation - The Third Korea National Health and Nutrition Examination Survey, Korea Institute for Health and Social Affairs - Population projection for Korea, Korea National Statistical Office - Annual report on the survey of economically active population, Korea National Statistical Office - 6 Report on Wage Structure Survey, Ministry of Labor - 6 Yearbook of disaster, National Emergency Management Agency - Estimating and assessment the costs of road traffic accident in 6, Road Traffic Authority - Estimating and assessment the costs of road traffic accident in 6, Road Traffic Authority - Estimating and assessment the costs of road traffic accident in 6, Road Traffic Authority
Table. Direct costs of health insurance and medical aid benefit related to underage drinking (unit: thousand won) Diseases Oropharyngeal cancer Oesophageal cancer Liver cancer Laryngeal cancer Female breast cancer Alcoholic psychosis Alcohol dependence Alcohol abuse Epilepsy Hypertension Supraventricular cardiac dysrhythmias Haemorrhagic stroke Ischaemic stroke Oesophageal varices Gastro-oesophageal haemorrhage Alcoholic gastritis Alcoholic liver cirrhosis Unspecified liver cirrosis Cholelithiasis Chronic pancreatitis Low birthweight Psoriasis Alcohol poisoning Health insurance benefits Male Female 589 46 9857 9389 86 337 839 83 46 49676 77599 96789 499698 4393 3539 676 4566 4955 673 749 57949 467 544 88 47 584 749 5 33 9464 583 765387 65 5569 796 64654 33 837 47 74986 657 6 983976 5794 47 Medical aid benefits Male 389 35989 36 47 667 677 859 763 94556 58 6953 3874 387 357 7869 86 7 6895 776 Female 3563 446 3 47 948 967 855 36784 759 879 3693 5 356 97 6 9946 57 485 63477 754 Health insurance benefits related to underage drinking Male Female Total Male Female Total 3 475 33 36 778 55 4456 7638 5856 387 475 49 67 675 3884-888 89 6575 55 65 764 5348 3 94 9379 9583 373 596 388 85985 887 44 5989 736 6-394 9879 367 786 366 866 398 33 3 4964 3788 4834 76789 36 9685 456 6559 95 6 33 48883-8583 78 9 335 Medical aid benefits related to underage drinking 4 35 8 394 667 393 78 35 36 4887 359 89 387 946-94 99 537 43 76 9 47 75 5 789 4699 59 4735 44 658 9 5-94 3 436 33697 9 37 446 78 995 5479 5 54 97 359 355 478 4997-4 493 848 Total 3757774 38879 4394 3799 74595 5366 858 959 8536 39495 Table 3. Future income losses resulting from premature death related to underage drinking (unit: person, thousand won) Diseases Oropharyngeal cancer Oesophageal cancer Liver cancer Epilepsy Haemorrhagic stroke Ischaemic stroke Unspecified liver cirrhosis Acute pancreatitis Low birthweight Road traffic injuries: non-pedestrian Road traffic injuries: pedestrian Fall injuries Fire injuries Drowning Aspration Occupational/machine injuries Suicide Assault Male 6 37 4 9 55 36 5 53 4 7 5 38 Deaths Female 34 9 6 56 93 7 3 4 4 4 39 Deaths related to underage drinking Male Female 73 3 5 9 4 6 3 6 6 Future income losses resulting from premature death Male Female Total 99883 974 6438 656567 64647 567943 468465 488398 6863658 88559 7637978 3656 6696 45 485436 564 55888 6675 5456 73673 38559 55797 4786 673698 566 99883 6696 45 455576 766645 7455 6695888 583564 4438 76957 7463 98377 4374959 6636 Total 87 535 5 47 33377 9483 55868
Table 4. Productivity losses resulting from sick leave related to underage drinking (unit: day, thousand won) Diseases Oropharyngeal cancer Oesophageal cancer Liver cancer Laryngeal cancer Female breast cancer Alcoholic psychosis Alcohol dependence Alcohol abuse Epilepsy Alcoholic polyneuropathy Hypertension Alcoholic cardiomyopathy Supraventricular cardiac dysrhythmias Haemorrhagic stroke Ischaemic stroke Oesophageal varices Gastro-oesophageal haemorrhage Alcoholic gastritis Alcoholic liver cirrhosis Unspecified liver cirrhosis Cholelithiasis Acute pancreatitis Chronic pancreatitis Low birthweight Psoriasis Alcohol poisoning Length of stay Male 65 58 43 57 47 3 4945 5 46 433 4799 48 3 98 695 47 3869 46 Female 4 5 9 7 8 697 3 369 56 839 3374 5858 68 4 54 77 963 6 377 9 3 Outpatient days Male 365 59 59 3 3 98 3 893 946 436 75 673 38 7 59 539 4598 49 5 5 69 58 Female 38 38 765 3 47 39 7 3 97789 89 648 85 679 57 95 39 339 3565 558 4,33 6658 57 Visit days related to underage drinking Male Female 33 6 64 46 93 3945 33 6 7 74 33 8 66-39 84 47 8 5 4 39 5 78 6 589 3 66 57 67 344-43 8 83 37 Costs of productivity loss resulting from sick leave Male Female Total 89 64 5 7 85 48 54 355 83 7 466 3 355 8 765-4 3 394 76 6 74 7 68 386 77 49 38 93 96 443 5 96 444 56-9 365 367 63 8 778 5 7 4 47 54 33 493 577 37 99 36 65 66 39-96 589 76 38 Total 99379 78399 635 5447 6559 487 759 38 389
