• Asian Pacific Journal of Cancer Prevention
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• 제16권13호
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• pp.5257-5260
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• 2015

Rates based on age-adjusted incidence of colorectal cancers over a 10-year period in Kerman, the biggest province of Iran, were estimated from 2003 to 2013. Data were obtained from the population-based cancer registry unit of Kerman University of Medical Sciences (CR-KMU). Information included age, sex, city, ICD-O and year of registry. Our trend analyses cover 3.91% of the Iranian population. The data set comprised cases diagnosed from 2003 to 2013.The population of over 20 years was interpolated using 2003 and 2010 censuses. Then, truncated age-adjusted incidence rates were calculated. Increase was noted from 2003-2009 to 2010-2013 for 731 cancer cases considered in the analysis. The increases was most prominent in 2009. Totally, the frequency of the cancer was greater in males. Moreover, calculating truncated age-adjusted incidence rate indicated that the most prevalent age of colorectal incidence was in the 50-59 year age group except in 2007-2008 and 2012- 2013, when greatest incidences occurred in people aged 60-69 years. Our data revealed that the incidence rates of colorectal cancer have increased over the past decade in our region of Iran.

• 보건행정학회지
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• 제30권2호
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• pp.199-210
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• 2020

Background: Based on the importance of ceasing smoking programs to control the regional disparity of smoking behavior in Korea, this study aims to reveal the variation of smoke rate and determinants of it for 229 provinces. An evaluation of the relative efficiency of the cease smoking program under the consideration of regional characteristics was followed. Methods: The main sources of data are the Korean Statistical Information Service and a national survey on the expenditure of public health centers. Multivariate regression is performed to figure the determinants of regional variation of smoking rate. Based on the result of the regression model, clustering analysis was conducted to group 229 regions by their characteristics. Three clusters were generated. Using data envelopment analysis (DEA), relative efficiency scores are calculated. Results from the pooled model which put 229 provinces in one model to score relative efficiency were compared with the cluster-separated model of each cluster. Results: First, the maximum variation of the smoking rate was 16.9%p. Second, sex ration, the proportion of the elder, and high risk drinking alcohol behavior have a significant role in the regional variation of smoking. Third, the population and proportion of the elder are the main variables for clustering. Fourth, dissimilarity on the results of relative efficiency was found between the pooled model and cluster-separated model, especially for cluster 2. Conclusion: This study figured regional variation of smoking rate and its determinants on the regional level. Unconformity of the DEA results between different models implies the issues on regional features when the regional evaluation performed especially on the programs of public health centers.

• Journal of Preventive Medicine and Public Health
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• 제54권2호
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• pp.103-109
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• 2021

Objectives: The aim of this study was to calculate the burden of stroke in Kurdistan Province, Iran between 2011 and 2017. Methods: Incidence data extracted from the hospital information system of Kurdistan Province and death data extracted from the system of registration and classification of causes of death were used in a cross-sectional study. The World Health Organization method was used to calculate disability-adjusted life years (DALYs). Results: The burden of stroke increased from 2453.44 DALYs in 2011 to 5269.68 in 2017, the years of life lost increased from 2381.57 in 2011 to 5109.68 in 2017, and the years of healthy life lost due to disability increased from 71.87 in 2011 to 159.99 in 2017. The DALYs of ischaemic stroke exceeded those of haemorrhagic stroke. The burden of disease, new cases, and deaths doubled during the study period. The age-standardised incidence rate of ischaemic stroke and haemorrhagic stroke in 2017 was 21.72 and 20.72 per 100 000 population, respectively. Conclusions: The burden of stroke is increasing in Kurdistan Province. Since health services in Iran are based on treatment, steps are needed to revise the current treatment services for stroke and to improve the quality of services. Policy-makers and managers of the health system need to plan to reduce the known risk factors for stroke in the community. In addition to preventive interventions, efficient and up-to-date interventions are recommended for the rapid diagnosis and treatment of stroke patients in hospitals. Along with therapeutic interventions, preventive interventions can help reduce the stroke burden.

