• Journal of Preventive Medicine and Public Health
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• 제56권3호
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• pp.248-254
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• 2023

Objectives: Measuring the quality of care is paramount to inform policies for healthcare services. Nevertheless, little is known about the quality of primary care and acute care provided in Korea. This study investigated trends in the quality of primary care and acute care. Methods: Case-fatality rates and avoidable hospitalization rates were used as performance indicators to assess the quality of primary care and acute care. Admission data for the period 2008 to 2020 were extracted from the National Health Insurance Claims Database. Case-fatality rates and avoidable hospitalization rates were standardized by age and sex to adjust for patients' characteristics over time, and significant changes in the rates were identified by joinpoint regression. Results: The average annual percent change in age-/sex-standardized case-fatality rates for acute myocardial infarction was -2.3% (95% confidence interval, -4.6 to 0.0). For hemorrhagic and ischemic stroke, the age-/sex-standardized case-fatality rates were 21.8% and 5.9%, respectively in 2020; these rates decreased since 2008 (27.1 and 8.7%, respectively). The average annual percent change in age-/sex-standardized avoidable hospitalization rates ranged from -9.4% to -3.0%, with statistically significant changes between 2008 and 2020. In 2020, the avoidable hospitalization rates decreased considerably compared with the 2019 rate because of the coronavirus disease 2019 pandemic. Conclusions: The avoidable hospitalization rates and case-fatality rates decreased overall during the past decade, but they were relatively high compared with other countries. Strengthening primary care is an essential requirement to improve patient health outcomes in the rapidly aging Korean population.

• 보건행정학회지
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• 제33권4호
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• pp.421-431
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• 2023

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to socio-economic issues, highlighting the importance of strengthening health systems for future infectious diseases. This study aims to analyze the relationship between health system preparedness, response levels, and COVID-19 fatality rates across 194 countries. Methods: This study examined various indicators of national health system preparedness and response, including health service delivery, health workforce, health information systems, essential medicines and health products, health financing, and leadership and governance. Results: A correlation was found between the health system and the COVID-19 case fatality rate (CFR). Further examination of specific indicators within health service delivery, health workforce, health information systems, health financing, and leadership/governance showed significant correlations with the CFR. Multiple regression analysis, considering aging and urbanization rates, identified reproductive/maternal/newborn and child health, infectious diseases, nursing and midwifery personnel density, birth registration coverage, and out-of-pocket health expenditure as significant factors affecting the CFR. Conclusion: Countries with strong health system indicators experience lower case fatality rate from COVID-19. Strengthening access to essential health services, increasing healthcare personnel and resources, ensuring reliable health information, and bolstering overall health systems are crucial for preparedness against future infectious diseases.

• Molecules and Cells
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• 제44권9호
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• pp.680-687
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• 2021

Coronavirus disease, COVID-19 (coronavirus disease 2019), caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), has a higher case fatality rate in European countries than in others, especially East Asian ones. One potential explanation for this regional difference is the diversity of the viral infection efficiency. Here, we analyzed the allele frequencies of a nonsynonymous variant rs12329760 (V197M) in the TMPRSS2 gene, a key enzyme essential for viral infection and found a significant association between the COVID-19 case fatality rate and the V197M allele frequencies, using over 200,000 present-day and ancient genomic samples. East Asian countries have higher V197M allele frequencies than other regions, including European countries which correlates to their lower case fatality rates. Structural and energy calculation analysis of the V197M amino acid change showed that it destabilizes the TMPRSS2 protein, possibly negatively affecting its ACE2 and viral spike protein processing.

• 응용통계연구
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• 제33권6호
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• pp.777-789
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• 2020

COVID-19는 지난 2019년 12월부터 중국에서 발생하여 전세계적으로 확산된 대유행병이 되었다. 본 연구에서는 한국 질병 관리 본부에서 공개한 오픈 자료를 이용하였으며 시각화 기법을 통해 확진자의 남녀별 지역별 추세를 조사하였다. 또한 평균 바이러스 잠복기간을 추정하기 위해 감염원이 알려진 두 감염 그룹의 증상 발현 시점과 양성 확진 시점을 활용하였다. 하지만 양성 확진자 중 86%가 무증상으로 정확한 증상 발현시점을 알 수 없었다. 또한 주어진 자료에서는 감염시점도 알려져 있지 않아 감염시점과 증상 발현 시점차로 정의되는 잠복기간은 정확하게 측정하기가 어렵다. 이에 생존 분석의 한 기법인 구간 중도 절단을 적용하여 잠복기간의 분포를 추정하였다. 여러가지 모수 분포를 적용한 결과 최적의 분포하에서 평균 잠복 기간은 5.4일 (95% 신뢰구간 (4.70,6.01)일)이었다. 본 분석에서는 확진자 표본을 이용하여 치사율과 치유율을 구하기 위해 경쟁 위험 모형을 적용하였다. 분석 결과 50대이상의 치사 위험률은 50대미만 그룹의 30배이상이며 남성 양성 확진자가 사망할 확률이 더 높았다. 또한 여성이고 나이가 젊고 무증상일 때 치유될 가능성이 더 높았다.

