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Comparison of Integrated Health and Welfare Service Provision Projects Centered on Medical Institutions (의료기관 중심 보건의료·복지 통합 서비스 제공 사업 비교)

  • Su-Jin Lee;Jong-Yeon Kim
    • Journal of agricultural medicine and community health
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    • v.49 no.2
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    • pp.132-145
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    • 2024
  • Objectives: This study compares cases of Dalgubeol Health Care Project, 301 Network Project, and 3 for 1 Project based on program logic models to derive measures for promoting integrated healthcare and welfare services centered around medical institutions. Methods: From January to December 2021, information on the implementation systems and performance of each institution was collected. Data sources included prior academic research, project reports, operational guidelines, official press releases, media articles, and written surveys from project managers. A program logic model analysis framework was applied, structuring the information based on four elements: situation, input, activity, and output. Results: All three projects aimed to address the fragmentation of health and welfare services and medical blind spots. Despite similar multidisciplinary team compositions, differences existed in specific fields, recruitment scale, and employment types. Variations in funding sources led to differences in community collaboration, support methods, and future directions. There were discrepancies in the number of beneficiaries and medical treatments, with different results observed when comparing the actual number of people to input manpower and project cost per beneficiary. Conclusions: To design an integrated health and welfare service provision system centered on medical institutions, securing a stable funding mechanism and establishing an appropriate target population and service delivery system are crucial. Additionally, installing a dedicated department within the medical institution to link activities across various sectors, rather than outsourcing, is necessary. Ensuring appropriate recruitment and stable employment systems is needed. A comprehensive provision system offering services from mild to severe cases through public-private cooperation is suggested.

Morbidity Pattern and Medical Care Utilization Behavior of Residents in Urban Poor Area (도시 영세지역 주민의 상병양상과 의료이용행태)

  • Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Chang-Yoon;Kim, Seok-Beom;SaKong, Jun;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.107-126
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    • 1991
  • The purpose of the study was to assess the morbidity pattern and the medical care utilization behavior of the urban residents in the poor area. The study population included 2,591 family members of 677 households in the poor area of Daemyong 8 Dong, Nam-Gu, Taegu and 2,686 family members of 688 households, near the poor area in the same Dong, were interviewed as a control group. On this study the household interview method was applied. Well-trained interviewers visited every household in the designated area and individually interviewed heads of households or housewives for general information, morbidity condition, and medical care utilization with a structured questionnaire. Individuals were interviewed from 1 to 30 December 1988. The major results were summarized as follows : The proportion of the people below 5 years of age was 4.2% of the total study population and 5.5% were above 65 years of age in the poor area. This was slightly higher than in the control area. The average monthly income of a household in the poor area was 403,000 won versus 529,000 won in the control area. Fifty-eight percent of the residents in the poor area and sixty-one percent in the control area were medical security beneficiaries, but the proportion of medical aid beneficiaries was 7.8% in the poor area and 4.6% in the control area. The 15-day period morbidity rate of acute illnesses was 57.1 per 1,000 in the poor area and 24.2 per 1,000 in the control area. Respiratory disease is the most common acute illness in both areas. The most frequently utilized medical facility was the pharmacy among the patients with acute illnesses in the poor area. Among them 58.1% visited pharmacy initially while 38.4% of the patients in the control area visited a clinic. Among persons with illnesses during the 15 days 8.8% in the poor area and 4.6% in the control area did not seek any medical facility. Mean duration of utilization of medical facilities was 3.5 days in the poor area and 3.3 days in the control area. Initially of the medical facilities in Daemyong 8 Dong, The pharmacy in the poor area and the clinic in the control area were most commonly utilized. The most common reason for visiting the hospital was 'regular customers' in the poor area and 'geographical accessibility' in the control area. The one year period morbidity rate of chronic illness in the poor area was 83.0 per 1,000 population and 28.0 per 1,000 in the control area. Disease of nervous system was the most common chronic illness in the poor area while cardiovascular disease in male and gastrointestinal disease in female were most prevalent in the control area. The most frequently utilized medical facility was the pharmacy among the patients with chronic illnesses in the poor area. Among them 24.2% visited the pharmacy initially while 34.7% of the patients in the control area visited the out-patient department of the hospital within a 15-day period. Among the patients with chronic illnesses 34.9% in the poor area and 16.0% in the control area did not seek any medical facility. Mean duration of utilization of medical facilities was 9.2 days in the poor area and 9.9 days in the control area within a 15-day period. Initially of the medical facilities in Daemyong 8 Dong, the pharmacy in the poor area and the hospital in the control area were most commonly utilized. The most common reason for visiting the hospital, clinic, health center or pharmacy in the poor area was 'geographical accessibility' while the reason for visiting herb clinic was 'good result' and 'reputation' in both areas.

