• Health Policy and Management
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• v.26 no.4
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• pp.352-358
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• 2016

Summary measures of population health (SMPHs) have been used to estimate the burden of diseases. Among various type of SMPHs, disability adjusted life year (DALY) and healthy life expectancy (HALE) have been calculated in the global and national burden of disease studies. In order to calculate DALY and HALE, disability weight is an essential element. Disability weights quantify the level of disability for health states or diseases and have values between 0 (full health) to 1 (being dead). In this study, we reviewed the main disability weights studies and determined their meaning and limitations. Furthermore, we provided the whole process of typical disability weight study and reviewed key issues as follows: health state or disease description development, panel composition, valuation method, validation of disability weight, cross-cultural variability in health state or disease, and so on. The results from this study will be helpful to conduct future disability weight studies for adapting disability weights and developing new methodologies.

• Health Policy and Management
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• v.17 no.2
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• pp.33-51
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• 2007

The disabled population is a vulnerable group, having very complex medical conditions, but little is known about differences in the level of access by type of disability. This study was performed to investigate the differences of health care utilization by the type of disability. The database was constructed from registry of the disabled and health insurance and medical aid claims data submitted to the Korea Health Insurance Cooperation during in the year 2003. The disability classified three groups according to the Disabled Welfare Act; physically disability with external dysfunction, physically disability with organic disease, and mentally disability. There were huge differences in health care utilization by the type of disability. For the inpatient care, those with a mental disability were more likely to utilize health care services in terms of average visit number of medical facilities and visit days per case, but the treatment amount per case was the highest in physically disabled with organic disease. For the outpatient care, those who the physically disabled with organic disease were more likely to utilize health care services in terms of average visit number of medical facilities, treatment amount per case, and the treatment days per case. Also, those who physically disabled with organic disease were more likely to utilize general hospital for both inpatient and outpatient care, and spent more out-of-pocket expenditure. As the number of persons with disabilities rises, the need to consider new approaches to protecting their health grows increasingly. Especially, Korean health care system should be refined to be more responsive to the needs of the type of disability.

• Health Policy and Management
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• v.24 no.2
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• pp.172-180
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• 2014

Background: People with disabilities have higher prevalence rates and earlier onset of chronic disease than the non-disabled; therefore, their participation in health screening is important. This study evaluates the participation rate and trends in health screening of people with disabilities, and examines the association between their participation rate and disability characteristics, and socioeconomic status. Methods: Data on disability-related characteristics were collected from the National Disability Registry, and participants' corresponding health examination data were taken from the Korean National Health Insurance Corporation between 2002 and 2011. A total of 873,819 participants aged ${\geq}20$ years were analyzed in this study. Results: The rate of participation of people with disabilities in health screening has increased each year, but their participation rate is lower than that of the total population. The participation rate was lower in females than in males; the elderly group than in the younger group; those who live in city areas than rural areas; self-employed for health insurance than employees; those with an internal organ disability than those with an external physical disability; those with a severe disability than those with a mild disability; and those with a short-term disability than for those with a long-term disability. Conclusion: The factors associated with participation rate are age, sex, socioeconomic status, and disability characteristics. These findings indicate that health check-ups of people with disabilities should be promoted using an approach that takes into account the large individual differences in socioeconomic status and disability characteristics in this population.

• International Journal of Human Ecology
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• v.7 no.2
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• pp.75-84
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• 2006

Internalizing and externalizing behavior problems may be more common in children with disability families but rarely known is the magnitude of the problem and the risk factors compared to those in children with non-disability families. This study was undertaken to examine if socio-economic factors, parental health, and family functioning affect children's internalizing and externalizing behaviors differently between two comparison groups. The research literature on childhood behaviors was briefly reviewed. The data was derived from the Mental Health of Children and Young People in Great Britain, 2004. Regression analyses provide evidence that the family type, economic status, and income level are uniquely associated with an increased risks of internalizing or externalizing behavior problems in children with disability families, whereas sex, age, family size, parental health, and family functioning factors have similar impacts on the child's internalizing or externalizing variances between two groups. Intervention is desirable to address the concerns influencing internalizing and externalizing performances among children with disability or non-disability families.

• Health Policy and Management
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• v.21 no.4
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• pp.565-584
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• 2011

Objective: This study is examined the factors affecting forms of untreated experiences in persons with physical disability. Method: The data collected from 461 persons with physical disability in community. Based on the Behavioral Model of Andersen, predisposing, enabling, and need factors are hypothesized to affect persons with physical disability's untreated experiences. The data were analyzed by statistical methods such as frequency and multiple logistic regression analysis. Result: Participation rates of untreated experiences were 26.7%. The significant factors of persons with physical disability's untreated experiences are predisposing factors (gender, partner, and religion), enabling factors (income, private insurance, information of assistive device, disability discrimination, and subjective discrimination), and need factors(subjective health status health screening and chronic disease). Also untreated experiences related to gender, subjective health status, health screening, and chronic disease factors using multiple logistic regression analysis. Conclusion: Implications of the findings were discussed and the recommendations for the improvement of health care utilization, subjective health statue. Especially, development of health education and program should be needed persons with physical disability.

