• Title/Summary/Keyword: Health gap

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Effects of Regional Medical Insurance on Utilization of Medical Care in Urban Population (지역의료보험 실시전후 도시 일부주민의 의료이용양상 비교 - 소득 계층별 의료필요충족도와 주민 만족도를 중심으로 -)

  • Kim, Seok-Beom;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.1 s.45
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    • pp.117-134
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    • 1994
  • The effects of regional medical insurance on utilization of medical care in urban population was examined in this study. The data was collected in a 2-year follow-up household survey conducted at Taegu city before and after implementation of the regional medical insurance. The study population was divided into 2 groups. Cohort I was the uninsured in 1989 and cohort II was the insured in 1989. After the coverage of medical insurance, physician visit rate per 1,000 population, use-disability ratio and use-restricted activity ratio in cohort I were increased compared to cohort II in both of acute and chronically ill people. The use-disability ratio and use-restricted activity ratio of the insured poor were lower than those of the insured nonpoor in both of cohort I and cohort II. The major reasons for pharmacy use were accessibility and affordability before the coverage of medical insurance in cohort I, however, after the coverage of medical insurance, the important reason was accessibility rather than affordability. In logistic regression analysis of physician visit, the significant independent variables were acute illness episode (+), chronic illness episode (+) and income (+) in both of cohort I and cohort II. In cohort I, after the coverage of medical insurance, more people replied that the medical cost of hospital and clinic was reasonable. The people who covered by the regional medical insurance were more dissatisfied with the imposed premium than those who covered by other types of medical insurance in both of cohort I and cohort II. More people in cohort II than cohort I were dissatisfied with the services from hospitals and clinics after implementation of the regional medical insurance. In conclusion. after the coverage of medical insurance, the gap between the poor and the nonpoor still exists in terms of medical care utilization.

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A comparative Study of Changing Pattern of Cause of Death Analysis of Korean, Korean in Japan and Japanese (재일한국인의 생활문화의 이질화와 적응과정에 관한 보건학적 연구(제 1보 한국, 재일한국인, 일본의 사인구조분석)

  • 김정근;장창곡;임달오;김무채;이주열
    • Korea journal of population studies
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    • v.15 no.2
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    • pp.15-59
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    • 1992
  • After world war II Japanese life expectancy has been improved remarkably, and reached the highest level in the world around late 1970's. The life expectancy of Korean has also shown tremendous improvement in recent years with about 20 year's gap from the Japanese. The reason of rapid improvement of life expectancy can be explained by changes in the structure of cause of death due to health system, living standard, social welfare, health behavior of individuals and so on. Korean in Japan is placed under different situations from both Korean in Korea and Japanese in these regards, and expected to show different picture of cause of death pattern. The objective of this study is the comparision of changing patterns of cause of death of three population groups, Korean in Japan, Korean in Korea and Japanese, and to investigate the reasons which effect to the structural difference of mortality cause with special emphasis on health ecological aspects. One of the major limitations of the Korean causes of death statistics is the under-registration which ranges about 10% of the total events, and inaccuracy of the exact cause of death. Some 20% of registered deaths were unable to classify by ICD. However, it is concluded that the Korean data are evaluated as sufficient to stand for over-viewing of trends of cause of death pattern. The evaluation is done by comparing data from registration and field survey over the same population sample. Population data of Korean in Japan differ between two sources of data; census and foreigner's registration. Correction is done by life table method under the assumption that age-specific mortality pattern would accord with that of the Japanese. The crude death rate was lowest among Korean in Japan, 5.7 deaths per 1,000 population in 1965. The crude death rates of Korean in Japan and Japanese are increasing recently influenced by age structure while Korean in Korea still shows decreasing tendency. The adjusted death rate is lowest among Japanese, followed by Korean in Japan, and Korean in Korea. The leading causes of death of Korean in Korea until 1960's was infectious diseases including pneumonia and tuberculosis. The causes of death structure changed gradually to accidents, neoplasm, hypertensive disease, cerebro-vascular disease in order. The main difference in cause of death between Korean and Japanese if high rate of liver diseases and diabetes for both Korean in Japan and Korea. A special feature of cause of death among Korean in Korea is remakably high rate of hypertensive disease, which is assumed to be caused by physicians tendency in choosing diagnostic categories. The low ischemic heart disease and high vasculo-cerebral disease are the distinctive characteristic of the three population groups compared to western countries. Specific causes of death were selected for detailed sex, age and ethnic group comparisons based on their high death rates. Cancer is the cause of death which showed most dramatical increase in all three population groups. In Korea 20.1% of all death were caused by cancer in 1990 compared with 10.5% in 1981. Cancer of the liver is the leading cause of cancer death among Korean in Japan for both sexes, followed by cancer of the lung and cancer of the stomach, while that of Korean in Korea is cancer of the stomach, followed by cancer of the liver and cancer of the lung for male. Causes of infant mortality were examined among the three population groups since 1980 on yearly bases. For both Japanese and Korean in Japan, leading cause of death ranks as conditions originating in the perinatal period, congenital anomalies, accidents and other violent causes. Trends since 1980 for these two population groups in the leading cause of infant mortality showed no changes. On the contrary, significant changes in leading cause of death structure in Korea were observed : the ranking of leading cause of death in 1981 were congenital asnomalies, pneumonia bronchitis, infectious disease, heart disease, conditions originating in the perinatal period, accident and other violent causes ; in 1990 the ranking shifted to congenital anomalies, accident, pneumonia bronchities, conditions originating in the perinatal period, infectious disease. The mortality rate by congenital anomalies in Korea continuously grew than any other causes. Larger increase ocurred during the 1990's

