National trends in prevalence and healthcare expenditures of pediatric endocrine disorders in South Korea: a claims-based analysis.

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.