• Journal of Preventive Medicine and Public Health
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• v.55 no.1
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• pp.28-36
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• 2022

The current multimorbidity correction method in the Global Burden of Disease studies assumes the independent occurrence of diseases. Those studies use Monte-Carlo simulations to adjust for the presence of multiple disease conditions for all diseases. The present study investigated whether the above-mentioned assumption is reasonable based on the prevalence confirmed from actual data. This study compared multimorbidity-adjusted years of lived with disability (YLD) obtained by Monte-Carlo simulations and multimorbidity-adjusted YLD using multimorbidity prevalence derived from National Health Insurance Service data. The 5 most common diseases by sex and age groups were selected as diseases of interest. No significant differences were found between YLD estimations made using actual data and Monte-Carlo simulations, even though assumptions about the independent occurrence of diseases should be carefully applied. The prevalence was not well reflected according to disease characteristics in those under the age of 30, among whom there was a difference in YLD between the 2 methods. Therefore, when calculating the burden of diseases for Koreans over the age of 30, it is possible to calculate the YLD with correction for multimorbidity through Monte-Carlo simulation, but care should be taken with under-30s. It is useful to apply the efficiency and suitability of calibration for multiplicative methods using Monte-Carlo simulations in research on the domestic disease burden, especially in adults in their 30s and older. Further research should be carried out on multimorbidity correction methodology according to the characteristics of multiple diseases by sex and age.

• Journal of Preventive Medicine and Public Health
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• v.32 no.3
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• pp.400-414
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• 1999

Objectives: This is a descriptive study which was carried out to identify characteristics of the chronic mentally ill and their families in a rural area and the influencing factors on family burden. Methods : Data was collected for seven months beginning April 1, 1998 by questionnaire from chronic mentally ill patients and their families in two towns and seven townships of the rural areas of Kyonggi Province. In additional to the mental diagnosis of the mentally ill patients, family burden was measured by interviewing the other family members using the questionnaire developed by Pai & Kapur (1981). Of those interviewed, 103 patients were selected for final analysis. Results : Of 103 mentally ill patients, 36.1% of the subjects were not under treatment. In particular, of 29 patients with schizophrenia, 48.3% of the subjects had stopped taking medication and 6.9% of the subjects had never been treated. According to the results of a specialized examination by a psychologist, 81% of patients were in need of Hospitalization. Most primary caregivers were parents. Of the 101 primary caregivers in the study, 39.6% were over 65 years old. In case of death of the primary caregiver, 50.5% of these 101 mentally ill patients would not have anyone to care for them. Of the various kinds of family burden, primary caregivers most often reported psychological stress. Overall, the families of dementia and schizophrenia patients complained of the most family burden. Through univariative analysis, the variables of sex, education and current treatment type of the patients, the relationship with the patient and marital status of the primary caregiver and the number of people living together in the household showed significant correlation with the family burden of schizophrenia patients. Univariative analysis also showed that there were a number of variables which were correlated to the family burden in mentally retarded patients. Concerning the need for mental health services, the most common requests were for entitlement to disability benefits and housing programs. Conclusions: Community mental health services in rural areas must be developed, planned and executed in consideration of the local situation. In particular, the development of various family support programs is needed in order to mitigate emotional, mental and economic burdens and carry out a positive role to care for and rehabilitate patients.

• 한국노년학
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• v.30 no.4
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• pp.1213-1223
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• 2010

The purpose of this study is to explore and describe the health and welfare needs experienced by old parents living with disabled adult children, and to help generate research interest and public policy attention on this critical issue. For the purpose of this study, the survey was conducted with older parents who are living with dependent adult children with physical or mental disability. Among collected data for this study, data for 105 older parents were analyzed. The results showed that older parents have suffered with care responsibilities for their disabled adult children as well as special needs resulted from their old age. And older parents have little or even nothing prepared for later life because of lifetime economic, physical and social difficulties related to their disabled children. Also these difficulties had a significant impact on their idea of health and welfare needs in later life. It showed that older parents had mainly concerned and wanted to have the direct cash benefits and medical provisions but hardly recognised the importance of other services such as leisure activities. Preliminary suggestions of this study therefore may be helpful to improve the public policy approach in order to better serve older parents with disabled adult children in the coming aging society.