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Prevalence and Management of Dyslipidemia Among Korean Adults: KNHANES 2010-2012 (한국 성인의 이상지질혈증 유병률과 관리: 국민건강영양조사 2010-2012)

  • Jang, Sungok;Lee, Jongseok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.11
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    • pp.7978-7989
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    • 2015
  • Dyslipidemia is a major risk factor for cardio-cerebrovascular disease. Although the prevalence among Korean adults is very high, its management is known to be poor. The aim of this study was to access the prevalence, awareness, treatment, and control rates of dyslipidemia according to treatment guideline rather than diagnostic criteria. The risk factors for cardio-cerebrovascular disease were evaluated to apply the appropriate risk-based threshold of the lipid treatment targets according to risk category. Analysis was done using nationally representative data (n = 16,263) collected from adults aged 20 years and older participating the Korea National Health and Nutrition Examination Survey (KNHANS) 2010-2012. The age-standardized prevalence rate of dyslipidemia according to treatment criteria was 34.1%. Of these prevalent cases, however, only 19.2% were aware; 9.5% treated; and 8.7% controlled. The age-standardized control rate among treated persons was 47.5%. Men had a significantly higher prevalence than women (39.7% vs. 28.8%), but a significantly lower rate of awareness, treatment, and control (16.0% vs. 22.3%, 7.7% vs. 11.3%, and 6.1% vs. 11.2%, respectively). As the higher risk category, the prevalence rate was higher but the control rate was lower. The prevalence of patients with diabetes was 82.5% when applying the treatment criteria (LDL-cholesterol level of ${\geq}100mg/dL$ and triglyceride level of ${\geq}200mg/dL$). However, only 11.9 % of these were controlled, whose LDL-cholesterol and triglycerides were lower than the treatment goals. Our findings suggest that effective strategies are required to decrease the gap between the prevalence of dyslipidemia and the following treatment. It would be worthwhile to strengthen the follow-up management of patients with dyslipidemia in the National Health Screening Program, especially in the high risk group of cardio-cerebrovascular disease.

Relationship between Bone Morphological Microstructure and Inflammatory Markers in Growing Mice Fed a High Fat Diet (고지방식이 공급에 따른 성장기 마우스의 골의 형태학적 미세구조와 염증지표 변화)

  • Kim, Mi-Sung;Lee, Hyun-A;Kim, Ok-Jin;Sohn, Cheong-Min
    • Journal of Nutrition and Health
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    • v.44 no.6
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    • pp.481-487
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    • 2011
  • Obesity not only reduces bone mineral density but also increases inflammatory markers. Therefore, we examined the change in inflammatory markers and morphological microstructure of the bones using a mouse model fed a high-fat diet. C57BL/6J 4-week-old male mice were divided into a control group (n = 6) and a experimental group (n = 6); the control group was provided with 10% Kcal fat diet, and the high-fat diet group was provided with 45% Kcal fat diet for 12 weeks using the free provision method. Blood was analyzed for inflammatory markers, and micro-computed tomography was used to measure the morphological microstructure of the femoral bone. The weight increases in the control group and high-fat diet group were $5.85{\pm}1.84g$ and $16.06{\pm}5.64g$, respectively (p < 0.01), glucose was $115.00{\pm}16.88mg/dL$ and $188.33{\pm}13.29mg/dL$ (p < 0.01), and triglycerides were $65.00{\pm}6.19mg/dL$ and $103.33{\pm}8.02mg/dL$ (p < 0.05) respectively. Leptin and interleukin (IL)-6 were significantly higher in the high-fat diet group than that in the control group (p < 0.01). As a result of a biochemical index analysis of bone metabolism, osteocalcin tended to be lower in the high-fat diet group, whereas CTx was significantly higher in the high-fat diet group compared to that in the control group (p < 0.01). The thickness of the bony trabecula was significantly narrower in the high-fat diet group than that in the control group (p < 0.05), and the gap in the bony trabecula was significantly wider in the high-fat diet group than that in the control group (p < 0.05). IL-6 and the gap in the bone trabecula, which was a morphological microstructure of the bones, showed a positive correlation (p < 0.05). Taken together, inducing obesity through a high-fat diet in mice during the growth phase caused a change in bone microstructure and was correlated with the inflammation index. Accordingly, restriction of excessive fat intake may be needed to suppress the inflammatory reactions and promote normal bone formation.

