• Title/Summary/Keyword: Binary logistic regression analysis

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The analysis of medical care behaviors influencing New Diagnosis-Related Groups (DRG) based payment - focused on hospitalized patients with medical illness (신포괄수가에 영향을 미치는 의료행태 요인 분석 - 내과 입원환자 중심으로)

  • Lee, Kyunghee;Wi, Seung Bum;Kim, Suk Il;Choi, Byoong Yong
    • Korea Journal of Hospital Management
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    • v.25 no.2
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    • pp.45-56
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    • 2020
  • Purpose: The purpose of this study is to investigate medical care behaviors influencing accuracy of the payment based New diagnosis-related groups (DRG) compared to fee for service (FFS) in hospitalized patients with medical illness. Methodology: In order to estimate the difference in medical costs between New DRG and FFS depending on medical care behaviors, medical records and hospital claims data (n=4,232) were utilized, which were collected from a single public hospital during the first-half of 2018. Data were analyzed by descriptive statistics, t-test, chi-square test, and multivariate binary logistic regression. Findings: The average difference in medical costs between New DRG and FFS were KRW 506,711±13,945 with incentives and KRW -51,506±12,979 without incentives, respectively. Forty-four point two percent (44.2%, n=1,872) of total subjects were shown to have negative compensation in overall medical costs with New DRG compared to the costs with FFS. Medical care behaviors that affected on the negative compensation were the presence of severe bed sores on admission, medical consultations, death, operations, medications and laboratory or imaging tests with unit price over KRW 100,000, hospital-acquired complications or underlying comorbidities, elderly patients (≧65 years), and hospitalized for more than average inpatient days defined by New DRG (p<0.001). The difference in average medical cost between New DRG and FFS for a group with mild illness was KRW -11,900±10,544, whereas it was KRW -196,800±46,364 for a group with severe illness (p<0.0001). Practical Implications: These findings suggest that New DRG payment model without incentives may incompletely cover the variation of medical costs in real clinical practice. Therefore, policy makers need to consider that the current New DRG reimbursement should be focused and refined to improve accuracy of payment on medical care resources utilized in severe and complex medical conditions.

A Study on Why Married Men Decide to Have Additional Children (기혼남성의 추가 출산계획 여부에 영향을 미치는 요인 연구)

  • Jeon, Na Ri;Cho, Bok Hee
    • Korean Journal of Childcare and Education
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    • v.8 no.1
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    • pp.125-143
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    • 2012
  • This study examined the cause of the low fertility rate by the Policy on Childbirth Encouragement demographic of married males, parenting burden, parental role satisfaction, and policy on childbirth encouragement perception. It also explored these factors of having an effect on the Plan to have another Child. The study method involved a survey answered by married males in Seoul, Gyung-gi, Incheon and a total of 188 copies were used for the final analysis. The data analyses used SPSS 12.0 which employs basic statistics, reliability tests, and binary logistic regression. The results were as follows: First, It turns out that couples who don't have many children and when the wife is not that old, particularly have high parental role satisfaction. And when they acknowledge the policy on childbirth encouragement, they tend to choose the 'Both Husband and Wife want to give birth' category. Second, the 'Only wife wants to give birth' category was chosen for those who have a small number of children and when a wife was currently not working and the husband was not satisfied with his parental role. Third, the 'Only husband wants to give birth' category tends to be chosen when couples have a small number of children and especially if the wife is working. Last, it was shown that coupless who have many children choose the 'Both husband and wife don't want to give birth' category.

Relationship between Menopause, Anxiety Symptoms and Perceived Oral Symptoms in Menopausal Woman (폐경기 여성에서 폐경 및 불안 증상과 구강자각 증상과의 관련성)

  • Yu, Hyeon-Ju;Oh, Jin-Yeong;Kang, Ji-Won;Kim, Bo-Mi;Kim, Se-Hee;Lee, Eun-Ji;Lee, Ji-Yeon;Choi, Min-Jeong;Han, Gyeong-Soon
    • Journal of dental hygiene science
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    • v.13 no.1
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    • pp.53-61
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    • 2013
  • The aim of this study was to assess oral health related quality of life and evaluation the risk factors in menopausal woman. The subjects of this study were 531 menopausal woman from August 5 to September 27, 2012. Data were analyzed with t-test, one-way ANOVA, and binary logistic regression analysis SPSS 12.0. The most influential factors of perceived oral symptoms was menopause symptoms (odds ratio [OR], 3.72; 95% confidence interval [CI], 2.34~5.92), anxiety symptoms (OR, 2.14; 95% CI, 1.34~3.41), drinking (OR, 1.37; 95% CI, 1.04~1.81), living with a spouse (OR, 0.83; 95% CI, 0.70~0.98). There are a statistically significant relationship between perceived oral symptoms and menopause, anxiety symptoms. The postmenopausal woman can be the important menopause and anxiety symptoms interventions in maintaining perceived oral health as good.

