Trend analysis and Bayesian projection of childhood life-limiting conditions in Korea: insights into incidence and mortality.

Abstract

Objective: To estimate long-term trends in the incidence and mortality of life-limiting conditions among children and young people in Korea from 2012 to 2022, and to project these trends through 2035.

Design: A population-based observational study using joinpoint regression for temporal trend analysis and a Bayesian age-period-cohort model with integrated nested Laplace approximation for projections.

Setting: Nationwide data from the Korean National Health Insurance Service and national mortality statistics (2012-2022).

Participants: Children and young people in Korea diagnosed with life-limiting conditions.

Main outcome measures: Age-standardised incidence rates and age-standardised mortality rates per 100 000 population.

Results: Between 2012 and 2022, the age-standardised incidence rate increased from 398.5 to 565.4 per 100 000, while the age-standardised mortality rate decreased from 7.2 to 5.8. In 2022, non-cancer conditions had a 5.43 times higher incidence and 1.16 times higher mortality than cancer-related conditions. Incidence was consistently higher among females. Mortality declined overall; however, the previously declining mortality trend in non-metropolitan areas reversed during the COVID-19 period, although the subsequent increase was not statistically significant. Projections indicate that by 2035, the age-standardised incidence and mortality rates will reach 551.5 and 5.7 per 100 000, respectively.

Conclusions: The increasing incidence and changing mortality patterns of life-limiting conditions among children and young people in Korea indicate growing care needs. Enhancing paediatric palliative care strategies and national surveillance systems is required to address the future burden.