• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.460-470
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• 1998

By expanding health insurance, customers will carry a smaller burden of medical costs. As a result, the number of visits to a physician increase and this result in the improvement of medical accessibility. But medical care utilization may be changed not only by insurance status but also by socio-demographic factor, economic status and other factors. The question thus remains, at which level of accessibility and what price of medical care service in health insurance will the customer and the medical care service be satisfied. The price of medical care service ls comprised of the customer's out-of-pocket money and the costs not covered by health insurance. If the price of medical care services in health insurance are appropriate, medical care utilization should not differ because of the difference in income status or the acuteness of illness. But If the price is not adequate, low income groups will receive relatively low medical care utilization, particularly in the case of chronic disease. The purpose of this study is to evaluate the differences in medical care utilization among the various income groups and those with varying acuteness of illness. The major hypotheses to test in this study are : (i) whether there are differences in medical care utilization among different income groups exist, (ii) whether differences in medical care utilization among different income groups exist with the hospital type. (iii) whether differences in medical care utilization among different income groups exist with the acuteness of illness and with age. The data was collected from the JongRo District Health Insurance Society in Seoul. A total of 118,336 persons were selected as the final sample for this study. The major findings of this study were as follows; 1. The volume of ambulatory utilization among users was statistically significant by income level. 2. Among different income groups, the volume of ambulatory utilization was statistically significant by the acuteness of illness. 3. Higher income groups with chronic diseases had a greater volume of ambulatory utilization than other groups.

• Journal of Home Health Care Nursing
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• v.9 no.2
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• pp.103-113
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• 2002

Purpose: This study was conducted to explore the relationship among health belief. health locus of control and patients sick-role behavior compliance of diabetic mellitus patients visiting public health center. Method: The subjects of this study were 193 of the diabetic patients who were visiting 4 Public Health Center in B city. The instrument used for measuring health belief was Park's(1985). for health locus of control was Wallston. et al's(1978) and for sick-role behavior compliance was Park's(1984). The data were collected with structured questionnaires; total 58 items contained about health belief. health locus of control and sick-role behavior compliance from 1st to 31st July. 2001. The data was analyzed by the SPSS/PC programs using t-test. Pearson's correlation coefficient. ANOVA and Scheffe-test. Result: The average score of the health belief was $57.99\pm9.45$ health locus of control was $66.83\pm9.48$ and sick-role behavior compliance was $42.81\pm7.00$. Statistically significant factors influencing the health belief among social demographic characteristics were family number(F=3.818. p=0.024), monthly income(F=5.153, p=0.002), time of diagnosis(F=3.937. p=0.002) and difficult to control disease(F=5.803. p=0.000). The significant factors influencing the health locus of control were marital status(F=4.669. p=0.010). Also significant factors influencing the sick-role behavior compliance were monthly incomes(F=5.245, p=0.000). the time of diagnosis(F=4.424. p=0.001) and admission to hospital with diabetes(F=9.031. p=0.000). There was negative mild correlation comparatively between health belief and sickrole behavior compliance(r=-0.142, p<0.05) but no correlation in sensitiveness/severity, barrier, benefit(p<0.05). There was no correlation between internal. external. chance health locus of control and sick-role behavior compliance (P>0.05). Conclusion: There was a negative weak relationship between health locus of control and patient's sick role behavior compliance. Therefore further study to investigate the relating factor of the sick role behavior compliance among above of middle aged diabetes mellitus patients is necessary.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.7 no.2
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• pp.190-202
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• 1996

This study assessed psychiatrically referred 5-to 13-year-old children who presented inattention or hyperactivity as chief complaints. Demographic characteristics, primary diagnosis, and comorbid psychiatric conditions of them were identified, and they were assessed using questionnaires and neuropsychological tests. Primary diagnoses included ADHD, anxiety disorder, mental retardation, depression, oppositional defiant disorder, developmental language disorder and others. functional enuresis, conduct disorder, and developmental language disorder were among the secondarily diagnosed disorders. In patients diagnosed as ADHD, overall comorbidity rate was 55.3%. The disorders that frequently co-occured with ADHD were specific developmental disorder, conduct disorder, oppositional defiant disorder, anxiety disorder and other. ADHD groups with or without comorbidity differed in performance IQ and CPT scores. ADHD group differed from externalizing disorders group in the information subscore of IQ, MFFT, and CPT scores, and differed in teachers rating scales, the uncommunication factor of CBCL, and CPT card error compared with internalizing disorders group. The authors concluded that inattentive or hyperactive children should be assessed using various instruments to differentiate other disorders and to identify possible presence of comorbid conditions.

