• Korean Journal of Health Education and Promotion
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• v.31 no.4
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• pp.51-62
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• 2014

Objectives: The objective of study was to calculate the municipal level environmental burden of disease (EBD) due to heat wave. Methods: The data used were Korea National Health Insurance 2011 claim data and 2011 death registry. Heatwave related diseases included hypertensive heart diseases, ischemic heart diseases, cerebrovascular disease, and heat related illness. According to the method that WHO proposed, the study computed population-attributable fraction with relative risk which come from previous study and proportion of exposure which the study calculated with historical meteorology data. Results: The Average of 251 municipal EBD was 2.11 per thousand persons. The value of years lost due to disability was 11 times higher than that of years of life lost. On average EBD of county and southern geographical areas tended to be higher than those of District or city areas. The relationship between municipal deprivation index (composite deprivation index) and EBD showed the positive association, which means that the worse deprived municipal is, the higher EBD takes. Conclusions: Climate change is getting one of the major risk factors of cardio-cerebrovascular disease, which is the second leading cause of death. The study results suggested the urgent policy planning and reaction of climate change adaptation.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.2
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• pp.19-34
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• 1995

The purpose of this study was to analysis level on family caregiver's burden for the elderly with chronic disease in a rural area and to choose priority care group, thereby facilitating the development of interventions to reduce the caregiver's burden. For this purpose, data were collected by questionaire from June 10 to October 8, 1994. The instruments for data collection were Caregiver Burden Inventory by Novak(1989) and Zarit et al(1982), severity of dementia by Hughes Scales(1982), ADL by Lawton(1971), patients' family caregiving activity by pre-survey and reference review(Lee, 1993 ; Jang, 1990 ; Yoo, 1982). The subjects were 213 family caregiver of elderly with chronic disease in a rural area. The data was analysed by the use of t-test, ANOVA, correlation and multiple regression. The results were as follows ; 1. Total burden was evaluated below average, the mean of family burden was 46.98. By the diagnostic classification, Hypertension was 27.37, DM 32.46, CVA 62.96, Dementia 61.24. 2. Significant variables which were correlated to the family caregiver's burden were the patient's disease diagnosis (F=33.82, p<0.001), severity of dementia(F=30.52, p<0.001), the status of disease management(F=11.53, p<0.001), ADL(F=10.54, p<0.001), PADL(F=7.50, p<0.001), income(F=7.17, p<0.001), caregiver's health status(F=24.53, p<0.001), a view of patient's prognosis (F=22.17, p<0.001), relationship with the patient(F=33.82, p<0.001), the number of hours per day spent on caregiving(F=77.52, p<0.001), level of intimacy of caregiver and patients(F=8.75, p<0.001), level of helping(F=4.90, p<0.01), the frequency of caregiving activity(F=3.80, p<0.01), the number of admission(F=5.54, p<0.01), the length of caregiving(F=4.43, p<0.01), other chronic patient in family(t=2.81, p<0.01), caregiver's job(F=3.11, p<0.01), the duration of illness(F=2.98, p<0.05), caregiver's religion(F=2.93, p<0.05), medical security(F=3.89, p<0.05), caregiving's helper(t=2.42, p<0.05). 3. PADL was the most important predictor to family caregiver burden(R2=0.6611). In addition to this, IADL, caregiver's health status, the length of caregiving. level of intimacy of caregiver and patients, patient's age, the patient's disease diagnosis and patient's job accounted for 76% of family caregiver burden. 4. The criteria of priority care group were as follows ; the mean of family caregiver burden was above 58, above of moderate ADL, the number of hours per day spent on caregiving above of 8 hours, above of moderate dementia. By the diagnostic classification, number of priority care group, Hypertension was 4 (8.0%), DM 4(8.0%), CVA 34(64.1%), Dementia 45(75.0%).

• Journal of Preventive Medicine and Public Health
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• v.46 no.6
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• pp.293-299
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• 2013

Objectives: The purposes of this study were to evaluate the prevalence of epilepsy and to estimate the cost of epilepsy in Korea, 2010. Methods: This study used a prevalence based approach to calculate the cost of epilepsy. Claims data from the Korean national health insurance and data from the Korea health panel, the Korea National Statistical Office's records of causes of death, and labor statistics were used to estimate the cost of epilepsy. Patients were defined as those who were hospitalized or visited an outpatient clinic during 2010 with a diagnosis of epilepsy (International Classification of Diseases 10th revision codes G40-G41). Total costs of epilepsy included direct medical costs, direct non-medical cost and indirect costs. Results: The annual prevalence of treated epilepsy was 228 per 100 000 population, and higher in men. The age-specific prevalence was highest for teenagers. The total economic burden of epilepsy was 536 billion Korean won (KW). Indirect cost (304 billion KW) was 1.3 times greater than direct cost (232 billion KW). By gender, the male (347 billion KW) were more burdened than the female (189 billion KW). The estimated cost in young age younger than 20 years old was 24.5% of the total burden of epilepsy. Conclusions: A significant portion of the economic burden of epilepsy is borne by people in young age. To reduce the economic burden of epilepsy, effective prevention and treatment strategies are needed.