Development of 2.5D Electron Dose Calculation Algorithm (2.5D 전자선 선량계산 알고리즘 개발)

  • 조병철;고영은;오도훈;배훈식
    • Progress in Medical Physics
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    • v.10 no.3
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    • pp.133-140
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    • 1999
  • In this paper, as a preliminary study for developing a full 3D electron dose calculation algorithm, We developed 2.5D electron dose calculation algorithm by extending 2D pencil-beam model to consider three dimensional geometry such as air-gap and obliquity appropriately. The dose calculation algorithm was implemented using the IDL5.2(Research Systems Inc., USA), For calculation of the Hogstrom's pencil-beam algorithm, the measured data of the central-axis depth-dose for 12 MeV(Siemens M6740) and the linear stopping power and the linear scattering power of water and air from ICRU report 35 was used. To evaluate the accuracy of the implemented program, we compared the calculated dose distribution with the film measurements in the three situations; the normal incident beam, the 45$^{\circ}$ oblique incident beam, and the beam incident on the pit-shaped phantom. As results, about 120 seconds had been required on the PC (Pentium III 450MHz) to calculate dose distribution of a single beam. It needs some optimizing methods to speed up the dose calculation. For the accuracy of dose calculation, in the case of the normal incident beam of the regular and irregular shaped field, at the rapid dose gradient region of penumbra, the errors were within $\pm$3 mm and the dose profiles were agreed within 5%. However, the discrepancy between the calculation and the measurement were about 10% for the oblique incident beam and the beam incident on the pit-shaped phantom. In conclusions, we expended 2D pencil-beam algorithm to take into account the three dimensional geometry of the patient. And also, as well as the dose calculation of irregular field, the irregular shaped body contour and the air-gap could be considered appropriately in the implemented program. In the near future, the more accurate algorithm will be implemented considering inhomogeneity correction using CT, and at that time, the program can be used as a tool for educational and research purpose. This study was supported by a grant (#HMP-98-G-1-016) of the HAN(Highly Advanced National) Project, Ministry of Health & Welfare, R.O.K.

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A Comparative Study on the Ametropias of Philippines and Koreans (한국인과 필리핀인의 굴절이상에 대한 연구)

  • Lee, Hark-Jun;Kwen, Man-Sung
    • Journal of Korean Ophthalmic Optics Society
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    • v.17 no.4
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    • pp.477-482
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    • 2012
  • Purpose: This study is aimed at finding the conditions of ametropia of adults in the Philippines and the South Korean. Methods: The study objects were 7,695(15,390 eyes) Koreans and 2,256(4,512 eyes) Philippines who visited optic clinics and took refraction test. The distributions of their hypermetropias and myopias about astigmatisms were examined, using the method of equivalent spherical power. When astigmatisms were marked in S-C, cylinder lens diopter and astigmatism axis, presbyopic additions and pupillary distances were analyzed by comparison respectively. Results: Among ametropias of Koreans myopias and hypermetropias were 93.69% and 6.31% respectively and about ametropias of Philippines myopia and hypermetropias were 73.43% and 26.57% respectively. As for spherical equivalent power about Koreans, the results showed that Koreans marked -3.352 D about myopia and Philippines marked -2.213 D about it. There is a gap of -1.139 D between them. About hypermetropia Koreans marked 1.147 D and Philippines, 1.251 D and their gap is 0.104 D. As for ametropia of Koreans there is 49.86% in middle myopia, 32.28% about low myopia, 11.55% about high myopia, and 5.54% about low hypermetropia, 0.75% about middle hypermetropia. As for it about Philippines there is 44.53% in low myopia, 25.11% about middle myopia, 3.79% high myopia and 23.03% low hypermetropia, and 3.51% low hypermetropia respectively. As for cylinder lens there is differences of 0.194 D and 0.22 D between Korean and Philippine for both sexes. Totally Koreans have higher cylinders of 0.175 D than Philippines. As for astigmatism, Koreans have direct astigmatism, inverse astigmatism, and oblique astigmatism in their suffering sequence. As for Philippines, they have direct astigmatism, inverse stigmatism, and oblique astigmatism in their abnormal sequence, and they have higher oblique stigmatism than Koreans. As for presbyopic addition, Philippines have higher distributions than Koreans, and 0.296 D is higher in average. As for pupillary distance, Koreans have longer distance of 0.97 mm in man and 0.63 mm in women than Philippines. Conclusions: As for ametropia, Koreans and Philippines have more myopias than hypermetropias, but Philippines have more rates of hypermetropias than Koreans. And Philippines have more presbyopic additions. Koreans have higher morbidity of inverse astigmatism, and Philippines have higher morbidity of oblique astigmatism comparatively. As for pupillary distance, Koreans have longer length in the body characteristics. This shows that geographical circumstances have much to do with refraction conditions of eyes.