• 보건행정학회지
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• 제14권3호
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• pp.20-44
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• 2004

The National Health Insurance Expenditure has been increased rapidly since the introduction of the separation of prescription and dispensing in 2000, and this trend of rapid growth in overall spendings rate has been observed predominantly among medical practitioners. This study was conducted to investigate the growth rate and distributional changes in private medical practitioners' expenses from 1999 to 2002 and its determinants using the National Health Insurance claims data. The total increasing rate of all medical practitioners' expenditure paid by the National Health Insurance between 1999 and 2002 was $41.71\%$, which exceeding that of general hospitals by $20\%$p. But the income distribution among each practitioner was improved as the changes in Gini coefficient(from 0.40 to 0.38) and decile distribution ratio(from 0.25 to 0.29) during the same period showed. However, this improvement in distributional patterns is not enough since even in 2002 it turned out that the highest $10\%$ income group earned 33times more than the lowest $10\%$ income group did. Also, higher Gini coefficient was observed in larger cities and some department like plastic surgery, obstetrics and gynecology. The major causes of this differentials in medical practitioners' expenses were factors related to medical demand like proportion of old population, residential economic status in a given area. In addition, providers' economic incentives also played an important role in determining their income distribution. The large income differentials among physicians may imply a skewed distribution of patients and thus long waiting time, inefficient utilization of resources and potential inadequate quality of care. In this sense, unreasonable distributional gaps should be reduced, so effective measures as well as ongoing monitoring would be necessary to correct current distributional problems.

• 보건행정학회지
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• 제33권1호
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• pp.40-54
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• 2023

Background: Based on the increase in the needs for convalescent rehabilitation medical services in Korea, this study aims to calculate the needs for rehabilitation services and examine its determinants for 229 regions. Methods: Claim data from the Health Insurance Review and Assessment Service were used to estimate patients who need to receive rehabilitation services, and data from various sources were also used for analysis. The number of cases and incidence rates of hospitalization related to convalescent rehabilitation were calculated to estimate the needs for services by region, and the results were visualized via a map. Multivariate regression and fixed effects regression using panel data were performed to identify the determinants of regional variation of the incidence rate. Results: First, the incidence rate of rural areas such as Jeolla-do, Gyeongsang-do, and Chungcheong-do was higher than urban areas (metropolitan cities). Second, the population, proportion of the elder, medical aid recipients, financial independence, traffic deaths, smoking, diabetes rate, and medical infrastructure correlated significantly with the incidence rate. Third, 'rho' values which mean the fraction of variance due to individual terms in panel data regression models were 0.965 and 0.976, respectively. Conclusion: The incidence rate of hospitalizations was correlated with most independent variables in this study and there is a gap between urban and rural areas. These regional disparities are fixed in our society. An improved regional convalescent rehabilitation system is suggested to cover the entire area including rural areas with a high rate of aging.

• 보건행정학회지
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• 제28권3호
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• pp.233-239
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• 2018

A rapid decrease of total fertility rate to 1.08 in 2005 prompted the Korean government to plan and implement a '5-year plan for ageing society and population policy' starting from 2006. The 1st and 2nd 5-year plans had not shown any discernible impact on the fertility and the 3rd 5-year plan was launched in 2016. However, the fertility rate is going down further. The author reviewed the contents and assessment reports of the fertility promotion plan to suggest ideas for complementing the shortcomings of it. Author defined the major determinants of marriage and child birth as philosophy, politics, sense of value, social norm, culture, healthcare, and education. The plan was examined in view of these determinants. Transformation of Korea from an agricultural society to an industrialized society in a short period of time had brought about changes in most of the determinants of marriage and child birth; in particular philosophy and sense of value. These aspects were not put into consideration in the plan. Author suggested to launch a social education program for the general public to establish a sound philosophy of life, reform the sense of value on family, child birth and education, and cultivate the skill to draw a consensus through discussions on the social issues. A special program to promote marriage of women at the optimum age for child birth was proposed. The government should implement well balanced policy for economic development and labor. Multidisciplinary approach was recommended for these tasks.

