• Health Policy and Management
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• v.22 no.2
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• pp.207-224
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• 2012

This study estimates the total health expenditure of ambulatory dental care and explores the factors related to disbursements. The study used two waves of a 2008 Korea Health Panel (KHP) survey, of which each wave is composed of 7866 households and 24,659 persons. The KHP includes missing expanses of reimbursement data of the National Health Insurance (NHI), such as out-of-pocket, drugs, and private health insurance. The study estimates total monthly ambulatory dental expenditure and the sub-special categories of dental care. For influential factors analyses, the study exploits log-linear model with age, gender, education, job, equivalence income, the status of chronic diseases, means-tested benefit recipients, private insurance, and the composite deprivation index as independent variables. The total monthly outpatient health spending is estimated to be 102,468 won per household, and for dental, each household spends 31,115 won per month. Older age, means-test recipients, non-regular workers are more likely to spend less money on dental care, whereas private insurers, high income, and those who live in less deprived areas are more likely to spend more money for dental services. From the study we found that the KHP data are more suitable to estimate the total amount of health care markets, especially when the NHI coverage is low, such as for dental care in Korea.

• Health Policy and Management
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• v.21 no.1
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• pp.23-43
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• 2011

Access to health care is complicated to define. It is a multidimensional process. In addition to the matters of quality of care, geographical accessibility and availability of the right type of care, finance, and acceptability are all involved. The purposes of this paper are to measure the geographic distances between patient residency locations and health service organizations in which the patients hadvisited, and to investigate the association between geographical distance measures and variables involved in health service utilization. The study used the first and the second wave of the 2008 Korea Health Panel Survey. The samples of analyses were patients who had visited outpatient or used ambulatory health services, and the total observations (visit numbers) analyzed were 229,128. We divided the samples into a frequent-visit illness group (Group 1) and a non-frequent visit illness group (Group 2) based on over 5,000 total visit numbers. We exploited three level analyses using xtmixed of STATA${\Box}$ 11.1 command with/without interaction terms among age, sex, and occupation. Geographical distances were measured using the Haversine method. Group 1 was tended to older and lower equivalent income than those of Group 2, but the geographic difference were not observed in terms of area deprivation index and standard mortality ratios. Amongst group 1, diabetes mellitus patients travelled far to visit health care organizations, and arthritis patients were more deprived in terms of the personal and areal characteristics. The study revealed that residents in rural areas traveled about 10 times more long distances than those whom lived in larger cities after adjusting for various variables, which we used for analyses. This study contributed to the practical understanding of health service utilizations using empirical analyses, and found that the types of diseases and socioeconomic characteristics of patients tended to define the amount of travel distance to healthcare organizations.

• Health Policy and Management
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• v.23 no.3
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• pp.233-243
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• 2013

Background: This study was conducted to evaluate the individual and community level factors which were influencing the severe injury patients' death and transfer at discharge. Methods: Analysis data is based on Korean National Hospital Discharge In-depth Survey Data released by the Korea Center for Disease Control and Prevention from 2006 to 2008. Study subjects was 11,026 inpatients with of severe injury. For multi-level analysis, socio-demographic characteristics, injury related characteristics, hospitalization related characteristics were used as individual level factors, and socio-environmental characteristics and health care resource characteristics were used as community level factors. Results: As to community level factors affecting mortality of severe injury, the possibility of death was also high in cases of less numbers of surgeons per a population of 100,000 and more number of operation beds. As to community level factors affecting transfer of severe injury, vulnerable areas with higher social deprivation index and low population density had higher possibility of transfer. Conclusion: Both individual level factors and community level factors affected clinical outcomes of treatment for severe injury. In particular, since there happened higher death and transfer of severe injury in socioeconomic and medical vulnerable areas, special efforts for establishing preventive policy and care system for injury in national and area level should be directed toward such areas.

• Safety and Health at Work
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• v.9 no.2
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• pp.203-209
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• 2018

Background: Night shift work is associated with many problems such as sleep deprivation, sleepiness, decreased cognitive performance, increased human errors, and fatigue. This study set out to measure cognitive performance, melatonin rhythms, and sleep after different consecutive night shifts (7 vs. 4) among control room operators (CORs). Methods: The participants included 60 CORs with a mean age of 30.2 years (standard deviation, 2.0) from a petrochemical complex located in Southern Iran. Cognitive performance was assessed using the n-back task and continuous performance test. To evaluate melatonin, saliva was collected and tested by enzyme-linked immunosorbent assay. To assess sleep and sleepiness, the Pittsburgh Sleep Quality Index and Karolinska Sleepiness Scale were used, respectively. Results: Individuals who worked 7 consecutive night shifts had a significantly better cognitive performance and sleep quality than those who worked 4 consecutive night shifts. However, salivary melatonin profile and sleepiness trend were not affected by shift type. Conclusion: The main duty of CORs working night shifts at the studied industry included managing safety-critical processes through complex displays; a responsibility that demands good cognitive performance and alertness. It is suggested that an appropriate number of consecutive night shifts in a rotating shift system should be planned with the ultimate aim of improving CROs performance/alertness and enhancing safety.