• Journal of Preventive Medicine and Public Health
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• v.45 no.4
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• pp.211-218
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• 2012

Objectives: The objective of this study was to identify the differences in obesity rates among people with and without disabilities, and evaluate the relationship between obesity rates and the existence of disabilities or characteristics of disabilities. Methods: Mass screening data from 2008 from the National Disability Registry and National Health Insurance (NHI) are used. For analysis, we classified physical disability into three subtypes: upper limb disability, lower limb disability, and spinal cord injury. For a control group, we extracted people without disabilities by each subtype. To adjust for the participation rate in the NHI mass screening, we calculated and adopted the weight stratified by sex, age, and grade of disability. Differences in obesity rates between people with and without disabilities were examined by a chi-squared test. In addition, the effect of the existence of disabilities and grade of disabilities on obesity was examined by multiple logistic regression analysis. Results: People with disabilities were found to have a higher obesity rate than those without disabilities. The obesity rates were 35.2% and 35.0% (people with disabilities vs. without disabilities) in the upper limb disability, 44.5% and 34.8% in the lower limb disability, 43.4% and 34.6% in the spinal cord injury. The odds for existence of physical disability and grade of disability are higher than the nondisabilities. Conclusions: These results show that people with physical disability have a higher vulnerability to obesity.

• Korean Journal of Social Welfare Studies
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• v.44 no.2
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• pp.297-326
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• 2013

The purpose of this study was firstly to analyse the conceptualization of disability of the Mental Health Act and related laws and to suggest revision of the definition of psychiatric disability of Mental Health Act to improve the protection of human rights and welfare of the people with psychiatric disability. For these purposes this paper reflected on the disability models of WHO(1980, 2001) and multiple paradigm of disability of Priestley(1998) and suggested a new conceptualization of disability consists of impairment, functional disability, and social interactional disability. Based on the analyses of conceptualizations of psychiatric disability of related laws, this study suggested revision of Mental Health Act to distinguish between mental disorder and psychiatric disability, to introduce the definition of mental capacity, and to expand the conceptualization of social interactional disability.

• Korean Journal of Health Education and Promotion
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• v.32 no.3
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• pp.109-120
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• 2015

Objectives: The purpose of this study was to investigate risk factors for chronic ADL, IADL disability. The study explored clinical and socio-demographic risk factors of functional status decline. Methods: Data from the Survey of Living Condition of Elderly 3-year panel study were analyzed. The study subjects were 5,928 community-dwelling people aged 65 years or older who were no disability in ADL and IADL at baseline. Predisposing factors, pathology, impairment, and functional limitations were regarded as risk factors. Logistic regression analysis was used. Results: During the 3-year study period, 3.9% participants developed chronic ADL disability, 9.4% participants were IADL disabled. After controlling for predisposing factor, the best predictors for ADL disability at 36 months were fall as a pathology factor, cognitive decline, disability judgement, lower limb functional limitation. Comorbidity, fall, cognitive decline, disability judgement, lower limb and upper limb functional limitation were risk factors for IADL disability. Conclusions: Health promotion program focusing elderly is essential to prevent ADL and IADL disability. Mobilizing physical activity should be included in health promotion program for elderly.

• Safety and Health at Work
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• v.10 no.3
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• pp.362-369
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• 2019

Background: Chronic nonspecific symptoms attributed to indoor nonindustrial work environments are common and may cause disability, but the medical nature of this disability is unclear. The aim was to medically characterize the disability manifested by chronic, recurrent symptoms and restrictions to work participation attributed to low-level indoor pollutants at workplace and whether the condition shares features with idiopathic environmental intolerance. Methods: We investigated 12 patients with indoor aire-related work disability. The examinations included somatic, psychological, and psychiatric evaluations as well as investigations of the autonomic nervous system, cortisol measurements, lung function, and allergy tests. We evaluated well-being, health, disability, insomnia, pain, anxiety, depression, and burnout via questionnaires. Results: The mean symptom history was 10.5 years; for disabling symptoms, 2.7 years. Eleven patients reported reactions triggered mainly by indoor molds, one by fragrances only. Ten reported sensitivity to odorous chemicals, and three, electric devices. Nearly all had co-occurrent somatic and psychiatric diagnoses and signs of pain, insomnia, burnout, and/or elevated sympathetic responses. Avoiding certain environments had led to restrictions in several life areas. On self-assessment scales, disability showed higher severity and anxiety showed lower severity than in physician assessments. Conclusion: No medical cause was found to explain the disability. Findings support that the condition is a form of idiopathic environmental intolerance and belongs to functional somatic syndromes. Instead of endless avoidance, rehabilitation approaches of functional somatic syndromes are applicable.

• Journal of Preventive Medicine and Public Health
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• v.35 no.4
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• pp.331-339
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• 2002

Objectives : To measure DALE (Disability-Adjusted Life Expectancy) in Korea to find out how long Koreans live in a state of full heath. Methods : DALE was calculated using the life table of 1999 and the disability prevalence from the National Health Interview Survey (NHIS), which was conducted with a sample of 13,523 households in 1998. The disability prevalence was measured using the annual prevalence of the long-term limitation of activities, which were divided into classes 1, 2, 3, 4, 5 and 6 according to the severity of the limitation. The disability weights were measured for each 6 class by conducting a survey of 16 healthcare professionals. The severity-adjusted disability prevalence was calculated by multiplying the disability prevalence of each class by the disability weights respectively. Healthy life years lost due to disability was calculated by multiplying the life expectancy by the severity-adjusted disability prevalence. Finally DALE was measured as the life expectancy minus healthy life years lost due to disability. Results : DALE for 1999, which refers to the expectation of equivalent years of good health, were 72.5, 69.5 and 75.3 years, for total, for males and for females, respectively. The percentages for DALE out of the life expectancy were 95.8, 96.6 and 94.4% for total, for males and for females, respectively. Conclusions : DALE is a newly developed indicator, which could effectively show the healthy life expectancy of populations. A greater notice and use of DALE would be expected as life expectancies increase and the quality of life changes in Korea.