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What Factors Affect Mortality over the Age of 40? (40세 이후의 사망에 영향을 주는 요인에 관한 코호트내 환자-대조군 연구)

  • Park, Jong-Ku;Koh, Sang-Baek;Kim, Chun-Bae;Park, Kee-Ho;Wang, Seung-Jun;Chang, Sei-Jin;Sin, Soon-Ae;Kang, Myung-Guen
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.383-394
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    • 1999
  • Objectives: This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. Methods: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. Results : In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. Conclusions: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area.

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The Effect of Hospital Service Coordinator Education Curriculum on the Education Satisfaction and the Quality of Medical Service (병원서비스코디네이터 교육과정이 교육만족과 의료서비스 품질에 미치는 영향)

  • Choi, Eun-Kyoung;Park, Chang Sik;Seo, Jong-Bum
    • The Korean Journal of Health Service Management
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    • v.2 no.1
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    • pp.137-154
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    • 2008
  • The increase of the supply of medical service and the increase of hospitals have intensified the competition of hospitals, and the advancement towards internationalization in the opening of medical industry has triggered the infinite competition of medical profession. In addition, the high expectation of customers and quality improvement in the medical care in accordance with the improvement of overall income, and the change of active role of medical consumers according to the popularization and the improvement of rights awareness reflect the customer needs and choice in the medical service. Customers wanted to receive the kind and pleasant service under the up-to-date medical service. Therefore, as a solution, hospital coordinators were emerged for the purpose of smooth treatment and customer satisfaction by generalizing all service of hospital. Accordingly, this thesis attempted to investigate the effect of hospital coordinator education curriculum on the education satisfaction and the quality of medical service. In order to solve the purpose of this study, I, author reviewed the existing literatures, established hypothesis, and verified hypothesis by using the variety of statistics techniques such as reliability, validity, frequency analysis, and regression analysis. The verification of hypothesis is as followings: First, among education training factors of hospital coordinators, the quality of instructor significantly affects the satisfaction of hospital coordinator education training. Second, among training factors of hospital coordinator, the attitude of trainee significantly affects the training satisfaction of hospital coordinator. Third, among education training factors of hospital coordinator, education course significantly affects the training satisfaction of hospital coordinator education. As the qualities of instructor are better equipped, the satisfaction of education becomes higher. It indicates that the education method of instructors is important as an index to represent the qualities of instructor such as the appropriateness of education method, preparation, passion, visual materials, the adequacy of education procession, and specialized knowledge, and it has important effect on the satisfaction of education. In order to enhance the satisfaction of hospital coordinator education, the creation of education environment, making trainee concentrate on the education, is required by appropriately allocating programs, arousing interest in education, based on the attitude of trainee, discussion, and preliminary programs, preparation, ahead of enforcement of education. Fourth, the satisfaction of hospital coordinator education training significantly affects the reliability among the qualities of medical service. Fifth, satisfaction of hospital coordinator education training significantly affects hospitality I kindness among the qualities of medical service. If the education satisfaction of trainee is high, it is effective in the practical application such as dealing with complaints, the duty performance for the patients, and so on in offering the medical service, related to reliability and furthermore, we can find the positive change in the attitude change of medical professions related to the reliability of hospital coordinator. In addition, in the process of offering medical services such as the kind explanation on the duty, rapid response to the customers inquiry, and tidy uniform, practical effect was verified. Sixth, the education training factor of hospital coordinator significantly affects the reliability among the quality of medical service. Seventh, the education training factors of hospital coordinator significantly affect hospitality/kindness. In the education of hospital coordinator, the methods to attract the interest of trainee by emphasizing reliability should be sought and for gaining the practical effect of hospital coordinator education, the sufficient preparation and investigation on the education curriculum should be prerequisite and under this condition, intensified discussion on the instructor and education course is needed. In the design of education course, more education hours and subjects should be allocated in the part of hospitality in order to improve the practical application of hospitality. Therefore, it is meaningful in a sense that this study newly approached the components of hospital coordinator education and the need to modify the quality components of medical service in accordance with the study subjects was raised. This study also finds its meaning in that it provides basic materials for the study of future hospital coordinator education by suggesting the system development model of hospital coordinator education through preliminary study of education training. In addition, this study is meaningful in the aspect that it suggested the direction of education training by showing how the hospital coordinator education training would applied to the hospital coordinator course of the Continuing Education Center at Pusan and Kyungnam National University to some extent. Since all investigation of this study was approached from the side of hospital coordinator, the thoughts of patients who are beneficiaries of medical service, and care givers cannot be identified. Therefore, the satisfaction of patients and care givers through the experience of medical service, which is the essential prerequisite of medical service, should be importantly considered and investigated. Accordingly, The study of comparing and analyzing the views of both patients and care givers should be carried out in the future.