The Influence of the Restrictions in Chinese economic growth on Korean commercial environment (중국 경제성장의 제약요인이 한국 통상환경에 미치는 영향)

  • Shong, Il-Ho;Lee, Gye-Young
    • International Commerce and Information Review
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    • v.15 no.4
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    • pp.457-479
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    • 2013
  • Through a Chinese rise, Chinese dream is actualizing as the world's great power. According to outlook of World Bank and IMF, Around 2030 China will be a great power bigger than America's economic power. The rise of China will give a huge impact to the whole world. China expands her influence through a global manufacturing base and a global market. To actualize 'Peaceful Rise' Strategy, China has many constraints. Chinese society is facing many difficult social problem due to side effects of a rapid development. Such as the spread of corruption, the severity of wealth gap, environmental degradation and energy shortage. Internationally there are containment from hegemon so-called 'China threat' dispute, Taiwan issue and territorial disputes. Western countries are hostile to China for two reasons. Based on expectations, one is China's socialist system and the other is the rising China which will compete for supremacy with Europe and America. Recent emergence of Chinese nationalism and the containment of the neighboring countries are also serious limiting factors. Domestically they have the rampant corruption in the bureaucracy, weakened capacity of Communist rule, wealth disparity due to the discriminatory economic development strategy, seriousness of rural problem, social instability, lack of social security systems and the development gap between the eastern coastal areas and western inland areas, ethnic minorities problems, the constraint of sustainable development issues due to lack of resources, environmental pollution and energy constraints. Like the former Soviet Union, China may face a dismantlement. After the rise, China may encounter possibilities of a war between great powers or a collapse of Chinese society caused by deepening internal conflict. Serious economic polarization would make peasants and urban workers, who are social vulnerable people, to turn their back to communist party and threaten the justification and the appropriateness of the ruling communist party. Chinese government will think internal system security threat is more formidable risk factor than a system security threat from the hegemon. The decline of great country comes from internal reasons rather than external reasons. To achieve peaceful rise, unification with Taiwan is an essential prerequisite. Taiwan issues are complex problems which equipped with international and domestic factors. Lack of energy resources, environmental pollution in China will bring economic crisis to Korean enterprises. Important influence to Korean economy will be a changeover of the method in economic development. It will turn the balance of investment and consumption, GDP-centered growth to consumption and environment-centered growth. Services industries including finance, environment, culture, education, health care and social welfare will grow. Change in China's growth model will give a great challenge upon the intermediate goods industry in Korea. Korea should reduce the portion of machinery, automotive, semiconductor, steel and chemical-centered export industry to China, and should increase the proportion of the service industry.

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Analysis of User Perception Gap regarding User Management by the Characteristic of Districts in Gyeongju National Park (경주국립공원 지구특성에 따른 이용자 관리 정책에 대한 인식 차이 분석)