• 대한간호학회지
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• 제2권1호
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• pp.73-85
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• 1971

A epidemiological study was conducted by author on 925 official reported patients with the first grade legal communicable disease during the period from January 1969 to December 1970 in all area of Kangwon province. As the results of this study, tile following conclusion were obtained. A) Typhoid fever 1. Of all 925 patients surveyed, typhoid fever showed the highest rate as 50.7 percent. 2. Age group from 10 to 14 years old showed the highest rates 3. High epidemic period was from June to September. 4. As for the occupational distribution, unemployed showed the highest rate as 63.2 percent, followed by-21.1 percent in farmer and 9.4 percent in student. 5. Most of all patients(93.7%) were isolated in their own house 6. The morbidity rate was 16.0 per 100, 000 population and case fatality rate was 1.76 percent 7. The mean of the duration from onset to diagnosis and carnation were 11.7$\pm$7.1 days and 25.1$\pm$13, 8 days respectively. 8. Main diagnostic method was almost the clinical examination B) Dysentery 1, Of all 925 patients surveyed, dysentery showed 44.4 percent 2. Age group from 0 to 9 years old showed the highest rate 3. High epidemic period of this disease was from April to August 4. As for the occupational distribution, unemployed showed the highest rate as 73.9 percent, followed by 17.7 person in farmers and 7.0 percent in student 5. the attack rate of agricultural area was higher than of fishing area 6. The mean of the duration from onset to diagnosis and crating duration were 10.4$\pm$4.3 days and 15.7$\pm$8.8 days respectively. 7. The morbidity rate and case fatality rate were 21.8 per 100.000 population and 1.46 percent, respectively. 8. Most of all patients were isolated in own house 9. Most of all patients (97.6%) were diagnosed by the clinical examination C) Diphtheria 1. As for the age distribution, 0-4 years old group showed the highest rate as 44.4 percent followed by 27.7 percent in 5-9 years old group and 22.2 percent in 10-14 years old group 3. Epidemic season was almost in autumn, winter and spring 3. The morbidity rate was 0.96 per 100.000 population and case fatality rate was high as 26.6 percent 4. 66.6 percent of this disease was isolated in their own house and the others were admitted in hospital D) Paratyphoid fever 1. Most of all patients were attacked below 20 years old 2. Epidemic season was almost was almost in late summer 3. The morbidity rate was 0.53 per 100.000 population 4. The mean of the duration from onset to diagnosis and crating duration were 18.3$\pm$1.3 day and 13.7$\pm$0.2 day. respectively.

• Journal of Preventive Medicine and Public Health
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• 제52권3호
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• pp.195-199
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• 2019

Objectives: Jeju Province is well known as the region showing the highest incidence of severe fever with thrombocytopenia syndrome (SFTS) in South Korea. The aim of this study was to evaluate the epidemiological and clinical characteristics of SFTS patients in Jeju Province. Methods: The primary data for this study were obtained from the Integrated Diseases and Health Control System of the Korea Centers for Disease Control and Prevention (KCDCIS). The selection criteria were confirmed cases of SFTS with a residence listed in Jeju Province at the time of diagnosis, reported to the KCDCIS between July 16, 2014 and November 30, 2018. Results: Of 55 confirmed cases of SFTS, the case fatality rate was 10.9% (95% confidence interval [CI], 4.1 to 22.2). The most common presenting symptoms at diagnosis of severe fever, myalgia, and diarrhea had incidences of 83.6% (95% Cl, 71.2 to 92.2), 45.5% (95% Cl, 32.0 to 59.5), and 40.0% (95% CI, 27.0 to 54.1), respectively. Conclusions: Compared to SFTS patients nationwide in 2013-2015, the subjects of this study exhibited a lower case fatality rate and had a lower incidence of severe fever, myalgia, and confusion.