Table 5. The socioeconomic costs of underage drinking (unit : thousand won) Direct costs Medical costs Health insurance Benefits Cost not insured Medical aid Types of costs Total (%) Industrial accident compensation insurance Automobile insurance Non-medical costs Transportation Care giver Hangover Subtotal Indirect costs Future income losses from premature death Reduction of productivity from hangover Productivity losses from sick leave Subtotal Other costs Property damage Traffic accidents Fire Public administrative expenses Automobile insurance Police administration Traffic accidents compensation Automobile insurance Injuries Deaths Subtotal Total 858 8955 8958 989 5768 39495 74786 8399 347456 (.9) 347 33683 59878 (6.7) 66357 (6.87) 35464 (7.77) 55868 (39.38) 86957 (48.5) 389 33957773 (87.63) 98549 (.33) 55877 4665 (3.77) 9597 44979 494 (.36) 83938 78363 (4.6) 38749688 ()
Table 6. Sensitivity analysis (unit : thousand won) Future income losses resulting from premature death Reduction of productivity from hangover Industrial accident compensation insurance Discount rate (%) 3 4 5 6 7 Rate of productivity reduction (%) 5 5 3 35 Attributable rate of industrial accident compensation insurance (%) 5 5 3 35 Attributable rate of binge drinker (%) Hangover costs from binge drinker 8 6 4 Future income losses (%) Indirect costs (%) 6835 (5.64) 9778376 (45.7) 55868 (39.38) 973684 (33.76) 95469896 (8.9) Costs of productivity reduction (%) 7437 (35.87) 49565769 (4.7) 86957 (48.5) 4348654 (5.8) 67497 (56.6) Costs of industrial accident compensation insurance (%),44837 (.),59789 (.5),74786 (.9),896744 (.3) 46 (.7) 44878358 (9.34) 384779884 (88.93) 33957773 (87.63) 36737 (86.49) 8466 (85.5) Indirect costs (%) 64794846 (84.68) 38689 (86.3) 33957773 (87.63) 37696973 (88.7) 443666 (89.63) Direct costs (%) 986549 (7.7) 99566 (7.73) 35464 (7.77) 3549 (7.8) 344378 (7.84) Costs of hangover (%) Direct costs (%) 59878 (6.7) 789694 (5.44) 5597 (4.3) 394847 (.8) 59744 (.4) (.) 35464 (7.77) 4984 (6.5) 9767 (5.3) 45393 (3.9) 935769 (.54) 48346 (.4) Socioeconomic costs of underage drinking 495997445 4369897 38749688 3546594 333857 Socioeconomic costs of underage drinking 373933 355376 38749688 448886 467973 Socioeconomic costs of underage drinking 3879793 38734736 38749688 38764675 38779573 Socioeconomic costs of underage drinking 38749688 3899394 37797 3794547 366774 36597
. Hingson R, Kenkel D. Social, health and economic consequences of underage drinking. In National Research Council and Institute of Medicine, Reducing Underage Drinking: A Collective Responsibility. Washington, DC: National Academies Press 4: 35-38.. Hoaken PN, Stewart SH. Drugs of abuse and the elicitation of human aggressive behavior. Addict Behav 3; 8(9): 533-554. 3. Iciardi JA, Pottieger AE. Kids, crack, and crime. J Drug Issues 99; (): 57-7. 4. Schulenberg J, Wadsworth KN, O Malley PM, Bachman JG, Johnston LD. Adolescent risk factors for binge drinking during the transition to young adulthood: Variable-and pattern-centered approaches to change. Dev Psychol 996; 3(4): 659-674. 5. Cho JA, Chun SS. A study of drinking prevalence and drinking levels, related social and psychological factors among Korean middle school students. J Korean Alcohol Sci 8; 9(): 4-55. (Korean) 6. Park NH. Gender differences in the association between psycho-social factors and smoking, drinking in adolescents. J Korean Soc Health Educ Promot 5; (4): 3-36. (Korean) 7. Korea Institute for Health and Social Affairs. The First Korea National Health and Nutrition Examination Survey (KNHANES ). Seoul: Korea Institute for Health and Social Affair; 999. (Korean) 8. Korea Institute for Health and Social Affairs. The Third Korea National Health and Nutrition Examination Survey (KNHANES ). Seoul: Korea Institute for Health and Social Affair; 6. (Korean) 9. Lee CS, Kim SJ, Kweon YR. The effect of smoking and drinking prevention program on middle