We have experienced 25 cases of aortic aneurysm from October 1987 to January 1996. Patients ranged in age from 26yrs to 73yrs(mean age 52. Syrs). There were 13 males and 12 females. Eighteen cases were thoracic aneurysm and seven were abdom nal aneurysm. The cause of aneurysm were dissecting in 16cases aneurysms and non-dissecting in 9 cases. Risk factors of aortic aneurysm were hypertension, hypercholesterolemia, Marfan's syndrome. In thoracic aneurysm patients, 1'S cases of dissecting aneurysm underwent aneurysmectomy and replacement of vessel interposition graft with or without coronary artery implantation on the graft. 6 cases of non-dissecting aneurysm underwent operation with same policy as dissecting aneurysm. In 7 case of abdominal aneurysm,all patients underwent aneurysmectomy and graft interposition with straight i)r Y graft. Thcre were 5 postoperative death(mortality 20%). Several cases of complications were improved with proper managements. All survivors showed improvement in clinical symptom and sign and discharged without specific complications.
The aging process in this country is underway at the fastest pace compared to those of the leading countries. On the other hand, preparing for retirement funds is more difficult than before due to the impact of slow interest rate and slow growth. The purpose of this study is to examine the necessity of providing various financial services in preparation for the future aging era. After analizing the various materials and utilizing a survey of the bank employees and the general public, we have found the followings. The replacement rate of this country, 55%, is much lower than the suggested level of World Bank, 75%. Also, the pension ratio in the income after retirement of this country is much lower compared to those of the States and Japan. The most people who participated in the survey needed ₩2,000 - ₩2,990 thousand for monthly living expenses after retirement. For the retirement funds, the higher the age the higher proportion of savings deposits they want, and the lower the age the higher proportion of insurance and pension products they want. Based on these analyses, the necessities of developing financial life planning which includes both financial and non-financial sides, retirement funds management according to age, revitalization of housing pension and developing diverse retirement funds are suggested.
Purpose: The purpose of this study was to analyze the current state of home health nursing (HHN) for elders and to provide basic data on policy alternatives for establishing home medical care in the advanced general hospital. Methods: This study was conducted as a secondary data analysis, using electronic medical record (EMR) data of older patients who received HHN more than once from the S advanced general hospital between January 2016 and December 2018. Results: A total of 1,790 patients received HHN visits, with 22,477 visits being made. The mean age was 76.8±7.3 years old, 96.0% of elders had health insurance and 24.6% had orthopedics problems. Of the 1,168 people who visited emergency rooms, the most frequent symptom was pain (23.4%) and all patients visited the hospital at least once and at most 163 times outpatient care during HHN. Causative diseases were degenerative knee joint osteoarthritis (0.6%), surgery for right knee replacement (4.0%), and for dressings (9.7%) in the HHN service content analysis. Conclusion: The progress towards an aging society and the introduction of community care are expected to further enhance the need for HHN which should be able to provide comprehensive and continuous visiting health care services to the older patients. The results of this study are expected to help doctors solve problems not solved by HHN, reduce unnecessary emergency room or outpatient visits, and readmission, while at the same time contributing to the improvement of patient quality of life through efficient patient health care.
International Journal of Advanced Culture Technology
/
v.6
no.4
/
pp.323-330
/
2018
The growth of the older population is expected to further increase social problems associated with population aging, such as isolation, poverty, and depression. The emerging issues associated with the older population are also expected to provide further momentum on studies about the dwelling environment as factors that ensure the health of older people as well as improve their quality of life. Therefore, approaches for explaining the issues of the older age group should be diversified using a variety of factors and appropriate analytic tools. Studies on measuring depression have principally focused on assessing an objective self-report questionnaire, usually in a highly structured, textual form which may not reflect the cognitive impairment of older adults. The aim of this study was to define and measure dwelling depression among older adults in Korea. There are two specific hypotheses in this study as follows: (a) there will be statistically significant relationships with dwelling dissatisfaction and depression, and (b) dwelling depression tools containing text and images will be, respectively, assessment tools that have a good construct with content validity and reliability. In the first experiment, to define and measure dwelling depression, 301 people over 65 years old living in single and two-person households were surveyed using a text-based dwelling depression questionnaires from September 1-30, 2017. In the second experiment, to examine whether the projective image questionnaire could serve as a suitable replacement for the text-based questionnaires, the same participants were surveyed from January 22 to February 2, 2018. The results show that depression has a close correlation with dwelling dissatisfaction. In addition, the geriatric dwelling depression index (GDDI) based on the projective image was refined. Additionally, the projective image questionnaire has a close correlation with the text-based questionnaire. Finally, through ROC curve analysis, it was found that the projective image questionnaire can accurately predict a depression group. To this end, this preliminary study examined the validity of the projective image questionnaire in older adults to make this instrument feasible for older populations and to contribute to a profound understanding of geriatric depression due to the living environment. We hope they will provide a basis for further research on psychological diagnoses using projective images.