• Korean Journal of Clinical Pharmacy
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• v.21 no.2
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• pp.170-181
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• 2011

Purpose: There is considerable variability in rates of hospitalization for patients with community-acquired pneumonia (CAP) in part because of physicians' uncertainty in assessing the severity of illness at presentation. The purpose of the study was to examine the current treatment patterns and factors influencing the Pneumonia Severity Index (PSI) and clinical outcomes in the patient with CAP. Method: The retrospective data collection of the patients with CAP was conducted and the data were reviewed. The collected data included demographic, clinical, laboratory and microbiological medical information. All patients were stratified into three risk groups according to PSI: low risk (PSI score I-II), moderate risk (III) and high risk (IV-V) groups. The examined treatment patterns were the appropriateness of admissions, category of antibiotics used. The prognostic factors associated with PSI and clinical outcomes were examined. Results: One hundred and six patients' medical data were reviewed. The overall appropriateness of admissions was low presenting many of patients were admitted or intensely treated in the hospital despite of lower risk of prognosis and treated with intravenous antibiotics instead of oral fluoroquinolones. Primary pneumonia pathogens were Klebsiella pneumoniae (27%) and Streptococcus pneumoniae (21.6%). Mean LOS was 8.5 days and was significantly longer (10.0days) (p<0.001) in high risk group. The patients with age >65 (p<0.001), diabetes mellitus (p<0.001), mental alteration (p<0.001), and/or $PaO_2$ <60 mmHg (p<0.001) had a tendency to have higher PSI. The prognostic factors associated with longer LOS were age >65 years (p=0.008), mental status alteration (p<0.001), dyspnea (p=0.002) and PSI score (p=0.001). The prognostic factors associated with mortality were congestive heart failure (p=0.038), systolic blood pressure <90 mmHg (p=0.002) and arterial pH <7.35 (p=0.013). Conclusion: Most of patients were found to over-utilize medical service according to appropriateness of admissions. The elderly, mentally altered patients with low $PaO_2$ had higher PSI score with increased risk of LOS. The mortality could be increased in the patient with disease state of congestive heart failure, high blood pressure, and/or acidosis.

• 대한공업교육학회지
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• v.40 no.1
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• pp.163-179
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• 2015

Sustainable development brings many potential advantages to the society and environment. As such, many educational communities have concentrated on incorporating this concept into their educational programs for the K-12 classrooms. The K-12 technology educators have also exerted efforts to infuse the sustainable development concept into the K-12 national-curriculum level. The purpose of this study was to investigate the high school students' attitudes towards sustainable development. The study participants were 1,073 high school students from six high schools in Gyeonggi province. A self-reported instrument was used to obtain the students' demographic information and to come up with an attitudinal scale towards sustainable development. This study employed statistical ways of exploring the attitudinal level of the South Korean high school students and of describing the subcategories of the sustainable development. The findings described the high school students' attitudes towards sustainable development with regard to three components: (1) cognition of sustainable development; (2) practices in pursuit of sustainable development; and (3) perception of the education for sustainable development. The exploratory factor analysis supported three perspectives of the students' attitudes towards sustainable development. Also, the qualitative data collected and analyzed from the students' responses to the open-ended question posed to them indicated two domains of the students' cognition of and practices in pursuit of sustainable development. These findings were made on the bases of several recommendations regarding the research on and implementation of Education for Sustainable Development(ESD).