school students. J Korean Acad Psychiatr Ment Health Nurs 9; 8(): 5-5. (Korean). WHO. International Guide for Monitoring Alcohol Consumption and Related Harm Geneva: WHO;.. Noh IC, Suh MH, Kim YR. Socioeconomic Costs and Policy Priorities of Alcohol Drinking. Seoul: Korea Institute for Health and Social Affairs; 997. (Korean). Chung WJ, Chun HJ, Lee SM. Socioeconomic costs of alcohol drinking in Korea. J Prev Med Public Health 6; 39(): -9. (Korean) 3. Lee SM, Chung WJ, Kim IS, Kum HJ, Cho WH, Shin EC et al. Socioeconomic costs of alcohol drinking in Korea. J Korean Acad Fam Med 8; 9(3): -. (Korean) 4. Rice DP. Cost-of-illness studies: fact or fiction? Lancet 994; 344(8936): 59-5. 5. Byford S, Torgerson DJ, Raftery J. Economic note: cost of illness studies. BMJ ; 3(745): 335. 6. Ridolfo B, Stevenson C. The Quantification of Drugcaused Mortality and Morbidity in Australia, 998. Canberra: Australian Institute of Health and Welfare;. 7. National Health Insurance Corporation. 6 Natiional Health Insurance Statistical Yearbook. Seoul: National Health Insurance Corporation; 7. (Korean) 8. Ministry of Labor. 6 Yearbook of Labor Statistics. Seoul: Ministry of Laber; 7. (Korean) 9. Korean National Police Agency. Status for Occurrence of Traffic Accidents Caused by Intoxication; 7. (Korean). Chang YC, Park HH, Cho HE, Lee EY, Yoo CS, Hwang
JH, et al. Estimating and Assessment the Costs of Road Traffic Accident in 6. Seoul: Road Traffic Authority; 7. (Korean). Kim JH, Lee HY, Hwang RI, Chung HJ. 6 Research on the Actual Conditions of Co-payment. Seoul: National Health Insurance Corporation; 7. (Korean). Korea National Statistical Office. Annual Report on the Consumer Price Index. Seoul: Korea National Statistical Office; 7. (Korean) 3. Korea Care Worker Education Center. Medicare service. [cited 8 Oct 5]. Available from: URL:http://www. kcenet.com/?page=service/fee. 4. Korea National Statistical Office. Annual Report on the Cause of Death Statistics. Seoul: Korea National Statistical Office; 7. (Korean) 5. Korea National Statistical Office. Life Table. Seoul: Korea National Statistical Office; 7. (Korean) 6. Korea National Statistical Office. Annual Report on the Survey of Economically Active Population. Seoul: Korea National Statistical Office; 7. (Korean) 7. Ministry of Labor. 6 Report on Wage Structure Survey. Seoul: Ministry of Laber; 7. (Korean) 8. Ministry of Labor. Survey Report on the Wages and Working Hours at Establishments. Seoul: Ministry of Laber; 7. (Korean) 9. Korea National Statistical Office. Population Projections for Korea. Seoul: Korea National Statistical Office; 7. (Korean) 3. Devlin NJ, Scuffham PA, Bunt LJ. The social costs of alcohol abuse in New Zealand. Addiction 997; 9(): 49-55. 3. National Emergency Management Agency. 6 Yearbook of Disaster. Seoul: Natioanl Emergency Management Agency; 7. (Korean) 3. Kim KK. Drinking and safety of worker. Korea Occupational Safety and Health Agency; 6 (Korean) 33. Gold MR, Siegel JE, Russell LB, Weinstein MC. Cost Effectiveness in Health and Medicine. New York: Oxford University Press; 966. p3-33. 34. Drummond MF, O Brien B, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes, nd ed. New York: Oxford University Press; 997. p7-73. 35. Canadian Coordinating Office for Health Technology Assessment(CCOHTA). Guidelines for Economic Evaluation of Pharmaceuticals, nd ed. Ottawa: Canadian Coordinating Office for Health Technology Assessment (CCOHTA); 997. 36. Levy DT, Miller TR, Cox KC. Costs of Underage Drinking. U.S. Pacific Institute. Office of Juvenile Justice and Delinquency Prevention. Department of Justice; 999. 37. Miller TR, Levy DT, Spicer RS, Taylor DM. Societal Costs of Underage drinking. J Stud Alcohol 6; 67(4): 59-58. 38. Underage Drinking Enforcement Training Center. Underage Drinking Costs. Pacific Institute for Research and Evaluation. 7. 39. Ministry for Health, Welfare and Family Affairs. The Symposium on National Health Investment and Chronic Disease Management. Seoul: Ministry for Health, Welfare and Family Affairs; 7. (Korean) 4. Choi EJ, Seo MK, Park SW, Lee YM, Park SJ. The Middle-Long Term Policy of Underage Drinking and Smoking. Seoul: Korea Institute for Health and Social Affairs, National Youth Commission; 7. (Korean)