Low fertility has become quite commonplace worldwide, and Europe has experienced below replacement fertility for several decades. In addition, lowest-low fertility, defined as period total fertility rate below 1.3, has rapidly spread in Europe during the 1990s and is likely to expand further. After the turn of century, lowest-low fertility started spreading in Eastern Asia. Korea's TFR of 1.19 in 2008 is lower than most European countries, although it is higher than the Hongkong(1.02) and Taiwan(1.09). The purpose of this paper is to examine the socioeconomic determinants of lowest-low fertility in Korea. In doing so, this paper discusses the effects of female labour force participation, labour instability on family formation and fertility. The data includes female labour force participation rate, unemployment rate, age at first marriage, and total fertility rate from 1980 to 2008. First, the economic recession hindered young people's economic independence and propensity to marry. Married couples were also depressed with uncertainty toward the future and avoided to have children. Second, the growth in female labor force participation had a negative impact on fertility, under the low level of compatibility between women's work and childrearing. Moreover, this paper argues that the rising cost of children including public and private educational costs is thought to be the main reason of the recent low fertility in Korea. Policy implications and some comments on population policies are also presented in the final section.
Mi-Sung Kim;Hyoung-Sun Jeong;Ki-Bong Yoo;Je-Gu Kang;Han-Sol Jang;Kwang-Soo Lee
Health Policy and Management
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v.34
no.1
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pp.78-86
/
2024
Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.
Although the decline in fertility rate is generally observed along the history of economic development throughout the world, the continuing decline hitting below the replacement level in Korea over the recent years gathered serious social concerns on the ground that it accelerates the process of population aging. The total fertility rate in Koreareached 2.08 in 1983, and gradually fell to the levels of 1.08 in 2005 and 1.26 in 2007. The policy debate over the role of the government has been focused mainly on the level of theoretical discussion without substantial basis on firm empirical evidence and the determinants of fertility. The objective of the paper is to empirically investigate the fertility effect of the female wage, which is understood as one of the most important determinants of fertility in Koreasince 1980 focusing on one aspect of fertility, namely birth spacing. Using the Korean National Fertility Survey conducted in 2006, I estimate a duration model of first and second births taking into account individual heterogeneity, which turned out to be an important factor to control for. Compared with previous studies in the literature on the Korean fertility, the study has an advantage of using the complete pregnancy history of women in a more representative sample. Unlike the previous studies, the analysis also deals with the endogeneity of marriage by treating a certain age, rather than age at marriage, as the time in which a woman becomes exposed to the risk of pregnancy. The study shares the common problem in the literature on birth spacing of lacking relevant wage information for respondents in a retrospective survey. I estimate the wage series as a function of the basic characteristics using the annual Wage Structure Survey from 1980 to 2005, which is considered as a nationally representative sample for wage information of employees. The results suggest that the increase in female wage by 10 percent leads to a decrease in second birth hazard by 0.56~0.92 percentage points and that the increase in spouse's wage by the equal amount is accompanied by the increase in second birth hazard by 0.36~1.13 percentage points. These estimates are more precisely estimated and of smaller magnitude than those presented by the previous studies. The results are robust to the different specifications of the wage equation. The simulation analysis based on the predicted values shows that about 17% of the change in the second birth hazard over the period 1980 to 2005 was due to the change in the female wage. Although there is some limitation in data, the results can be viewed as one estimate of the role of female wage on the recent fertility decline in Korea. The question raised by the paper is not a normative one of whether a government should promote childbearing but a positive one thatexplains fertility decline. Therefore, if there is a wide consensus on promoting childbearing, the finding suggests that the policies designed to reduce the opportunity cost of women in the labor market would be effective. The recent movement of implementing a wide range of family-friendly policies including child care support, maternity leave, parental leave and tax benefit in developed countries should be understood in this context.