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Suggestions for Invention Gifted Education Based on the Awareness of Teachers and Professionals Related to the Invention Gifted Education (발명영재 교원 및 전문직 인식에 기반한 발명영재교육의 방향 탐색)

  • Park, Ki-Moon;Lee, Kyu-Nyo;Lee, Byung-Wook;Na, Young-Min;Lee, Kyung-Pyo;Son, Da-Mi;Lee, Sang-Hyun
    • Journal of Gifted/Talented Education
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    • v.22 no.1
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    • pp.1-21
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    • 2012
  • The objective of this study is to suggest improvement plan for invention gifted education based on the awareness of teachers and professionals who related to the invention gifted education for the expansion and development of invention gifted education through improvement of relevant problems. To this end, invention gifted education system and its operational status were analyzed, and questionnaire survey on the awareness of the development plan and satisfaction level was conducted, targeting professionals related to the invention gifted education and teachers in charge of invention gifted education classes or gifted education center. The research results are as follows. First, the level of satisfaction on the invention gifted education was greater than normal (M=3.0) in general, but in the field of 'educational materials', 'teacher training programs' and 'human and material support system of support agencies', the level of satisfaction was relatively low, which requires expansion of the support. Second, it is necessary for Korean Intellectual Property Office and Korea Invention Promotion Association to designate and establish specialized research institution to play a key role in enhancing development and efficiency of invention gifted education. As a result of the questionnaire survey, it turned out that expectation and necessity of the specialized research agency was highly recognized. In particular, demand for 'research and development of gifted education method and materials' and 'research and development of teacher training materials and implementation of teacher training' was high among the key areas of the specialized research institution. Third, teachers and professionals related to the invention gifted education responded that 'invention knowledge' in the areas of invention knowledge and thinking and 'entrepreneurship' in the area of invention attitude was somewhat low toward the question on the level of the 9 characteristics of gifted students with invention talents which current beneficiaries of invention gifted education have, which leads to conclusion that review on the model for the selection of gifted children with invention talents as well as research and development of invention gifted education program to enhance characteristics with low levels is required. If long-term development plans and initiatives are deduced based on this, an effective framework for the invention gifted education will be established in the near future. In addition, it is expected that the differentiated political visions and goals will be established in connection with master plan for the promotion of gifted education.

