• Health Policy and Management
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• v.15 no.4
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• pp.136-160
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• 2005

Before introducing the national long-term care insurance in 2008, the want for long term care service has to be estimated and analysed. This study estimates the demand and analyses what determines the want of long term care service. This study investigated data of 3f6 elderlies, that was collected by age stratified random sampling. The elderies resided in Onyang 4 - dong (urban area) and Dogo-myun (rural area) In the city of Asan. The researchers visited the elderlies and their care giver, and assessed their demand for the long term care service and examined physical, mental, socio-economic status by the assessment tools for Korean Long-Term Care System. $64\%$ of the those who are entitled to be served refuse the long term care service. $26.7\%$ of them wants for home care service and $7.9\%$ want facility care service. It is estimated that the want of home care service are three or four times as much as that of facility care service. The demand for long term care service is 5.155 times higher for those who live in rural area (p=0.000), 3.040 times higher for those who do not have spouse(p=0.057), and 3.356 times higher for the people who is in medicaid than medical insurance(p=0.029). However, income(p=0.782), means(p=0.614), living alone(p=0.223), number of family to live with (p=0.341) and age of the elderly(p=0.420) are not related with the demand of long term care service. The assessment tools for Korean Long-Term Care System for need evaluation of the long term care service can reflect the demand well.(p=0.024) If medical care will cover $80\%$ of total cost, the willingness to pay of the out of pocket money of the people with medical insurance is 67,400 Korean Won(66.77 US$) for the home care service and 182,500 Korean Won(180.78 US$) for the facility care service. There is possibility that long term care demand is still small after Introducing the long term care Insurance due to the care given by family members. When developing service delivery system of long term care insurance, rural area has to be given more consideration than urban area because of the higher demand. The people who do not have spouse or are in medicaid have to be given special consideration as well.

• Journal of Korean Society for Geospatial Information Science
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• v.22 no.3
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• pp.107-112
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• 2014

In keeping with the increasing demand for medical services in accordance with the economic development, the use of oriental medicine is on the rise year by year. In particular, it is a tendency that the elderly over age 65 prefer the oriental medicine to the western medicine in Korea. Under the circumstance, changing into an aging society, the importance of oriental medical services has been growing. In this regard, this study evaluated the quality of medical services by conducting the density analysis and the accessibility analysis of oriental medical clinic targeting Jinju, which is one of local small and medium-sized cities. The study results reveal that oriental medical hospitals accounted for 27% of the entire medical facilities in Jinju, and there was an imbalance in the quality of the oriental medical services according to districts(called dong) because oriental medical hospitals were mainly concentrated in the central commercial areas. In particular, in terms of the analysis on the accessibility of an aging population over age 65 to the oriental medical hospitals, over 50% of the whole districts (dongs) in Jinju were blind spots in medical services, showing a very vulnerable condition. Accordingly, it is judged that systematic measures for improvement in support of the oriental medical services in local small and medium-sized cities should be provided in Korea when we consider the characteristics of Korea where an aging population is rapidly increasing.

• Journal of Hospice and Palliative Care
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• v.18 no.4
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• pp.322-328
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• 2015

Purpose: The aging of society has rapidly progressed, especially in Korea. Therefore, the necessity of research on end-of-life (EOL) care in elderly patients has increased. However, there are few studies on EOL care intensity for non-cancer patients. This study was designed to compare the EOL care intensity between cancer and non-cancer patients. Methods: We retrospectively analyzed the EOL care intensity based on medical records of decedents of Kyung Hee University Medical Center, a tertiary referral hospital from December 2014 through March 2015. And we compared EOL care intensity between cancer patients and non-cancer patients using statistical analysis of the frequency of invasive procedures and logistic regression analysis for factors that affect the EOL care intensity. Results: Statistical analysis showed invasive procedures, such as intensive care unit admission, endotracheal intubation followed by mechanical ventilation and emergency dialysis, were performed more frequently in non-cancer patients than cancer patients (29.3% vs. 72.4%, P<0.001). And age (P=0.038) and morbidity of cancer (P<0.001) influenced the invasive procedural decision when analyzed by logistic regression analysis. Conclusion: The EOL care was more intensive in non-cancer patients, and age and morbidity of cancer were major factors for the treatment intensity.

• The Journal of the Korea Contents Association
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• v.12 no.2
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• pp.358-368
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• 2012

The purpose of this study was to discover the factors affecting on physical activity levels of community-dwelling older adults in Korea. The data was analyzed on 12,322 older adults, aged 65 or above, from the 2008 National Elderly Survey. The results of this study were as follows: First, 29.9% of older men and 46.4% of older women were classified as physically inactivity. Second, age(OR=1.44, p<.001), education(OR=1.17, p=.026), location of residence(OR=1.19, p=.016), perceived health status(OR=2.18, p<.001), chronic disease(OR=1.23, p=.020), pain(OR=1.24, p=.011), ADL(OR=1.86, p<.001), fear of fall(OR=1.26, p=.003), depression(OR=1.78, p<.001) predicted physical activity levels in older men. Age(OR=1.54, p<.001), perceived health status(OR=1.63, p<.001), pain(OR=1.45, p<.001), falling experience(OR=1.24, p=.001), ADL(OR=1.72, p<.001), depression(OR=1.46, p<.001) predicted physical activity levels in older women. It is suggested that the findings of this study are helpful to develop effective physical activity interventions for older adults.

