J Korean Med Sci.  2019 Aug;34(31):e207. 10.3346/jkms.2019.34.e207.

Estimating Nationwide Prevalence of Live Births with Down Syndrome and Their Medical Expenditures in Korea

  • 1Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea. sunghow@gmail.com
  • 2Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Korea.
  • 3SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Korea.
  • 4Pediatric Allergy and Respiratory Center, Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 5Institute of Health and Environment, Seoul National University, Seoul, Korea.
  • 6Interdisciplinary Program of Bioinformatics, Seoul National University, Seoul, Korea.
  • 7Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea. pedalllee@gmail.com


This study aimed to estimate the nationwide prevalence of live births with Down syndrome (DS) and its trends and compare the observed and model-based predicted prevalence rates. Further, we compared the direct medical expenditures among DS and non-DS patients.
Using the health administrative data of Health Insurance Review and Assessment in Korea, we selected 2,301 children with DS who were born between 2007 and 2016 to estimate the prevalence of live births with DS, and 12,265 non-DS children who were born between 2010 and 2014 to compare the direct medical expenditures among patients.
The prevalence of live births with DS was 5.03 per 10,000 births in 9 years, and 13% of children with DS were medical aid recipients during the study period. The medical expenditure of children with DS was about 10-fold higher than that of non-DS children and their out-of-pocket expenditure was about twice as high.
The prevalence of live birth with DS is high in the low socioeconomic group and the healthcare costs for the children with DS are significantly higher than those for non-DS children. Therefore, health authorities should help mothers at lower socioeconomic levels to receive adequate antenatal care and consider the cost of medical care for children with DS.


Down Syndrome; Live Birth; Health Expenditures; National Health Insurance Claims

MeSH Terms

Down Syndrome*
Health Care Costs
Health Expenditures*
Insurance, Health
Live Birth*
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