This study is a descriptive study conducted to investigate the effect of smoking cigarette sign sold in Korea on the smoking cessation effects and to use it as a basis for future smoking cessation and health related health data. To this end, we surveyed 500 men and women over 20 years of age on the Internet Naver web using Naver form questionnaire for 10 days from October 1, 2018 using blogs and cafes. The analyzed data were analyzed by factor analysis, T-test and correlation using SPSS WIN20.0. The main findings were as follows: First, the cigarette warning picture harmful to human body had the biggest influence on the smoking cessation effect. Second, the smoking cessation effect had the highest correlation with the pre-question consciousness about the cigarette warning picture. This indicates that the cigarette pack warning is considered the most sensitive part of smokers. Based on the results of this paper, diversification of cigarette warning picture and regular replacement of warning picture are expected to provide useful basic data for suggesting practical measures to prevent smoking. do. Therefore, the smoking warning picture is widely promoted through the media and the media, which has a positive effect on the practice of quitting smoking to the public, and is also used as a basic data for the health policy for the health promotion of the public.
To be an adjunct professor(gyeomgyosu) literally means to act as an instructor while also holding a different position. Adjunct professors were initially introduced under Confucianism. Gradually, technical offices also appointed adjunct professors using Confucian-educated bureaucrats for the purpose of educating lower-level technical officials and cadets. This paper examines the history of the civil service system related to adjunct professors through the Code of Laws, and examines those who have been appointed to the public office described in various documents. This paper argues that changes in the medical office's adjunct professor system reflect changes in the national medical talent training policy. The main basis of specific recognizing medical personnel is to decouple the appointment of Confucian scholars from that of full-time doctors. The replacement of the role of medical educators from Confucian scholars to full-time doctors was largely accomplished during the reign of King Jungjong(中宗) and was completed during the period of King Injo(仁祖). The time when Euiyakdongcham was created and the Office of Euiyakdongcham was established coincided with the period when the adjunct professor was disrupted in the medical office. However, this change in the adjunct professor system of medical authorities is in contrast to interpretation, which is a representative technical field. In the case of interpretation, Moonshin's sayeogwon position as adjunct professor was maintained even in the late Joseon Dynasty, and apart from this, there was a hanhagmunsin in Seungmunwon. Interpreter families had institutional arrangements that prevented them from making interpretation their own monopoly. Therefore, families of medical bureaucrats had more room for institutional growth than those of bureaucratic interpreters. Of course, these institutional devices did not prevent the growth of interpreting bureaucratic families in the late Joseon Dynasty. However, the situation in which medicine was accepted only as a kind of knowledge, not as an object of full-time work for sadaebue, would have been an opportunity to rise for those in technical jobs who were full-time medicine. As medicine became more differentiated and developed in the late Joseon Dynasty, medical knowledge and the knowledge about the medical profession became more important. The politicians could not avoid the use of a philosophically oriented system in which a confucian-educated bureaucrat equipped with only Confucian knowledge might replace a full-time doctor. Thus, the contradiction between the reality and the ideal of ignoring or denying reality was reproduced like other Confucian-centered societies. These contradictions have implications for us living in the modern age. Establishing the relationship between philosophy (or belief) and technology should not end with the superiority of one side or the other.
Purpose : Aneurysms of sinus valsalva are rare anormalies thought to be primarily congenital in origin, progressing into death by acute heart failure in cases of rupture. Surgical correction is the only method of treatment. With these clinical implications, we reviewed the clinical characteristics and surgical results of patients with ruptured sinus of valsalva aneurysm. Methods : Between January 1991 and February 2004, 17 patients with ruptured sinus of valsalva aneurysm were retrospectively reviewed for their clinical symptoms, physical findings, past history, coexistent cardiac anormalies, surgical results, and mid-term prognosis. Results : The 17 patients included 13 men and four women, with a mean age of 30 years(10-59 years). Preoperatively accompanying cardiac anormalies were ventricular septal defect(VSD, eight cases of doubly committed juxta-arterial VSD) and aortic insufficiency(11 cases). During operations, patterns of fistulous tracts were found to be right colonary sinus-right ventricle in 13 patients, right coronary sinus-right atrium in one, noncoronary sinus - right ventricle in two, noncoronary sinus - right atrium in one, and VSD was noticed in 14 patients(all were doubly committed juxta-arterial in type). The defects were closed with a patch in 13 patients, without a patch in four, with concommitant aortic valve replacement in four and with aortic valvuloplasty in two. There were no mortalities during operations or the mid-term follow-up periods($40{\pm}49$ months). Conclusion : Because, at least in Orientals, VSD(especially doubly committed juxta-arterial) was accompanied in large numbers of patients with aneurysms of sinus valsalva, preoperative evaluations of this congenital heart disease should be made very careful. And we may need to revise the algorithm of treatment policy in small sized doubly committed juxta-arterial VSD.
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