• Journal of Families and Better Life
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• v.26 no.3
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• pp.37-52
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• 2008

The purpose of this study was to provide the valid data about residential-linked pension insurance development. The development was a part of national housing projects, which was an incentive for rural living of retired people, in order to relieve residential issues of elderly and revitalize rural communities by residents moving from cities. The insuring intent, decisive insuring factors and the residential service demand degree of people preparing retirement were analyzed. Data was collected in October, 2007. 364 Sample Subjects lived in Seoul Metropolitan area. Firstly, more than 90% of respondents had intention to purchase a residential-linked pension insurance and about 50% of them necessarily desired receiving premium for moving in. This indicated that it could be developed as an insurance which helped to meet housing expenses by housing-linked system, and in the mean time, it met the original purpose of pension insurance as the pension benefit could be guaranteed for all the insurance subscribers. Secondly, the respondents, whose income and private assets were higher, were able to pay more for insurance compared to average. Therefore, It was necessary to regulate monthly insurance bill and the payment period according to asset states of insurance subscribers after establishing certain amount of total insurance payment. Thirdly, by and large, it indicated the tendency that the less they prepare for older age the later they wanted to move into the pension insurance residence. It was inferred that in the case of insufficient preparation for older age, people preferred preparing behind time by postponing move in to moving in early to enjoy retired life, due to uncertainties. lastly, the respondents understood the significance of health, medical treatment and emergency management service and these two services were preferred as essential provided services. Because of the necessity of developing residential-linked pension insurance was found to be positive, further research to find the real cost, directives for operation and institutional support for this type of pension insurance might be needed.

• Tuberculosis and Respiratory Diseases
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• v.70 no.1
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• pp.28-35
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• 2011

Background: The aim of the study was to describe the characteristics, treatments, and outcomes of critically ill patients with pandemic Influenza A/H1N1 2009 at a major medical center in Korea. Methods: This retrospective observational study examined critically ill adult patients with pandemic Influenza A/H1N1 2009, who were admitted to the AMC between August and December 2009. Results: 27 patients with confirmed pandemic Influenza A/H1N1 2009 were admitted to the intensive care unit (ICU) at the Asan Medical Center (AMC). The median age (IQR) was 59 years (41~67), and 66.7% of the patients were older than 51 years. A total of 81.5% of the patients had 2 or more co-morbidities. The median time (IQR) from symptom onset to presentation was 2 days (1~4), and the median time from presentation to ICU admission was 0 days (0~1.5). All patients received oseltamivir (300 mg/day) and 13 patients received triple combination therapy (oseltamivir, amantadine, ribavirin). Twelve patients required mechanical ventilation on the first day of ICU admission. A total of 6 patients (22.2%) died within 28 days of admission. The patients who died had significantly higher acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores at presentation. There were no significant differences in age, co-morbidities, or antiviral regimens between survivors and non-survivors. Conclusion: Critical illness related to pandemic Influenza A/H1N1 2009 was common in elderly patients with chronic co-morbidities. All patients were given high-dose oseltamivir or triple combination antiviral therapy. Nonetheless, patients with critical illnesses associated with pandemic Influenza A/H1N1 2009 had a death rate of 22.2%.

• Korean Journal of Clinical Pharmacy
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• v.23 no.1
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• pp.42-48
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• 2013

Background: Patients diagnosed with cancer tend to have multiple risk factors for drug related problems such as old age, comorbid conditions, self-medication, additional medications for supportive therapy, and the cancer treatment itself. Objective: The aim of this study was to investigate notable polypharmacy and related problems in oncology patients during hospitalization or following clinic visit. Method: The electronic medical records of patients who were discharged from oncology division at Seoul National University Hospital (SNUH) from June $1^{st}$ to June $30^{th}$, 2011 were retrospectively reviewed. Results: A total of 334 discharged patients were included in this study. Among them, 221 patients had pre-admission medications. Forty percent of the patients, including 60.3% of elderly patients (over 65 years of age) were prescribed more than 5 kinds of medications. Twenty percent of the patients were prescribed to take medications more than 7 times a day. Medication duplications were observed in 2.4% of patients. In 10.5% of the reviewed patients, 47 cases of potential drug-drug interaction including 3 cases of contraindication and 17 cases of major clinical implication according to Micromedex were detected. Medication changes were made in 88% of patients during hospitalization and in 94.7% of patients at their first visit after discharge. Antidiarrheal agent (loperamide) was prescribed along with laxatives in 18.5% of the prescriptions and inadequate instructions on how to take it were observed in 63% of the prescriptions. Conclusion: This study identified the prevalence of polypharmacy and related problems in cancer patients, which presents the need for an active role of pharmacists in pharmaceutical care in oncology wards.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.215-220
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• 2009