• Journal of the Korean housing association
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• v.19 no.6
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• pp.95-104
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• 2008

This study was to develop the indicators for understanding social inclusion exclusion of the dwellers living in permanent rental apartment, and to present a important base about priority order of national housing policy for social inclusion. The ultimate purpose of this study was to provide basic information for the development of permanent rental apartment renewal techniques. The first phase of the study was to review of the social inclusion exclusion indicators mentioned in the literature. The indicators of EU (2001, 2006), KIHASA (2005), and Jehoel-Gijsbers & Brooman (2007), which were applied in many studies about social inclusion, or included various items about dwellers' subjective attitudes, were selected to construct the framework for the study. On the basis of 3 kinds of indicators at the above, the dimensions of social inclusion exclusion were categorized as material deprivation and access to social rights in an economicstructural exclusion view, and social participation and cultural normative accommodations in a socio-cultural exclusion view. And then, the domains of social inclusion exclusion were decided as follows: income, employment, education service, housing, health, family networks and social networks. The detail contents of indicators were adopted from the prior studies as many as possible, and the dwellers' subjective attitudes and housing domains were intensified with reference to UN housing rights and the study of "residents' satisfaction of housing facilities living in permanent rental housing". The developed indicators were modified through the advisory committee that consist of the specialists from the various fields of studies. The final indicators that were overlapped or not able to be measured were eliminated, and added, in a housing domain, the standards of convenient facilities, the management condition, safety, location, crime and etc. in the apartment complex, which were required to complement in the advisory committee.

• The Journal of Korean Society for School & Community Health Education
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• v.20 no.1
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• pp.69-84
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• 2019

Objectives: The purpose of this study is to examine change in adolescent depression across time and to determine the relation between individual and neighborhood socioeconomic status (SES) and depression. Methods: This study employed multilevel latent growth analysis using longitudinal data from Korea Children and Youth Panel Survey. A sample of this study consists of 2,351 adolescents who were in first grade of middle school in 2010. Results: Results showed that both initial level and downward trajectory of depression varied significantly across individuals as well as across neighborhoods. On the individual level, self-rated economic condition(b=-0.203, p<.001) was related to the initial level of depression. Adolescents whose father had a high educational level(b=0.028, p<.001) or whose mother had a low educational level(b=-0.022, p=.011) had lower rates of decline in adolescent depression. On the neighborhood level, neighborhood deprivation index (b=0.003, p=.019) and gini coefficient(b=0.124, p=.040) were associated with lower rates of decline in depression. Conclusions: Low SES in adolescence is correlated with worse mental health, especially depression. Social disparities in depression likely originate before adulthood. The findings argue for the importance of understanding depression in adolescence from a multilevel or ecological framework.

• Korean Journal of Environmental Biology
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• v.22 no.3
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• pp.351-368
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• 2004

Following the previous experiments, a starvation experiment was conducted to determine the influence of feeding and starvation on the histological and biochemical changes, the morphormetric changes in the sectioned body and the morphometric changes in Rhynchocypris oxycephalus (Sauvage and Dabry). The influence of starvation on nutritional conditions of the histological changes of hepatocyte and intestinal epithelium as hepatosmatic index (HSI), protein, RNA and DNA concentrations of liver in R. oxycephalus was tested. Although the starved group showed higher concentrations of protein, DNA and RNA than the fed group, food deprivation resulted in a decrease in the HSI, hepatocyte nucleus size and nuclear height of the intestinal epithelium. The RNA - DNA ratio appears to be a useful index of nutritional status in R. oxycephalus and may be useful for determining if R. oxycephalus is in a period of rapid or slow growth at the time of sampling. Additionally, the data have been interpreted in detail and some biologically important relationships discussed. The effects of starvation on the morphometrical changes in sectioned body traits, condition factor, viscera index and dressing percentage were determined for evaluating nutritional conditions of R. oxycephalus. Starvation for nine weeks resulted in a decrease in most sectioned traits as well as in condition factor and viscera index (P<0.05). These findings suggest that nutritional parameters used in this study appear to be a useful index for nutritional status in this species. The data has been interpreted in detail and some important body sectioned values of interest to commercial growers discussed. A 75-day study was conducted to determine the effect of starvation on classical and truss parameters in R. oxycephalus. Truss dimensions of almost the entire head and trunk region as well as the abdomen were increased significantly through feeding or starvation (P<0.05). Truss dimensions of the caudal region generally decreased through feeding or starvation, particularly those dimensions at the hind part of the trunk. There were some significant decreases in classical dimensions of the head region during feeding, in relation to body depth characteristics in the trunk and caudal region during starvation, whereas there was only one decreasing classical dimension in the caudal region during feeding. The results of this study indicate that application of the truss network as a character set enforces classical coverage across the body form, discrimination among experimental groups thus being enhanced. Considering that the dimension of the lower part of the head and some truss and classical dimensions were least affected by feeding and starvation, these dimensions may then be useful as a taxonomical indicator to discriminate the species of Rhynchocypris sp. The value of trunk region dimensions with a large component of body depth in R. oxycephalus is most likely to be compromised by variability related to differences in feeding regimes of fish in different habitats.