• Journal of Preventive Medicine and Public Health
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• v.47 no.2
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• pp.84-93
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• 2014

Objectives: The incidence and survival rate of colorectal cancer in Korea are increasing because of improved screening, treatment technologies, and lifestyle changes. In this aging population, increases in economic cost result. This study was conducted to estimate the economic burden of colorectal cancer utilizing claims data from the Health Insurance Review and Assessment Service. Methods: Economic burdens of colorectal cancer were estimated using prevalence data and patients were defined as those who received ambulatory treatment from medical institutions or who had been hospitalized due to colorectal cancer under the International Classification of Disease 10th revision codes from C18-C21. The economic burdens of colorectal cancer were calculated as direct costs and indirect costs. Results: The prevalence rate (per 100 000 people) of those who were treated for colorectal cancer during 2010 was 165.48. The economic burdens of colorectal cancer in 2010 were 3 trillion and 100 billion Korean won (KRW), respectively. Direct costs included 1 trillion and 960 billion KRW (62.85%), respectively and indirect costs were 1 trillion and 160 billion (37.15%), respectively. Conclusions: Colorectal cancer has a large economic burden. Efforts should be made to reduce the economic burden of the disease through primary and secondary prevention.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.305-308
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• 2012

Objective: To assess the health and economic burden of human papillomavirus (HPV)-related diseases (cervical cancer, cervical intraepithelial neoplasia (CIN) 1/2/3, and genital warts) in Singapore over a period of 25 years beginning in 2008. Methods: Incidence-based modeling was used to estimate the incidence cases and associated economic burden, with the assumption that age-stratified incidence rates will remain the same throughout the period of 25 years. The incidence rates in 2008 were projected based on data obtained from the National Cancer Registry for cervical cancer, and from a combination of published data and hospital registry review for CIN1/2/3 and genital warts. The population growth rate was factored into the projection of incidence cases over time. Direct cost data per cervical cancer and per CIN1/2/3 case were obtained from the financial database of large local hospitals while cost data for genital warts were obtained from the National Skin Center; these costs were multiplied by the number of incidence cases to produce an aggregate estimate of the economic burden over the 25-year period (in 2008 Singapore dollars) using a 3% discount rate. Results: The total number of incidence cases of HPV-disease over 25 years beginning in 2008 was estimated to be 60,183, including 8,078 for cervical cancer, 11,685 for CIN 2/3, 8,849 for CIN1, and 31,572 for genital warts. The estimated total direct cost was 83.2 million Singapore Dollars over 25 years: 57.6 million attributable to cervical cancer, 13.0 million to CIN2/3, 6.83 million to CIN1, and 5.70 million to genital warts. Conclusion: HPV-related diseases are expected to impose significant health and economic burden on the Singapore healthcare resources in the next 25 years.

• Tuberculosis and Respiratory Diseases
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• v.69 no.6
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• pp.434-441
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• 2010

Background: Chronic obstructive pulmonary disease (COPD) is a major health problem resulting in significant burden for patients and families. However, family caregivers' burden has not been well recognized. The objectives of this study were to evaluate the level of caregivers' burden and to explore the related factors based on family, patient, and social support factors. Methods: A face-to-face interview with 86 family caregivers who had been taking care of COPD patients was conducted. The participants answered a self-administered questionnaire. The questionnaire included the level of family caregivers' burden, health status and the relationship within the family, functional limitation of patients perceived by family caregivers and the social support. Results: The level of caregivers' burden among participants was considerably high. Risk factors for caregivers' burden included low educational level of family caregivers, low family income, hours of caregiving, and functional limitation of the patients. Protective factors for caregivers' burden were good relationship within the family and support from other family members or friends. Conclusion: It is proved that family caregivers are facing significant burden in taking care of COPD patients. To reduce family caregivers' burden, it is necessary to address socioeconomic status of the family and to provide various community resources including financial support and nursing services.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1525-1531
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• 2012

Cigarette smoking is one of the most important public health concerns in Korea and worldwide. A number of studies have been conducted to measure the health and economic burden of smoking, but these did not reflect recent changes such as the decrease in smoking rate and the increase in the incidence of cancer. The purpose of this study was to provide up-to-date estimates of the health and economic burden of cancer caused by smoking and to compare the results with those of previous studies. Cancer-related burden was assessed with nationally representative data such as claims data from the National Health Insurance Corporation, and cause of death records from the National Statistical Office and the Korea Health Panel. We determined the smoking-attributable burden by multiplying the smoking-attributable fraction by the total burden. As a result, the burden of major cancers due to smoking was found to be substantial despite a recent sharp decrease in smoking by the Korean population. The total economic cost reaches $2,234.0 million in males and $870.0 million in females. Also, the health burden of cancers due to smoking is 2,038.9 disability adjusted life years (DALYs) per 100,000 individuals in men and 732.2 DALYs per 100,000 individuals in women. Among all cancers, cancers of the trachea, lungs and bronchus are the leading causes of health and economic burden. The huge burden caused by cancers linked to smoking makes it imperative that adequate policies to decrease the prevalence of smoking be developed, particularly considering the recent increase in smoking rate among women.