Reliability and validity study of a life style questionnaire for elderly people (노인 생활습관 설문서의 신뢰도 및 타당도 평가 연구)

  • Park, Byung-Joo;Kim, Dae-Sung;Koo, Hye-Won;Bae, Jong-Myon
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.1 s.60
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    • pp.49-58
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    • 1998
  • The study was done to determine the reliability and validity of a life style questionnaire for the elderly. The questionnaires were sent to 16,524 elderly people who were beneficiaries of Korean Medical Insurance Corporation in Pusan. Among the completed 9,139 questionnaires, 200 were randomly sampled and retested. finally, 110 duplicates were collected. Weighted kappa-value and Pearson correlation coefficients were estimated to measure the reliability. Validity coefficient was estimated by using reliability coefficient. In self-self responses, reliability coefficients of the most of items were over 0.6 except some physical activity related item. Relatively high reliability was observed in smoking, alcohol related items and anthropometric items. In self-proxy responses, most of the physical activity related items were found to be less reliable than self-self responses. Smoking and alcohol related items were consistently reliable. Male showed higher validity in food related item than female. On the other hand, some of the physical activity related items and smoking and alcohol related items were less valid in male than female. With regard to bias of proxy respondents, offsprings tended to underestimate the frequency of house cleaning' and 'kitchen work' and overestimate the height of them. In conclusion, the life style questionnaire was found to be reliable in the most of items. But, some items related with physical activity were found to be somewhat less reliable. Sexual difference on the validity was identified in some items. With regard to bias of proxy respondents, offsprings tended to have bias in part of items of housework and anthropometry.

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Regulatory Reform Proposals for the Korean Deep Sea Fishing Industry (원양어업(遠洋漁業)에 대한 정부규제(政府規制)의 개선방안(改善方案))

  • Kim, Jong-seok
    • KDI Journal of Economic Policy
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    • v.12 no.1
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    • pp.93-110
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    • 1990
  • The basic purpose behind the Korean government's policy toward the Korean deep sea fishing industry is to limit growth of the industry. Therefore, the regulations on the industry are generally restrictive and interventionist. The policy is intended to maintain high domestic fish prices in order to protect the domestic coastal fishing industry. Some regulations have also been introduced to maintain "industrial order." Each fishing vessel must obtain a government permit for operation. The permit specifies the kind of fish it can catch, the area of sea in which it can operate, and the port at which it can unload its catches. The number of permits government issues each year is based on the estimates of the demand increase calculated by government officials, and the government traditionally has been fairly conservative in its estimation, reflecting its concern for fish price stabilization, which actually implies a gradual increase of the prices. There is also a restriction on importing vessels from abroad. This regulation is intended to protect the domestic shipbuilding industry. However, this regulation has resulted in an unusually high average age of Korean fishing vessels, causing fishing costs to rise. These regulations and the inflexible response of the regulators to changing circumstances have resulted in many problems: i) high domestic fish prices, which are, to some extent deliberately, inflated to three or four times the level of international prices, resulting in huge consumer welfare losses; ii) over-exploitation of coastal fish resources; iii) provision of a hospitable environment for inefficient firms to survive, which is especially evident from the fact that, despite the high fish prices in Korea, most of the firms in the industry do not enjoy high profitability. It also must be pointed out that the actual beneficiaries of the high fish prices are the large operators, who are protected from competition and provide most of the fish for domestic consumption, rather than the low-income fishing households and small coastal operators whom the policy was originally designed to help. This study proposes a set of regulatory reforms and policy changes which could Promote competition and equity within the industry and allow firms to reduce costs and increase productivity. Such changes can make the industry more efficient and internationally competitive. Major proposals are, among others: minimization of bureaucratic discretion in issuing fishing permits and maintaining transparency in the governments' decision-making processes; reduction of the government permit specifications and simplification of the operational categories within the industry; and removal of the restrictions on importing foreign fishing vessels.