• 보건행정학회지
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• 제13권2호
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• pp.23-43
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• 2003

The purpose of this study was to explore the determinants of induced abortions of married women in Korea, with focus on the socioeconomic factors including fertility behaviors and ideation regarding family values. Data from the 2000 Korea National Fertility Survey by Korea Institute of Health and Social Affairs were used for the research. In particular, the women´s fertility history from 1998 to 2000 was served as the main data for this study. Among 1,901 pregnancies in total, 1,612 pregnancy outcomes were selected for the final analysis. Chi-square test, Wilcoxon rank sum test and multivariate logistic regressions were employed to identify influential factors on induced abortions. According to the results, working women was more likely than those who did not work to terminate their pregnancy by an induced abortion. Women´s religion did not show any significant impact on an induced abortion. A pregnant woman already having more than or equal to two children was very likely to choose an induced abortion. Likewise, those in unwanted pregnancy showed high probability of induced abortions. However, contrary to what we believe, it turned out that the number of sons did not affect the choice of induced abortions.

• 대한간호학회지
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• 제53권1호
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• pp.101-114
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• 2023

Purpose: This study aimed to identify regional differences in problem drinking among adult males in single-person households and predict the determinants. Methods: This study used data from the 2019 Community Health Survey. Geographically weighted regression analysis was performed on 8,625 adult males in single-person households who had been consuming alcohol for the past year. The Si-Gun-Gu was selected as the spatial unit. Results: The top 10 regions for problem drinking among adult males in single-person households were located in the Jeju-do and Jeollanam-do areas near the southern coast, whereas the bottom 10 regions were located in the Incheon and northern Gyeonggi-do areas. Smoking, economic activity, and educational level were common factors affecting problem drinking among this population. Among the determinants of regional disparities in problem drinking among adult males in single-person households, personal factors included age, smoking, depression level, economic activity, educational level, and leisure activity, while regional factors included population and karaoke venue ratio. Conclusion: Problem drinking among adult males in single-person households varies by region, and the variables affecting each particular area differ. Therefore, it is necessary to develop interventions tailored to individuals and regions that reflect the characteristics of each region by prioritizing smoking, economic activity, and educational level as the common factors.

• Safety and Health at Work
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• 제14권4호
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• pp.368-374
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• 2023

Background: Recognizing that access to safe and healthy working conditions is a human right, the World Health Organization (WHO) calls for specific occupational safety and health (OSH) programs for health workers (HWs). The WHO health systems' building blocks, and the International Labour Organization (ILO), highlight the importance of information as part of effective systems. This study examined how OSH stakeholders access, use, and value an occupational health information system (OHIS). Methods: A cross-sectional survey of OSH stakeholders was conducted as part of a larger quasi experimental study in four teaching hospitals. The study hospitals and participants were purposefully selected and data collected using a modified questionnaire with both closed and open-ended questions. Quantitative analysis was conducted and themes identified for qualitative analysis. Ethics approval was provided by the University of Pretoria and University of British Columbia. Results: There were 71 participants comprised of hospital managers, health and safety representatives, trade unions representatives and OSH professionals. At least 42% reported poor accessibility and poor timeliness of OHIS for decision-making. Only 50% had access to computers and 27% reported poor computer skills. When existing, OHIS was poorly organized and needed upgrades, with 85% reporting the need for significant reforms. Only 45% reported use of OHIS for decision-making in their OSH role. Conclusion: Given the gap in access and utilization of information needed to protect worker's rights to a safe and healthy workplace, more attention is warranted to OHIS development and use as well as education and training in South Africa and beyond.

• 보건교육건강증진학회지
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• 제27권2호
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• pp.23-36
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• 2010

Objectives: This study was performed to suggest the roles and professional competencies of health education specialists to improve the efficacy of health promotion activities in public health organizations. Results and Conclusion: Based on the advanced cases of utilizing health education specialists in international and domestic public health organizations, five key roles of health education specialists were proposed. They included developing and applying behavior change strategies necessary to begin and maintain health behavior practices, analysing the needs of the priority population in a systematic way, organizing multiple health behavior change programs and multilevel intervention programs, and doing research on health determinants and scientific evidence of health promotion programs, In order to improve the quality of health promotion services in public health organizations, professional competencies of health education specialist should be developed and strengthened.