• The Korean Journal of Health Service Management
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• v.5 no.2
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• pp.173-186
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• 2011

The purpose of this study was to know dysfunctions degree, daily living activity, depression and quality of life among stroke elderly person; and to know what kind of factors affecting to quality of life of the stroke elderly person; after that provide a fundamental data to nursing arbitration plan about increase height quality of life of the stroke elderly person. The study subjects were collected 119 people, over than 60 age, who were diagnosed with stoke in D hospital, living in B city. The data was collected by using personal interviews and questionnaire, from Nov 2008 to Jan 2009. The questionnaire were Pre-Stroke MRDS(Modified Rankin Disability Scale), Barthel-ADL(Activities of Daily Living), K-IADL(Korean-Instrumental Activities of Daily Living), GDS-15(Geriatric Depression Scale-15-question form) methods. The pre-stroke MRDS was appeared a functional obstacle. The mean score of activity of daily living was 18.24 which showed the subjects were mildly disabled, the score of instrumental activities of daily living was 7.94 which showed the mildly abled, and score of depressiveness was 7.41 which showed the subjects were mildly depression. There was a significantly correlation among MRDS, ADL, IADL, depressiveness and quality of life. Through these study result, important to check the old subjects' depressiveness, cognitive functions, daily living abilities, dysfunctions degree to main tain their quality of life.

• Health Policy and Management
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• v.30 no.2
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• pp.185-191
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• 2020

Background: From January 2018, a policy was applied to differentially apply the co-payment for medical expenses of 15,000 won or more from 30% to 10%-30% for each medical fee. This policy lowers the burden on the medical use of the elderly, and it is necessary to analyze the effect of the policy by confirming changes in medical use and supply behavior after 2 years. Methods: The National Health Insurance Service's national medical use database was used. As for the analysis method, first, the medical use and medical supply behavior change over the age of 65 years were confirmed, and second, in order to check the net effect of the policy, the 66-year-old as the experimental group and the 63-year-old as the control group were selected as the control group. The propensity score matching was performed using the variables of age, living alone, income quartile, residence, disability, chronic disease, and co-morbid disease scores, and then it was analyzed using the difference in difference analysis method. Results: The share of the number of treatments under 15,000 won decreased from 37.0% in 2017 to 20.2% in 2018, while the share of the number of treatments under 15,001-20,000 won increased from 8.0% to 22.7%. It was confirmed that the reason for the increase in the cost of treatment per treatment was the result of the increase in the amount of physical therapy and examination. As a result of the policy effect, the burden of co-payment per person was reduced, and as a result, the number of hospital visits per person and the total medical cost per person increased. Conclusion: The self-pay rate differential policy reduced the burden of medical expenses for the elderly and confirmed the increase in medical use. However, the interpretation of the increase in medical use was not able to distinguish whether the unsatisfactory medical care was satisfied or the inducement demand. Efficient allocation of resources is a more important point in the future when the super-aged society is in front. It is necessary to prepare a plan to induce rational medical use within a range that does not impair the medical accessibility of the elderly.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.4
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• pp.1721-1731
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• 2011

This study was performed to determine the levels of depression symptoms among community elderlies and to reveal its related factors, specifically aimed at revealing social and family supports. The interviews were performed, during the period from July 1, to August 31, 2010, to 412 elderlies in urban areas. As a results, significantly higher level of depression symptoms was laid on those with lower social supports and family supports(p=0.000), and the subjects' depression was a negative correlation with social and family support. On multiple regression analysis, the level of depression symptoms was influenced by the variables of social and family support, with or without disability of visual acuity, sense of satisfaction in daily life, number of friends, educational level, with or without spouse, activity of hobbies and urinary incontinence. In conclusion, the level of depression symptoms was so complicatedly influenced by variable factors as well as socio-demographic characteristics, health-related behaviors, health status, social support net-work and social activities. Especially, the level of depression symptoms was more influenced by social supports and family supports.