• Journal of Music and Human Behavior
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• v.14 no.1
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• pp.63-84
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• 2017

The purpose of this study was to examine the relationship between self-perceived benefits from singing and the quality of life of older adults aged 75 years and older. A total of 231 older adults participated in this study with 141 of them living alone and 90 of them living with others. Each participant was instructed to complete the investigator-constructed questionnaire and the Quality of Life scale. The questionnaire consisted of 49 items on demographic information, involvement in leisure activities and singing-related experiences, and perceived benefits from singing. The results showed that the amount of involvement in leisure activities and the measured quality of life were found to differ between the two subgroups of older adults living with and without others. The number of older adults who had singing-related experiences was also differed between the groups. A positive correlation was found between the amount of self-perceived benefit from singing and quality of life. These results indicate that self-perceived benefits from singing could be an important factor for the quality of life of older adults. This study supports the potential benefits of incorporating singing as an active leisure activity into interventions for older adults, expanding the research that has been extensively based on listening-based interventions. Also, it presents clinical implications for how singing interventions and programs could be designed and suggested to support this population to better cope with their life issues and enhance the quality of life.

• Journal of Preventive Medicine and Public Health
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• v.39 no.3
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• pp.221-228
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• 2006

Objectives: The purpose of this study was to shed further light on the effect of modifiable health behavior risk factors on dependence in activities of daily living, defined in a multidimensional fashion. Methods: The study participants were 10,278 middle aged Americans in a longitudinal health study, the Health and Retirement Survey (HRS). A multi-stage probability sampling design incorporating the effect of population sizes (Metropolitan and non-metropolitan), ethnicity (the non- Hispanic White, the Hispanic, and the Black), and age (age 51-61) was utilized. Basic Activities of Daily Living (ADL) were measured using five activities necessary for survival (impairment in dressing, eating, bathing, sleeping, and moving across indoor spaces). Explanatory variables were four health behavior risk factors included smoking, exercise, Body Mass Index (BMI), and alcohol consumption. Results: Most participants at baseline were ADL independent (1992). 97.8% of participants were independent in all ADL's at baseline and 78.2% were married. Approximately 27.5% were current smokers at baseline, and the subjects reported moderate or heavy exercise were 74.8%. All demographic characteristics and behavioral risk factors were significantly associated with the ADL status at Wave 4 except alcohol consumption. Risk behaviors such as current smoking, sedentary life style and high BMI at Wave 1 were associated with ADL status deterioration; however, moderate alcohol consumption tended to be more related to better ADL status than abstaining at Wave 4. ADL status at Wave 1 was the strongest factor and the next was exercise and smoking affecting ADL status at Wave 4. People who were in ADL dependent at Wave 1 were 15.17 times more likely to be ADL dependent at Wave 4 than people who were in ADL independent at Wave 1. Concerning smoking cigarettes, people who kept only light exercise or sedentary life style at Wave 1 were 1.70 times more likely to be died at Wave 4 than the people who did not smoke at Wave 1. Conclusions: All demographics and health behaviors at wave 1 had consistently similar OR trends for ADL status to each other except alcohol consumption. Smoking and exercise in health behaviors, and age and gender in demographics at Wave 1 were significant factors associated with ADL group separation at Wave 4.

• Journal of Preventive Medicine and Public Health
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• v.32 no.2
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• pp.228-235
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• 1999

Objectives: Despite the importance of human immunodeficiency virus(HIV) transmission through heterosexual contact, the features of heterosexual transmission has not been well studied in Korea. So we conducted a cross sectional study to determine the transmission rates in married couples and assess risk factors for male to female heterosexual transmission of HIV. Methods: 169 HIV-infected males and their female sex partners were recruited from 1985 to tune 1998. We examined female sex partner's HIV infection status and interviewed male index partners and their female sex partners about demographic characteristics and sexual practices. We analysed heterosexual transmission rate by epidemiologic characteristics, disease status and sexual practices. And we assessed risk factors for HIV infection by univariate and multivariate analysis. Results: 30 female sex partners were infected at enrollment, yielding an transmission rate of 17.8%. Among couples who had used condoms consistently, none of the female sex partners was infected with HIV. In univariate analysis the significant risk factors were full blown AIDS status (OR=4.1, 95% CI: 1.49-11.43) and low CD4 T cell count of index partners at enrollment (OR=7.8, 95% CI: 2.19-27.80). In multivariate analysis HIV-1 RNA levels was significant risk factor when adjusted by CD4 T cell courts and mean sexual contacts per month (OR=19.2, 95% CI: 1.03-357.59) Conclusion: The risk of male to female heterosexual transmission increased with advanced stages of HIV infection in the index male partners.