• Journal of Korean Academy of Nursing
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• v.37 no.5
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• pp.665-675
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• 2007

Purpose: The purpose of this study was to explore the experiences of people with chronic hepatitis B (CHB) in Korea. The specific aim was to identify major problems that people with CHB face and strategies that they are dealing with. Methods: A grounded theory method was utilized. The data were collected by individual in-depth interviews from 12 CHB patients from one of the major hospitals in Korea. Results: After constant comparative analysis, a core category emerged as "illness management with self-reliance and will." Seven major strategies that were identified in dealing with the illness were maintaining receptive and positive attitudes; restraining excessive work and greed; searching for information; controlling illness information; adhering to practices for not spreading the viral disease; abstaining from alcohol and smoking and maintaining healthy eating habits; nd using alternative therapies. The outcomes that result from employing these strategies were identified as burden, depression and helplessness, stress for maintaining compliance, and dispirited interpersonal relationships. Conclusion: The results of this study suggest that most people with CHB in Korea have problems in psychosocial area. Thus health professionals need to provide not only informational support but also emotional one to improve quality of life of the people with CHB.

• Korean Journal of Social Welfare
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• v.43
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• pp.106-130
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• 2000

When parents as primary care takers to the mentally disabled adult are no longer taking care of their care-needed offsprings because of their own death or illness, instead themselves. who take care of their offsprings with the mental disability? Therefore, 'permanency planning' is very important for reduction of parents' care burden and social integration of mentally disabled adults. Accordingly, this study aims to find out factors which are related to permanency planning for adults with the mentally disability For the purpose of the study, 192 parents of the adult with the mental illness and mental retardation were conducted a survey regarding type of permanency planning, and its related factors including social functioning level of the mentally disabled, care burden, parents' self-perception of being aged, help from offspring without mental disability, social support, and financial ability. Furthermore, this study examined correlation between these factors and residential planning. Results obtained by the study were as follows: 1) 51% of the parents are having a plan for institution and most parents want other family member to take care for financial planning for their mentally disabled offsprings. 2) As a result of multiple regression for finding out factors which affect parents' permanency planning, social functioning level of the mentally disabled, parents' self-perception of being aged, help from offspring without mental disability, social support, and financial ability were statistically significant influenced factors, which has 23.3% of explanatory power. 3) As a result of step-wise multiple regression, financial ability, parents' self-perception of being aged, and help from offspring without mental disability were the most powerful influenced factors for permanency planning. 4) In case of having a plan for residential types-which are institution and community living-, parents who have a plan for the mentally disabled offsprings' future residence as community living than institution have the offsprings with more social functioning and also have more help from offspring without mental disability. Therefore, this study concluded that welfare policy for mental health and the handicapped which secure various types of community living facilities and income security is strongly needed. At the same time, mental health profession is needed to have more active interest and intervention for permanency planning for their adult clients and parents.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.209-215
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• 2013

Objectives: Terminal cancer patients and their caregivers often experience traumatic stress and need many types of assistance. In the present study we interviewed terminally ill cancer patients and caregivers to determine how much burden they experienced and to find out what factors are most important for satisfaction. Design: We constructed a questionnaire including overall care burden and needs experienced, and administered it to 659 terminal cancer patients and 659 important caregivers at 11 university hospitals and 1 national cancer center in Korea. Results: Finally, 481 terminal cancer patients and 381 caregivers completed the questionnaire. Care burden was not insubstantial in both and the caregiver group felt more burden than the patient group (P<0.001). While the patient group needed financial support most (39.0%), the caregiver group placed greatest emphasis on discussion about further treatment plans (44.8%). Stepwise multiple logistic regression analyses showed that in the patient group, patient's health status (OR, 2.03; 95%CI, 1.16-3.56) and burden (OR, 2.82; 95%CI, 1.76-4.50) influenced satisfaction about overall care, while in the caregiver group, high education level (OR, 1.84; 95%CI, 1.76-4.50), burden (OR, 2.94; 95%CI, 1.75-4.93) and good family function (OR, 1.94; 95%CI, 1.24-3.04) were important. Conclusions: Our study showed that burden was great in both terminal cancer patients and their caregivers and was perceived to be more severe by caregivers. Our study also showed that burden was the factor most predicting satisfaction about overall care in both groups.