• Sleep Medicine and Psychophysiology
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• v.9 no.2
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• pp.106-114
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• 2002

Objectives: Daytime sleepiness is a common symptom and is associated with sleep behavior, sleep deprivation, and night shift, etc. It is also one of the most important symptoms of sleep disorders like obstructive sleep apnea (OSA). According to our survey on Korean literature, a few studies have dealt with daytime sleepiness, and we have not been able to locate any study comparing normal subjects with polysomnography-proven sleep disorder patients regarding daytime sleepiness. We aimed at comparing daytime sleepiness among normal healthy daytime workers, medical students being expected to have daytime sleepiness due to chronic sleep deprivation, and patients having sleep disorders diagnosed with polysomnography. We also studied the association between subjective daytime sleepiness and objective polysomnographic findings in patients with sleep disorders. Methods: One hundred three hospital workers, 137 medical students, and patients with sleep disorders were studied. Sleep disorders included OSA, periodic limb movements in sleep (PLMS), insomnia, and narcolepsy. The degree of subjective sleepiness in each group was measured by the Korean version of Epworth sleepiness scale and compared. The relationship between polysomnographic findings reflecting severity of sleep disorder in each patient group and subjective sleepiness was analyzed. As for patients with narcolepsy, the relationship between the mean sleep latency and subjective sleepiness was studied. Results: There was a significant difference of ESS score (F=68.190, dF=5.752, p<0.001) among daytime workers, medical students, and sleep disorder patients. In OSA patient group, the degree of the sleepiness had no significant correlation either with mean O2 satuaration (p=0.062) or with RDI (p=0.807). In PLMS patient group, there was no correlation between periodic limb movement index (PLMI) and subjective sleepiness (p=0.761). In narcolepsy patient group, the subjective sleepiness had no correlation with mean sleep latency measured with MSLT (p=0.055). Conclusion: We found a significant difference of subjective sleepiness among daytime workers, medical students, and patients with sleep disorders. However, no consistent correlation was found between severity of subjective sleepiness and objective polysomnographic findings reflecting severity of each sleep disorder. This research confirms that the evaluation of subjective sleepiness is important clinically, but it cannot substitute the objective measures such as nocturnal polysomnography and MSLT.

• Informatization Policy
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• v.25 no.4
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• pp.37-64
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• 2018

This study aims to forecast the future of the Korean society via a big data analysis. Based upon two sets of database - a collection of 46,000,000 news on 127 media in Naver Portal operated by Naver Corporation and a collection of 70,000 academic papers of social sciences registered in KCI (Korea Citation Index of National Research Foundation) between 2005-2017, 40 most frequently occurring keywords were selected. Next, their temporal variations were traced and compared in terms of number and pattern of frequencies. In addition, core issues of the future were identified through keyword network analysis. In the case of the media news database, such issues as economy, polity or technology turned out to be the top ranked ones. As to the academic paper database, however, top ranking issues are those of feeling, working or living. Referring to the system and life-world conceptual framework suggested by $J{\ddot{u}}rgen$ Habermas, public interest of the future inclines to the matter of 'system' while professional interest of the future leans to that of 'life-world.' Given the disparity of future interest, a 'mismatch paradigm' is proposed as an alternative to social forecasting, which can substitute the existing paradigms based on the ideas of deficiency or deprivation.

• Sleep Medicine and Psychophysiology
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• v.20 no.1
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• pp.15-21
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• 2013

Objectives: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. Method: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education- matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools- including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). Results: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression ($GDS{\geq}10$) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. Conclusions: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.