• Journal of the Korean Society of School Health
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• v.12 no.1
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• pp.45-56
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• 1999

Adolescence is vulnerable to various Health Risk Behaviors (HRB). These behaviors can affect his remaining life as well as adolescence, thus prevention of HRB is a critical issue in health education. This study is aimed to provide basic information for prevention of HRB. Thus, this study was conducted to analyze the impact of peer group's health risk behaviors on health risk perception (HRP) and that of health risk perception on health risk behaviors based on 832 respondents. The 852 subjects were selected in six middle and high schools in Seoul through random sampling. Data were collected from September, 18-October, 21, 1998, and the 832 data were analyzed after excluding the 20 incomplete and inaccurate data. Questionnaire items and measures are based on an instrument to measure Perceived Health Risk Perception, which Hodge B.C. developed in 1992. Cronbach alpha is used to test the reliability. The reliability of HRP and HRB is 0.9473, 0.8768 in this study, Statistical analysis divided into four phases. First, the impact of socio-demographic characteristics on HRP is analyzed by oneway ANOV A. Male students have lower HRP than female students. As grade goes up, HRP is getting lower. Perceived higher concern of parents and HRP are correlated. And the experience of school health education and HRP are correlated. Second, the impact of peer group's HRB on the HRP is analyzed by linear regression. Peer group's HRB and HRP are negatively correlated, Third, the impact of HRP on HRB is analyzed by linear regression. There is a correlation between high HRP and low HRB. Fourth, Powerful impact factors on HRB are analyzed by stepwise multiple regression. Grade, gender, peer group's HRB, and related HRP is entered as independent variables. Because of correlation between entered variables, three interaction variables between grade, gender, peer group's HRB and related HRP also entered, In general, peer group's HRB is the most accountable factor to HRB. And Interaction variable between HRP and peer group's HRB and HRB are negatively correlated. These results indicate that HRP may reduce the impact of peer group's HRB on HRB. Some recommendations are as follows: First, health educational programs suitable for gender and grade are required. Second, a systematic cooperation between school and home is necessary for effective prevention of HRB. Third, the educational effect for decreasing HRB by increasing HRP is statistically assisted. However, peer group has much stronger impact on HRB than subjective HRP, thus special consideration and management are necessary for peer group which does HRB more frequently.

• Health Policy and Management
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• v.23 no.1
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• pp.35-43
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• 2013

Background: Diagnosis procedure combination (DPC) has recently been introduced in Korea as a demonstration project and it has aimed the improvement of accuracy in bundled payment instead of Diagnosis related group (DRG). The purpose of this study is to investigate that the model of end-stage liver disease (MELD) score as the severity classification of liver diseases is adequate for improving reimbursement of DPC. Methods: The subjects of this study were 329 patients of liver disease (Korean DRG ver. 3.2 H603) who had discharged from National Health Insurance Corporation Ilsan Hospital which is target hospital of DPC demonstration project, between January 1, 2007 and July 31, 2010. We tested the cost differences by severity classifications which were DRG severity classification and clinical severity classification-MELD score. We used a multiple regression model to find the impacts of severity on total medical cost controlling for demographic factor and characteristics of medical services. The within group homogeneity of cost were measured by calculating the coefficient of variation and extremal quotient. Results: This study investigates the relationship between medical costs and other variables especially severity classifications of liver disease. Length of stay has strong effect on medical costs and other characteristics of patients or episode also effect on medical costs. MELD score for severity classification explained the variation of costs more than DRG severity classification. Conclusion: The accuracy of DRG based payment might be improved by using various clinical data collected by clinical situations but it should have objectivity with considering availability. Adequate compensation for severity should be considered mainly in DRG based payment. Disease specific severity classification would be an alternative like MELD score for liver diseases.