Prognostic Value of Blood Lactate for Mortality of Acutely Poisoned Patients in Emergency Department (응급실내 급성 중독 환자들의 예후 예측에 대한 혈액 젖산 수치의 유용성)

  • Kim, Hye Ran;Kang, Mun Ju;Kim, Yong Hwan;Lee, Jun Ho;Cho, Kwang Won;Hwang, Seong Youn;Lee, Dong Woo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.1
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    • pp.16-25
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    • 2016
  • Purpose: Patients suffering from acute poisoning by different substances often visit the emergency department (ED) and receive various prognoses according to the toxic material and patients' condition. Hyperlactatemia, which is an increased blood lactate level that generally indicates tissue hypoperfusion, is commonly utilized as a prognostic marker in critically ill patients such as those with sepsis. This study was conducted to investigate the relationships between blood lactate and clinical prognosis in acute poisoned patients. Methods: This retrospective study was conducted from January 2013 to June 2014 at a single and regional-tertiary ED. We enrolled study patients who were examined for blood test with lactate among acute intoxicated patients. The toxic materials, patient demographics, laboratory data, and mortalities were also reviewed. Additionally, we analyzed variables including blood lactate to verify the correlation with patient mortality. Results: A total of 531 patients were enrolled, including 24 (4.5%) non-survivors. Patient age, Glasgow coma scale (GCS), serum creatinine (Cr), aspartate transaminase (AST), and serum lactate differed significantly between survivors and non-survivors in the binary logistic regression analysis. Among these variables, GCS, AST, and lactate differed significantly. The median serum lactate levels were 2.0 mmol/L among survivors and 6.9 mmol/L among non-survivors. The AUC with the ROC curve and odds ratio of the initial serum lactate were 0.881 and 3.06 (0.89-8.64), respectively. Conclusion: Serum lactate was correlated with fatalities of acute poisoning patients in the ED; therefore, it may be used as a clinical predictor to anticipate their prognoses.

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Association of miR-193b Down-regulation and miR-196a up-Regulation with Clinicopathological Features and Prognosis in Gastric Cancer

  • Mu, Yong-Ping;Tang, Song;Sun, Wen-Jie;Gao, Wei-Min;Wang, Mao;Su, Xiu-Lan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8893-8900
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    • 2014
  • Dysregulated expression of microRNAs (miRNAs) has been shown to be closely associated with tumor development, progression, and carcinogenesis. However, their clinical implications for gastric cancer remain elusive. To investigate the hypothesis that genome-wide alternations of miRNAs differentiate gastric cancer tissues from those matched adjacent non-tumor tissues (ANTTs), miRNA arrays were employed to examine miRNA expression profiles for the 5-pair discovery stage, and the quantitative real-time polymerase chain reaction (qRTPCR) was applied to validate candidate miRNAs for 48-pair validation stage. Furthermore, the relationship between altered miRNA and clinicopathological features and prognosis of gastric cancer was explored. Among a total of 1,146 miRNAs analyzed, 16 miRNAs were found to be significantly different expressed in tissues from gastric cancer compared to ANTTs (p<0.05). qRT-PCR further confirmed the variation in expression of miR-193b and miR-196a in the validation stage. Down-expression of miR-193b was significantly correlated with Lauren type, differentiation, UICC stage, invasion, and metastasis of gastric cancer (p<0.05), while over-expression of miR-196a was significantly associated with poor differentiation (p=0.022). Moreover, binary logistic regression analysis demonstrated that the UICC stage was a significant risk factor for down-expression of miR-193b (adjusted OR=8.69; 95%CI=1.06-56.91; p=0.043). Additionally, Kaplan-Meier survival curves indicated that patients with a high fold-change of down-regulated miR-193b had a significantly shorter survival time (n=19; median survival=29 months) compared to patients with a low fold-change of down-regulated miR-193b (n=29; median survival=54 months) (p=0.001). Overall survival time of patients with a low fold-change of up-regulated miR-196a (n=27; median survival=52 months) was significantly longer than that of patients with a high fold-change of up-regulated miR-196a (n=21; median survival=46 months) (p=0.003). Hence, miR-193b and miR-196a may be applied as novel and promising prognostic markers in gastric cancer.