Purpose: This study is to analyze the prevalence of various intra-articular lesions in patients with traumatic recurrent anterior dislocation of shoulder over 40 years and suggest clinical implications for treatment. Materials and Methods: We retrospectively studied 16 cases that underwent surgical treatment for recurrent anterior dislocation of shoulder from January 2001 to May 2009. There were 9 males and 7 females, and the mean age was 52.7years. We carried out arthroscopic exam for all patients based on standard protocol, which included labrum, capular lesion, cuff, bony lesions. Results: All 16 cases showed Hill-Sachs lesion, 3 patients (19%) had bony Bankart lesion, 6 patients (38%) had labral tear. Capsular tear were found 15 patients (94%). Twelve (75%) had ruptured supraspinatus and 5 (31%) had subscapularis tear. Only one (6%) had SLAP lesion. Conclusion: There was relatively higher incidence of capsular and rotator cuff tears in patients over age 40 years. Preoperative planning to address these lesions is highly recommended.

• Journal of Preventive Medicine and Public Health
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• v.52 no.6
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• pp.405-415
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• 2019

Objectives: The aim of this study was to evaluate the associations of frailty with perceived neighborhood walkability and environmental pollution among community-dwelling older adults in rural areas. Methods: The participants were 808 community-dwelling men and women aged 65 years and older in 2 rural towns. Comprehensive information, including demographics, socioeconomic status, grip strength, polypharmacy, perceived neighborhood environment (specifically, walkability and environmental pollution), and frailty, was collected from participants using face-to-face interviews conducted between June and August 2018. Perceived neighborhood walkability was measured using 20 items that were selected and revised from the Neighborhood Environment Walkability Scale, the Neighborhood Walkability Checklist from the National Heart Foundation of Australia, and the Physical Activity Neighborhood Environment Survey. The Kaigo-Yobo Checklist was used to assess participants' frailty. Results: The overall prevalence of frailty in this community-dwelling population was 35.5%. Sex, age, cohabitation status, educational attainment, employment status, grip strength, and polypharmacy were significantly associated with frailty. In the logistic regression analysis, frailty was associated with low perceived neighborhood walkability (adjusted odds ratio [aOR], 0.881; 95% confidence interval [CI], 0.833 to 0.932; p<0.001) and severe perceived neighborhood environmental pollution (aOR, 1.052; 95% CI, 1.017 to 1.087; p=0.003) after adjusting for sex, age, cohabitation status, educational attainment, employment status, monthly income, grip strength, and polypharmacy. Conclusions: More studies are warranted to establish causal relationships between walkability and environmental pollution and frailty.

• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.2
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• pp.108-117
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• 2019

Purpose: The study examined the poisoned patients' characteristics nationwide in Korea by using data from the National Emergency Department Information System (NEDIS). Methods: Among the patients' information sent to NEDIS from January 1, 2013 to December 31, 2015, the included subjects' main diagnosis in ED showed poisoning according to the 7th edition of the Korean Standard Disease Classification (KCD-7). We analyzed the patients' gender, age, initial vital signs, visit time, stay time of staying in ED, results of ED care, main diagnosis in ED, length of hospitalization, and results of hospitalization. Results: A total of 106,779 ED visits were included in the analysis. There were 55,878 males (52.3%), which was more than the number of females. The number of intentional poisoning was 49,805 (59.6%). 75,499 cases (70.8%) were discharged, and 25,858 cases (24.2%) were hospitalized. The numbers of poisoning patients per 1,000 ED visits were 14 in Chungnam and 11.9 in Jeonbuk. The most common cause of poisoning, according to the main diagnosis, was venomous animals. It was the same for hospitalized patients, and pesticide was next. Pesticide was the most common cause of mortality in ED (228 cases, 46.1%) and after hospitalization (584 cases, 54.9%). The incidence of poisoning by age group was frequent for patients in their 30s to 50s, and mortality in ED and post-hospitalization were frequent for patients in their 60s to 80s. Conclusion: This study investigated the characteristics of poisoning patients reported in the past 3 years. Pesticide poisoning had a high mortality rate for patients in ED and in-hospital. For mortality, there was a high proportion of elderly people over 60. Thus, policy and medical measures are needed to reduce this problem. Since it is difficult to identify the poison substance in detail due to nature of this study, it is necessary to build a database and monitoring system for monitoring the causative substance and enacting countermeasures.