• The Journal of the Korea Contents Association
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• v.14 no.8
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• pp.266-276
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• 2014

The present study aims to determine the effect of the prevention exercise program of musculoskeletal disorders developed for apple and pear farmers. To achieve this goal, 25 farmers who have subjective symptoms in the musculoskeletal system (Criteria 1 in the National Institute for Occupational Safety and Health) have conducted the prevention exercise program for 12 weeks from April 7, 2011 to July 1, 2011. As a result, the prevention exercise program of the musculoskeletal disorders for farmers in the fruit growing industry have improved physical capability of them (upper extremity endurance, lower extremity endurance, balance and agility) as well as a quality of life effectively. In addition, a quality of life showed a significant correlation with Oswestry Disability Index, and Psychosocial Well-being Index. For the future study, various studies are expected to develop and apply exercise programs in consideration of the characteristics of farming work.

• Physical Therapy Korea
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• v.21 no.4
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• pp.56-66
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• 2014

For maintaining adequate psychometric properties when reducing the number of items from an instrument, item level psychometrics is crucial. Strategies such as low item correlation or factor loadings, using classical test theory, have traditionally been advocated. The purpose of this study is to describe the development of a new short form assessing the impact of low back pain on physical activity. Rasch measurement model has been applied to the International Classification of Functioning, Disability and Health Activity Measure (ICF-AM). One hundred and one individuals with low back pain aged 19-89 years (mean age: $48.1{\pm}17.3$) who live in the community were participated in the study. Twenty-seven items of lifting/carrying construct of the ICF-AM were analyzed. Ten items were selected from the construct to create a short form. Item elimination criteria include: 1) high or low mean square (out of the range: .6-1.4 for the fit statistics), 2) similar item calibrations to adjacent items, 3) person separation value, and item-person map for potential gap in person ability continuum. All 10 items of the short form fit to the Rasch model except one item (i.e., carrying toddler on back). Despite its high infit and outfit statistics (1.90/2.17), the item had to be reinstated due to potential gaps at the upper extreme of person ability level. The short form had a slightly better spread of person ability continuum compared to the entire set of item. The created short form separated individuals with low back pain into nearly 4 groups, while the entire set of items separated the individuals into 6 groups. The findings prompted multidimensional models for better explanation of the lifting/carrying domain. The item level psychometrics based on the Rasch model can be useful in developing short forms with rationally retained items.

• Journal of agricultural medicine and community health
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• v.36 no.2
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• pp.120-129
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• 2011

The purposes of this study were to measure health related quality of life (HRQOL) of persons disabled by stroke dwelling in Gyeongju-si using EQ-5D and to estimate total QALYs loss of persons disabled by stroke in Korea. The eligible subjects were 982 persons with stroke aged 50 and over in Gyeongju-si disabled registry, as of March, 2008. Interviewers measured HRQOL of study subjects using EQ-5D. EQ-5D index, utility weight, was derived from the Korean valuation set. In order to compare the results of this study, we selected two comparison groups representing Korean healthy population and general population of Korean using the 4th Korean National Health & Nutrition Examination Survey. Finally, after age and gender standardization, we estimated the total QALYs losses of persons disabled by stroke in Korea. Of 982 eligible subjects, 566 persons participated in the survey (response rate: 57.6%). In both of female and male, utility weights in the 70s or 80s were lower than those of the 50s or 60s. Utility weights differences among persons with disability, general population, and healthy population in male were larger than those differences in female. Total estimated QALY losses of persons disabled by stroke were 67,011.6 QALYs lower than healthy control group and 54,167.1 QALYs lower than general population, respectively.

• Journal of Industrial Convergence
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• v.21 no.3
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• pp.99-106
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• 2023

The purpose of this study was to identify the factors affecting depression according to the causes of suicidal ideation. The data used the 2021 Community Health Survey data. The participants of the study were 5,328 adults between the ages of 20 and 60 who responded that they had suicidal thoughts in the past year. For the analysis of the data, a composite sample analysis was performed using the SPSS 25.0 program. The results of the study are as follows. 1) In the economic difficulties group, age, gender, education level, economic activity, job change due to COVID-19, life satisfaction, subjective health status, stress, sleep time, and annual unmet medical care were the main factors related to depression. 2) In the interpersonal problem group, age, gender, education level, economic activity, life satisfaction, subjective health status, smoking, drinking, stress, and sleeping time were the main factors associated with depression. 3) In the disease and disability group, age, marital status, education level, life satisfaction, smoking, stress, sleep time, and annual unmet medical care were the main influencing factors of depression. Therefore, in order to reduce the rate of suicide and prevent depression, it is necessary to establish various strategies according to the causes of suicidal ideation and the influencing factors of depression.