  • Lee, Seul Bee;Son, Soo-Hang;Kang, Eun-Jee;Kim, Yong-Geun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.43 no.4
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    • pp.75-86
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    • 2015
  • The survey was taken from July to August 2012 by users who visited Gyeongju National Park to compare the perceived gap of users regarding management policy by characteristic of Gyeongju National Park district type in this study. Gyeongju National Park users' characteristic, use pattern and perception regarding park management policy were created as survey items. First, district type was classified based on use pattern of the visitor and the key resources of 8 districts in Gyeongju National Park. Tohamsan District, which has many visitors for the purpose of scenery appreciation and recreation with Bulguksa and Seokguram Grotto, is classified as tourism type, Namsan and Daebon District, which bring in many visitors seeking to learn about historical culture and environmental education, could be classified as historical culture education types, and Hwarang, Seoak, Sogeum River, Gumisan District are places residents use for physical training, hiking and walking to improve health, thus classifying them as neighborhood park types. People perceived that the tourism type is where users for historical artifact tours are concentrated, thus consideration for plans that can improve visitors' satisfaction from a user limit policy is required, and a manager's right to control use behavior must be reinforced in historical culture education types. On the other hand, users of neighborhood parks found the lowest necessity for most of the policy, and this showed that users of each of Gyeongju National Park's districts felt differently about the need for policies. This result is expected to be utilized as a database for introducing policy that reflects the perception of users in each districts of Gyeongju National Park in the future.

Spectral Analysis of Resting EEG in Brain Compartments (휴지기 뇌파의 구역별 주파수 분석)

  • Lee, Migyung
    • Sleep Medicine and Psychophysiology
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    • v.27 no.2
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    • pp.67-76
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    • 2020
  • Objectives: Brain maturation involves brain lateralization and asymmetry to achieve efficient information processing and cognitive controls. This study elucidates normal brain maturation change during the gap between ages 6-9 and age 14-17 using resting EEG. Methods: An EEG dataset was acquired from open source MIPDB (Multimodal Resource for Studying Information Processing in the Developing Brain). Ages 6-9 (n = 24) and ages 14-17 (n = 26) were selected for analysis, and subjects with psychiatric illness or EEG with severe noise were excluded. Finally, ages 6-9 (n = 14) and ages 14-17 (n = 11) were subjected to EEG analysis using EEGlab. A 120-sec length of resting EEG when eyes were closed was secured for analysis. Brain topography was compartmentalized into nine regions, best fitted with brain anatomical structure. Results: Absolute power of the delta band and theta band in ages 6-9 was greater than that of ages 14-17 in the whole brain, and, also is relative power of delta band in frontal compartment, which is same line with previous studies. The relative power of the beta band of ages 14-17 was greater than that of ages 6-9 in the whole brain. In asymmetry evaluation, relative power of the theta band in ages 14-17 showed greater power in the left than right frontal compartment; the opposite finding was noted in the parietal compartment. For the alpha band, a strong relative power distribution in the left parietal compartment was observed in ages 14-17. Absolute and relative power of the alpha band is distributed with hemispheric left lateralization in ages 14-17. Conclusion: During the gap period between ages 6-9 and ages 14-17, brain work becomes more complicated and sophisticated, and alpha band and beta band plays important roles in brain maturation in typically developing children.

High Incidence of Hiatal Hernia in Esophageal Atresia and Its Etiologic Factors (선천성 식도폐쇄 수술 후 열공탈장의 호발과 그 유발인자)

  • Son, Hai-Young;Chang, Eun-Young;Chang, Hye-Kyung;Oh, Jung-Tak;Han, Seok-Joo
    • Advances in pediatric surgery
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    • v.17 no.2
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    • pp.170-178
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    • 2011
  • Hiatal hernia is a very rare disease in the pediatric population. However information from our esophageal atresia postoperative follow-up program has hypotheses; "Hiatal hernia may more frequently occur in postoperative esophageal atresia patients (EA group) than in the general pediatric population (GP group)" and "The tension on the esophagus after esophageal anastomosis may be an important etiologic factor of hiatal hernia in EA group". To prove the first hypotheses, we compared the incidence of hiatal hernia in the GP group with the incidence in the EA group. The Incidence in the GP group was obtained from national statistic data from Statistics Korea and Health Insurance Review and Assessment Service of Korea. The incidence in the EA group was obtained from the medical record and the imaging studies of our esophageal atresia postoperative follow-up program. To prove the second hypothesis, the presumptive risk factors for the development of hiatal hernia in EA group, such as the type of esophageal atresia, degree of esophageal gap, the stage operation and the redo-operation with resection and re-anastomosis of esophagus were analyzed statistically. The total number of patients in the EA group was ninety-nine and there were 5 hiatus hernias. The incidence of EA group (5 %) is significantly higher than incidence of GP group (0.024 %). (p=0.0001) The statistical analysis of the presumptive risk factors for hiatal hernia development in EA group failed to show any evidence of correlation between postoperative esophageal tension and the hiatal hernia. This study shows that the postoperative patients with esophageal atresia have high occurrence of hiatal hernia and should be followed up carefully to detect hiatal hernia.

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