• Safety and Health at Work
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• 제12권3호
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• pp.317-323
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• 2021

Background: The surface mining industry has one of the highest fatality rates among private industries in the United States. Despite recent decreases in the fatality rates of comparable industries, the fatality rate in the surface mining industry has increased. Meanwhile, a lack of safety research in surface mining has hindered efforts to improve safety strategies in the surface mining workplace. Method: This study examined quarry workers' hazard identification skills by conducting a case study of a surface mining facility in the Mid-Atlantic region of the United States. Semistructured interviews were conducted with eight quarry workers who were employed at the mine facility. In addition to the interviews, data were collected through field notes, notes from an expert meeting with safety managers, and site photographs to explore quarry workers' safety behaviors in the workplace. Results: The results showed that quarry workers identified hazards and improved their safety performance by translating safety knowledge learned from training into practice, acquiring hands-on work experience, learning from coworkers, and sharing responsibilities among team members. Conclusion: This study contributes to understanding quarry workers' safe performance beyond what they have learned in safety training to include their interaction with other workers and hand-on experience in the workplace. This study informs practitioners in the surface mining industry to build a safe work environment as they design effective safety programs for employees.

• Journal of Preventive Medicine and Public Health
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• 제54권6호
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• pp.385-394
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• 2021

Objectives: This study aimed to explore the status of regional variations in acute ischemic stroke (AIS) treatment and investigate the association between the presence of a thrombectomy-capable stroke center (TSC) and the case fatality rate (CFR) of AIS within hospital service areas (HSAs). Methods: This observational cross-sectional study analyzed acute stroke quality assessment program data from 262 hospitals between 2013 and 2016. TSCs were defined according to the criteria of the Joint Commission. In total, 64 HSAs were identified based on the addresses of hospitals. We analyzed the effects of structure factors, process factors, and the presence of a TSC on the CFR of AIS using multivariate logistic regression. Results: Among 262 hospitals, 31 hospitals met the definition of a TSC. Of the 64 HSAs, only 20 had a TSC. At hospitals, the presence of a stroke unit, the presence of stroke specialists, and the rate of endovascular thrombectomy (EVT) treatment were associated with reductions in the CFR. In HSAs, the rate of EVT treatment (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99) and the presence of a TSC (OR, 0.93; 95% CI, 0.88 to 0.99) significantly reduced the CFR of AIS. Conclusions: The presence of a TSC within an HSA, corresponding to structure and process factors related to the quality of care, contributed significantly to lowering the CFR of AIS. The CFR also declined as the rate of treatment increased. This study highlights the importance of TSCs in the development of an acute stroke care system in Korea.

• Journal of Veterinary Science
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• 제24권6호
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• pp.81.1-81.12
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• 2023

Background: The incidence of colic and the outcomes of colic surgery have not been surveyed in racetracks in Korea. Objectives: This study examined the incidence, mortality, and case fatality of colic and investigated the effects of age and sex after an exploratory celiotomy on the long-term survival rate (return to racing), subsequent racing performance, and career longevity. Methods: The incidence, mortality, and case fatalities of colic were examined over an 11-year period. The records of 40 horses that had undergone a celiotomy, after participating in at least one race and 75 race-matched control horses were analyzed. The racing performance and career length of the horses that returned to racing post-surgery were compared with a control group. Results: The annual incidence, fatality rate of colic, and annual mortality rate at Seoul Racecourse were 6.5, 2.8 per 100 horse-years, and 0.2 deaths cases per 100 horse-years, respectively. Of the 40 horses that underwent colic surgery, 26 (65%) returned to racing. The likelihood of returning to racing decreased with increasing age of the horses, and geldings had a lower probability of returning. While the performance in the five preoperative races between the two groups was not significantly different, a significant decrease in racing performance was observed after the surgery date (p < 0.01). Horses that underwent colic surgery did not show a significant decrease in career length. Conclusions: Surgical treatment for colic at the age of three and four years had a negative impact on the racing performance. On the other hand, there was no significant difference in career longevity between the two groups.

• 한국자동차공학회논문집
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• 제23권5호
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• pp.553-563
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• 2015

Reportedly the fatality rate from secondary collision is six times higher than the average fatality rate from all traffic accidents. So prevention of the secondary collision is attracting significant attention from automotive industries. However, the secondary collision prevention systems that have been developed are not considering possibility of brake actuator failure that can occur by the impact during the initial collision. In this paper, a new system has been developed that could prevent secondary collision even in case of brake actuator failure by taking advantage of still operating actuators. In this system, a steering control is performed for maintaining a lane by using linear quadratic regulator. Additionally, the system attempts differential brake control with the remaining braking capability to stop the vehicle in the shortest distance. Through simulation in various collision scenarios, the system has demonstrated significant potential of preventing secondary collision that could otherwise have resulted in severe fatality.