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A Study on the Influence of Entrepreneurship and Start-Up Competency on Entrepreneurial Satisfaction: Focusing on the Moderating Effect of Flow Experience (창업가정신, 창업역량이 창업만족도에 미치는 영향에 관한 연구: 플로우(Flow)경험의 조절효과를 중심으로)

  • Lee, Sang Hwa;Ha, Kyu Soo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.10 no.5
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    • pp.137-150
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    • 2015
  • This study investigated the influence of Entrepreneurship, Start-up Competency on Entrepreneurial Satisfaction and the moderating effect of Flow experience. The goal of this investigation is to empirically prove that despite the benefits of educational and financial support, mentoring and consulting which selected applicants received as a part of supporting business for start-up companies provided by national and local government and public organizations, there is a gap between individual entrepreneurs' satisfaction after actual foundation of the company. For the purpose of this investigation, data was collected through a survey with 320 entrepreneurs who were beneficiaries of government's supporting business for start-up companies and have founded their companies less than 5 years ago. For entrepreneurship variables, three factors of innovativeness, proactiveness and risk-taking were reviewed, and also reviewed the three variables network capability, market orientation and marketing capacity as Start-up competency. The collected data was used to perform a multiple regression analysis, and the moderating effect of flow experience was analysed using moderated regression analysis. The result of analysis shows that innovativeness, proactiveness and risk-taking of entrepreneurship positively affected the entrepreneurial satisfaction, and network capability, market orientation and marketing capability also positively affected the entrepreneurial satisfaction. As a result of analysing the moderating effect of flow experience, it appeared that there is a positive moderating effect between entrepreneurship, start-up competency, and the entrepreneurial satisfaction. This result concludes that evaluation items of entrepreneurship and start-up competency as applicant selecting criteria in supporting business for start-up companies, are valid. It is also concluded that start-up supports such as education, funds and consulting are also important, but it is necessary to make changes such as construction of start-up ecosystem and reinforcement of networking support, so that entrepreneurs can have the flow experience themselves in the process after founding a company.

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Performance of Drip Irrigation System in Banana Cultuivation - Data Envelopment Analysis Approach

  • Kumar, K. Nirmal Ravi;Kumar, M. Suresh
    • Agribusiness and Information Management
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    • v.8 no.1
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    • pp.17-26
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    • 2016
  • India is largest producer of banana in the world producing 29.72 million tonnes from an area of 0.803 million ha with a productivity of 35.7 MT ha-1 and accounted for 15.48 and 27.01 per cent of the world's area and production respectively (www.nhb.gov.in). In India, Tamil Nadu leads other states both in terms of area and production followed by Maharashtra, Gujarat and Andhra Pradesh. In Rayalaseema region of Andhra Pradesh, Kurnool district had special reputation in the cultivation of banana in an area of 5765 hectares with an annual production of 2.01 lakh tonnes in the year 2012-13 and hence, it was purposively chosen for the study. On $23^{rd}$ November 2003, the Government of Andhra Pradesh has commenced a comprehensive project called 'Andhra Pradesh Micro Irrigation Project (APMIP)', first of its kind in the world so as to promote water use efficiency. APMIP is offering 100 per cent of subsidy in case of SC, ST and 90 per cent in case of other categories of farmers up to 5.0 acres of land. In case of acreage between 5-10 acres, 70 per cent subsidy and acreage above 10, 50 per cent of subsidy is given to the farmer beneficiaries. The sampling frame consists of Kurnool district, two mandals, four villages and 180 sample farmers comprising of 60 farmers each from Marginal (<1ha), Small (1-2ha) and Other (>2ha) categories. A well structured pre-tested schedule was employed to collect the requisite information pertaining to the performance of drip irrigation among the sample farmers and Data Envelopment Analysis (DEA) model was employed to analyze the performance of drip irrigation in banana farms. The performance of drip irrigation was assessed based on the parameters like: Land Development Works (LDW), Fertigation costs (FC), Volume of water supplied (VWS), Annual maintenance costs of drip irrigation (AMC), Economic Status of the farmer (ES), Crop Productivity (CP) etc. The first four parameters are considered as inputs and last two as outputs for DEA modelling purposes. The findings revealed that, the number of farms operating at CRS are more in number in other farms (46.66%) followed by marginal (45%) and small farms (28.33%). Similarly, regarding the number of farmers operating at VRS, the other farms are again more in number with 61.66 per cent followed by marginal (53.33%) and small farms (35%). With reference to scale efficiency, marginal farms dominate the scenario with 57 per cent followed by others (55%) and small farms (50%). At pooled level, 26.11 per cent of the farms are being operated at CRS with an average technical efficiency score of 0.6138 i.e., 47 out of 180 farms. Nearly 40 per cent of the farmers at pooled level are being operated at VRS with an average technical efficiency score of 0.7241. As regards to scale efficiency, nearly 52 per cent of the farmers (94 out of 180 farmers) at pooled level, either performed at the optimum scale or were close to the optimum scale (farms having scale efficiency values equal to or more than 0.90). Majority of the farms (39.44%) are operating at IRS and only 29 per cent of the farmers are operating at DRS. This signifies that, more resources should be provided to these farms operating at IRS and the same should be decreased towards the farms operating at DRS. Nearly 32 per cent of the farms are operating at CRS indicating efficient utilization of resources. Log linear regression model was used to analyze the major determinants of input use efficiency in banana farms. The input variables considered under DEA model were again considered as influential factors for the CRS obtained for the three categories of farmers. Volume of water supplied ($X_1$) and fertigation cost ($X_2$) are the major determinants of banana farms across all the farmer categories and even at pooled level. In view of their positive influence on the CRS, it is essential to strengthen modern irrigation infrastructure like drip irrigation and offer more fertilizer subsidies to the farmer to enhance the crop production on cost-effective basis in Kurnool district of Andhra Pradesh, India. This study further suggests that, the present era of Information Technology will help the irrigation management in the context of generating new techniques, extension, adoption and information. It will also guide the farmers in irrigation scheduling and quantifying the irrigation water requirements in accordance with the water availability in a particular season. So, it is high time for the Government of India to pay adequate attention towards the applications of 'Information and Communication Technology (ICT) and its applications in irrigation water management' for facilitating the deployment of Decision Supports Systems (DSSs) at various levels of planning and management of water resources in the country.

