Objective: Along with aging, the elderly population with cancers is increasing. The costs of end-of-life (EOL) care are particularly high among cancer patients. The purpose of this study was to investigate the trends in medical costs in the last year of life among older adults with cancer. Design, setting, and participants: Using the Health Insurance Review and Assessment Services (HIRA) database for the period 2016–2019, we identified older adults aged ≥ 65 years who had a primary diagnosis of cancers and high-intensity treatment at least once in the intensive care unit (ICU) of tertiary hospitals. Main outcomes and measures: High-intensity treatment was defined as receiving at least one of the following treatments: cardiopulmonary resuscitation, mechanical ventilation, extracorporeal membrane oxygenation, hemodialysis, and transfusion. The EOL medical treatment costs were calculated by dividing periods 1, 2, 3, 6, and 12 months from the time of death, respectively. Results: The mean total EOL medical expense per older adult during the year before death was $33,712. The cost of EOL medical expenses for three months and one month before subjects’ death accounted for 62.6% ($21,117) and 33.8% ($11,389) of total EOL costs, respectively. Among subjects who died while receiving high-intensity treatment in the ICU, the costs associated with medical treatments that occurred during the last month before death were 42.4% ($13,841) of the total EOL expenses during the year. Conclusion: The findings indicate that EOL care expenditures for the older population with cancer are highly concentrated until the last month. The intensity of medical care is an important and challenging issue in terms of care quality and cost suitability. Efforts are needed to properly use medical resources and provide optimal EOL care for older adults with cancer.

College students are at a high risk of mental health problems due to continuous exposure to considerable stress as they transition into adulthood. It is necessary to reflect on young people’s needs and provide brief, personalized support interventions via mobile applications. This study aimed to (1) describe the co-design development process of a behavioral activation (BA) mobile health application called MEndorphins to help youth manage stress; and (2) evaluate the ease of use and quality of the application and its effects on psychological distress. College students aged 18–25 in South Korea participated as co-designers throughout the MEndorphins development process, which involved prototyping workshops. Thirty-five students also evaluated the application’s ease of use and quality, as well as its effects on psychological distress, using a self-reported online questionnaire. In the pilot evaluation, ease of use scored 74.21 out of 100 and quality 3.72 out of 5. There were statistically significant decreases in depression, anxiety, and stress after using MEndorphins (p ≤ 0.001 for depression and anxiety, p = 0.001 for stress) for 7 days. In this developed BA based mobile application, participants could monitor their mood, plan stress self-management strategies, and gain motivation by sharing experiences.

Purpose: This study investigated intentions and attitudes towards future parenthood and awareness of fertility among university students in South Korea.Methods: The participants comprised 166 female and male undergraduate students enrolled at five universities. A cross-sectional survey was conducted from May to July 2019 using the Korean version of the Fertility Awareness Questionnaire and Attitudes of Parenthood. The data were analyzed using descriptive statistics based on participants' general characteristics, the x2 test to identify differences in intentions, and the t-test to evaluate attitudes towards parenthood and awareness of fertility in female and male students.Results: Both female and male students desired to have two children, but they lacked awareness about fertility. The possibility of combining work and having children, along with the availability of childcare resources, impacted the desire for parenthood. Male students tended to consider parenthood as less impactful on their lives and careers than female students. Social structures might also impact the decision to have children.Conclusion: It is important to provide health education emphasizing fertility awareness and parenthood in young adulthood so participants can consider these facts in advance. In addition, the government should provide resources for couples making parenthood decisions.

Objectives To provide useful information for clinicians and policy makers to prepare guidelines for adequate use of medical resources during end-of-life period by analysing the intensive care use and related costs at the end of life in South Korea. Design Cross-sectional, retrospective, observational study. Setting Tertiary hospitals in South Korea. Participants We analysed claim data and patient information from the Health Insurance Review and Assessment Service national dataset. This dataset included 19 119 older adults aged 65 years or above who received high-intensity care at least once and died in the intensive care unit in South Korea between 2016 and 2019. High-intensity care was defined as one of the following treatments or procedures: cardiopulmonary resuscitation, mechanical ventilation, extra-corporeal membrane oxygenation, haemodialysis, transfusion, chemotherapy and vasopressors. Primary and secondary outcome measures Usage and cost of high-intensity care. Results The most commonly used high-intensity care was transfusion (68.9%), mechanical ventilation (50.6%) and haemodialysis (35.7%) during the study period. The annual cost of high-intensity care at the end of life increased steadily from 2016 to 2019. There existed differences by age, gender, length of hospital stays and primary cause of death in use of high-intensity care and associated costs. Conclusion Findings indicate that invasive and device-dependent high-intensity care is frequently provided at the end of life among older adults, which could potentially place an economic burden on patients and their families. In Korea’s ageing society, increased rates of chronic illness are expected to significantly burden those who lack the financial resources to provide end-of-life care. Therefore, guidelines for the use of high-intensity care are required to ensure affordable end-of-life care.