Health Promoting Lifestyle Behaviour in Medical Students: a Multicentre Study from Turkey

  • Nacar, Melis;Baykan, Zeynep;Cetinkaya, Fevziye;Arslantas, Didem;Ozer, Ali;Coskun, Ozlem;Bati, Hilal;Karaoglu, Nazan;Elmali, Ferhan;Yilmaze, Gulay
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8969-8974
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    • 2014
  • Background: The aim of this study was to determine the predictors of health promoting lifestyle behaviour among medical students attending seven of the medical schools in Turkey. Materials and Methods: This crosssectional descriptive study was performed during the second semester of the first and last (sixth) years of study from March to May 2011. A questionnaire with two sections was specifically designed. The first section contained questions on demographic characteristics; the second consisted of the Health Promoting Lifestyle Profile II (HPLP) Scale. From a total of 2,309 medical students, 2,118 (response rate 91.7%) completed the questionnaire. Data were analyzed using descriptive statistics, t, Anova, Tukey test and binary logistic regression analysis. The research was approved by the Ethics Committee of Erciyes University. Results: The mean age was $20.7{\pm}2.9$ years and it was found that 55.1% were men, 62.3% were in the first year. The overall prevalence of smoking was 19.1%, and for drinking alcohol was 19.4%. HPLP point averages of the first year students were $129.2{\pm}17.7$, and for last year $125.5{\pm}19.0$. The overall mean score for the HPLP II was $2.5{\pm}0.4$. They scored highest on the spiritual growth subscale ($2.9{\pm}0.5$), interpersonal relations ($2.8{\pm}0.5$), health responsibility subscale ($2.3{\pm}0.5$), nutrition subscale ($2.3{\pm}0.5$), stress management subscale ($2.3{\pm}0.4$), and the lowest subscale physical activity ($2.0{\pm}0.5$). It is established that student's grade, educational level of parents, economic status of family, marital status, smoking and general health perception of the students resulted in a significant difference in HPLP Scale total score average and the mean score of majority of subscales. There was no statistically significant difference between the total HPLP when evaluated for gender, chronic disease, alcohol drinking status and BMI. Conclusions: Based on these results, particularly in the curriculum of medical students in order to increase positive health behaviours including physical activity, health promotion issues, and giving more space to aim at behaviour change in these matters is recommended.

Contribution of the MLH1 -93G>A Promoter Polymorphism in Modulating Susceptibility Risk in Malaysian Colorectal Cancer Patients

  • Nizam, Zahary Mohd;Abdul Aziz, Ahmad Aizat;Kaur, Gurjeet;Abu Hassan, Muhammad Radzi;Mohd Sidek, Ahmad Shanwani;Lee, Yeong Yeh;Mazuwin, Maya;Ankathil, Ravindran
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.619-624
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    • 2013
  • Background: Colorectal cancer (CRC) exists in a more common sporadic form and less common hereditary forms, associated with the Lynch syndrome, familial adenomatous polyposis (FAP) and other rare syndromes. Sporadic CRC is believed to arise as a result of close interaction between environmental factors, including dietary and lifestyle habits, and genetic predisposition factors. In contrast, hereditary forms such as those related to the Lynch syndrome result from inheritance of germline mutations of mismatch repair (MMR) genes. However, in certain cases, the influence of low penetrance alleles in familial colorectal cancer susceptibility is also undeniable. Aim: To investigate the genotype frequencies of MLH1 promoter polymorphism -93G>A and to determine whether it could play any role in modulating familial and sporadic CRC susceptibility risk. Methods: A case-control study comprising of 104 histopathologically confirmed CRC patients as cases (52 sporadic CRC and 52 Lynch syndrome patients) and 104 normal healthy individuals as controls was undertaken. DNA was extracted from peripheral blood and the polymorphism was genotyped employing PCR-RFLP methods. The genotypes were categorized into homozygous wild type, heterozygous and homozygous variants. The risk association between these polymorphisms and CRC susceptibility risk was calculated using binary logistic regression analysis and deriving odds ratios (ORs). Results: When risk association was investigated for all CRC patients as a single group, the heterozygous (G/A) genotype showed a significantly higher risk for CRC susceptibility with an OR of 2.273, (95%CI: 1.133-4.558 and p-value=0.021). When analyzed specifically for the 2 types of CRC, the heterozygous (G/A) genotype showed significantly higher risk for sporadic CRC susceptibility with and OR of 3.714, (95%CI: 1.416-9.740 and p-value=0.008). Despite high OR value was observed for Lynch syndrome (OR: 1.600, 95%CI: 0.715-3.581), the risk was not statistically significant (P=0.253). Conclusion: Our results suggest an influence of MLH1 promoter polymorphism -93G>A in modulating susceptibility risk in Malaysian CRC patients, especially those with sporadic disease.