$H_2$ Receptor Antagonists and Gastric Cancer in the Elderly: A Nested Case-Control Study (노인 인구에서 $H_2$ Receptor Antagonist와 위암과의 관련성: 코호트 내 환자-대조군 연구)

  • Kim, Yoon-I;Heo, Dae-Seog;Lee, Seung-Mi;Youn, Kyoung-Eun;Koo, Hye-Won;Bae, Jong-Myon;Park, Byoung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.3
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    • pp.245-254
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    • 2002
  • Objective : To test if the intake of $H_2$ receptor antagonists ($H_2$-RAs) increases the risk of gastric cancer in the elderly. Methods : The source population for this study was drawn from the responders to a questionnaire survey administered to the Korea Elderly Pharmacoepidemiological Cohort (KEPEC), who were beneficiaries of the Korean Medical Insurance Corporation, were at least 65 years old, and residing in Busan in 1999. The information on $H_2$-RAs exposure was obtained from a drug prescription database compiled between inn. 1993 and Dec. 1994. The cases consisted of 76 gastric cancer patients, as confirmed from the KMIC claims data, the National Cancer Registry and the Busan Cancer Registry. The follow-up period was from Jan. 1993 to Dec. 1998. Cancer free controls were randomly selected by 1:4 individual matching, which took in to consideration the year of birth and gender. Information on confounders was collected by a mail questionnaire survey. The odds ratios, and their 95% confidence intervals, were calculated using a conditional logistic regression model. Results : After adjusting for a history of gastric ulcer symptoms, medication history, and body mass index, the adjusted OR (aOR) was 4.6 (95% CI=1.72-12.49). The odds ratio of long term use (more than 7 days) was 2.3 (95% CI=1.07-4.82). The odds ratio of short term use was 4.6 (95% CI=1.26-16.50). The odds ratio of parenteral use was 4.4 195% CI=1.16-17.05) and combination use between the oral and parenteral routes (aOR, 16.8; 95% CI=1.21-233.24) had the high risk of gastric cancer. The aOR of cimetidine was 1.7 (95% CI=1.04-2.95). The aOR of ranitidine was 2.0 (95% CI=1.21-3.40). The aOR of famotidine was 1.7 (95% CI=0.98-2.80). Conclusion : The intake of $H_2$-RAs might increase the risk of gastric cancer through achlorhydria in the elderly.