{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T06:27:13Z","timestamp":1786602433972,"version":"build-2736575974"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Diplopia is a disabling condition with diverse etiologies, but population-based studies on its healthcare utilization and healthcare costs are limited in South Korea. We conducted a nationwide cross-sectional study using all claims data submitted to the Korean Health Insurance Review and Assessment Service in 2023. Patients with diplopia were identified using diagnostic codes for diplopia and strabismus. Direct healthcare costs, healthcare utilization patterns, and demographic characteristics were analyzed, with subgroup analyses for ocular motor cranial nerve palsies. Among 51.4 million insured individuals in South Korea, 89,447 patients with diplopia were identified, corresponding to a one-year prevalence of 0.17%. Age-specific prevalence revealed a bimodal age distribution. A total of 248,431 diplopia-related healthcare visits were recorded, primarily managed in ophthalmology (70.2%) and neurology (21.3%). The annual direct healthcare cost attributable to diplopia was \u20a959.9 billion, and the mean cost per visit or admission day was \u20a9241,077, approximately 3.1 times the national average insurance benefit cost per outpatient visit or inpatient day (\u20a976,553). This nationwide claims-based study demonstrates that diplopia is associated with substantially higher healthcare costs than the national average across all medical conditions, with marked heterogeneity by age and underlying etiology. These findings underscore the need for age- and etiology-based, multidisciplinary strategies for optimized care and reducing healthcare costs of diplopia.<\/jats:p>","DOI":"10.3389\/fneur.2026.1922434","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T05:33:21Z","timestamp":1786599201000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare costs due to diplopia in Korea: analyses using the public data of Health Insurance Review and Assessment Service"],"prefix":"10.3389","volume":"17","author":[{"given":"Hyo-Jung","family":"Kim","sequence":"first","affiliation":[{"name":"Biomedical Research Institute, Seoul National University Bundang Hospital","place":["Seongnam, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Ryun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, College of Medicine, Seoul National University","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyejin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Seoul National University Bundang Hospital","place":["Seongnam, Republic of Korea"]},{"name":"Department of Family Medicine, College of Medicine, Seoul National University","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, College of Medicine, Seoul National University","place":["Seoul, Republic of Korea"]},{"name":"Department of Neurology, Dizziness Center, Clinical Neuroscience Center, Seoul National University Bundang Hospital","place":["Seongnam, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.survophthal.2013.04.001","article-title":"The impact of strabismus on quality of life in adults with and without diplopia: a systematic review","volume":"59","author":"McBain","year":"2014","journal-title":"Surv Ophthalmol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.1007\/s00415-022-11471-7","article-title":"Diplopia: characteristics and etiologic distribution in a referral-based university hospital","volume":"270","author":"Kim","year":"2023","journal-title":"J Neurol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1016\/B978-0-12-385157-4.00126-3","volume-title":"Encyclopedia of the Neurological 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Koreans: a 10-year Nationwide cohort study","volume":"27","author":"Jung","year":"2020","journal-title":"Ophthalmic Epidemiol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"3012","DOI":"10.1038\/s41433-020-01374-0","article-title":"The incidence and presumed Aetiologies of fourth cranial nerve palsy in Korea: a 10-year Nationwide cohort study","volume":"35","author":"Jung","year":"2021","journal-title":"Eye (Lond)"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"100088","DOI":"10.1016\/j.lanwpc.2020.100088","article-title":"Power of universal health coverage in the era of Covid-19: a Nationwide observational study","volume":"7","author":"Lee","year":"2021","journal-title":"Lancet Reg Health West Pac"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2103","DOI":"10.1016\/j.dsx.2020.10.022","article-title":"Charlson comorbidity index and a composite of poor outcomes in Covid-19 patients: a systematic review and Meta-analysis","volume":"14","author":"Tuty Kuswardhani","year":"2020","journal-title":"Diabetes Metab Syndr"},{"key":"ref16","volume-title":"2023 National Health Insurance Statistical Yearbook","year":"2024"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e0330090","DOI":"10.1371\/journal.pone.0330090","article-title":"Regional disparities in the distribution of public and private healthcare facilities in South Korea","volume":"20","author":"Park","year":"2025","journal-title":"PLoS One"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.1001\/jamaophthalmol.2017.4508","article-title":"Diplopia-related ambulatory and emergency department visits in the United States, 2003-2012","volume":"135","author":"De Lott","year":"2017","journal-title":"JAMA Ophthalmol"},{"key":"ref19","volume-title":"Health at a Glance 2023: OECD Indicators","year":"2023"}],"container-title":["Frontiers in 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