Cooperation of Industrial R&D Programs: Focussing on Types of R&D Cooperation (산업기술혁신사업의 성과창출에 미치는 영향에 관한 연구: 산학연협력형태를 중심으로)

  • Bae, Jin Hee;Oh, Myung Jun;Kim, Heon
    • Journal of Korea Technology Innovation Society
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    • v.17 no.3
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    • pp.604-628
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    • 2014
  • We analyse the impact of R&D cooperation on Industrial R&D programs of Government (Ministry of Trade, Industry & Energy, MOTIE), specially performance differentiating between type of R&D partners, type of R&D project leader organizations. And considering five performance measures: paper, patent, technology transfer, commercialization, new employment. Using data on a large sample of post-performance survey of MOTIE in Korea (2013), we examine the impact of R&D cooperation in 2008-2012. The method of analysis is binary logistic regression models operated by SPSS. The results of this study are follows; the performance is statistically significantly different between type of R&D partners, type of R&D project leader organizations on R&D cooperation. Specially, when a private enterprise cooperate with non-profit institutions, performance has a greater success of paper, patent, new employment. On the other hand, when a private enterprise cooperate with a private enterprise cooperate, performance decrease success of paper, technology transfer. Lastly, when non-profit institutions cooperate with a private enterprise, performance has a greater success of patent, technology transfer.

A Study of Decision Making Style according to Sasang Constitution (사상체질(四象體質)과 의사결정유형에 관한 연구(硏究))

  • Choi, Min-Gi;Yoo, Jun-Sang;Jung, Myoung-Suk;Han, Dong-Youn;Yoon, Ji-Young;Song, Hak-Soo;Yun, Woo-Yeong;Heo, Jae-Beom
    • Journal of Sasang Constitutional Medicine
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    • v.20 no.1
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    • pp.56-66
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    • 2008
  • 1. Objectives and Methods This study was performed to investigate the relationship between Sasang constitution and decision making style. Subjects were 69 men and 45 women. Decision making style score, physical measurements and results were measured and analyzed according to Sasang constitution. 2. Results Soeumin group had significantly high score in rational score compared with those of Soyangin. Soyangin group had significantly high score in intuitive score compared with those of Soeumin. Soeumin group had significantly high score in dependent score compared with those of Taeeumin. According to binary logistic regression analysis for decision making style score, Sasang constitution were significant risk factors and ORs of Taeeumin were significantly higer than those of Soyangin in rational score, ORs of Soyangin were significantly higer than those of Soeumin in intuitive score, and ORs of Soeumin were significantly higer than those of Taeeumin in dependent Score. 3. Conclusions Soyangin had significantly high score in intuitive score. Soeumin had significantly high score in dependent score. We found many evidences that Soyangin is intuitive style and Soeumin dependent style in the text of ${\ulcorner}$Dongyi Suse Bowon${\lrcorner}$ and other research. But as far as Taeeumin was concerned, the result of Taeeurnin’s was not coincident with other research. More cases and research were needed to confirm the personality and phychological type of Taeeumin. This study result will be an important method that classify Sasang Costitution and consultation of student career decision making and studying attitude.

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A Study on Adherence to Dental Revisit of Scaling Patients (치석제거 환자의 치과 재방문 준수에 관한 연구)

  • Gu, Ja-Young;Lim, Soon Ryun;Lee, Su-Young
    • Journal of dental hygiene science
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    • v.15 no.3
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    • pp.318-324
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    • 2015
  • The purpose of this study is to provide the basic date which is increase the number of revisits for scaling after analyzing factors that influence trend of dental revisits for 7 years. Research data was about 1,471 patients who visited S dental clinic in Seoul at 2007 for scaling. Data from January 2007 to December 2013 was collected. The subjects were divided into 3 groups by their trend in number of dental revisits for scaling: once, 2 times, 3~7 times. The data were analyzed using the chi-squire, independent-samples t-test and one-way ANOVA, binary logistic regression analysis. As a result, the trend of dental revisit for scaling is significantly decreased from first time to second time, and after 3rd time dental revisits were steadily continued. Factors affecting dental revisits for scaling are distance, family hospital, systemic disease, presence or absence of periodontal therapy. According to the results of the study, providing dental service in accordance with the patients' characteristics and increasing the dental revisits for scaling could give a positive influence to improvement of oral health.