• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.176-183
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• 2021

Objectives : The purpose of this study was to find out how demographic factors, suicide attempt patterns, psychiatric history and management of suicide attempters affect the completion of emergency department (ED) based case management program. Methods : Among the patients who attempted suicide and visited the emergency department of Chung-Ang University Hospital from June 1, 2018 to May 31, 2021, 661 patients who agreed to case management were studied. After being discharged from the emergency department, subjects were registered for an eight-week follow-up service program. Hierarchical logistic regression analysis was conducted with demographic factors, suicide attempt patterns, psychiatric history and management as independent variables, and completion of case management program as dependent variables. Results : Suicide attempt pattern had the most significant influence on the completion of case management program, followed by demographic factors, psychiatric history and management. Those who completed the case management program were significantly more likely to have suicide plans in the future, more authentic in suicide attempts, and had higher proportion of past suicide attempts than those who did not complete the program. Conclusions : To ensure that the subjects complete the follow-up project program and get connected to community services, an individualized approach with consideration of suicide attempt patterns, demographic factors, and psychiatric history is needed.

• Health Policy and Management
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• v.31 no.1
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• pp.74-90
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• 2021

Background: It is getting important to improve the oral health status of the elderly because oral health status may affect their health status of the whole body. In this respect, we aimed to explore the association of oral health status and behavior factors with self-rated health status by sex. Methods: Using the data from the 7th Korea National Health and Nutrition Examination Survey for health surveys and oral examinations (2016-2018), we analyzed a total of 3,070 people aged 65 or older (men: 1,329; women: 1,741). Our dependent variable, self-rated health status, was divided into two groups: not good (bad and very bad) and good (very good, good, and fair), whereas our independent variables of interest were oral health status and behavior factors. In addition to descriptive analysis and the Rao-Scott chi-square test, reflecting survey characteristics, we conducted hierarchical multivariable logistic regression analyses adjusted for socio-demographics and health status and behavior factors. All analyses were stratified by sex. Results: The proportion of people having 'not good' self-rated health was 36.5% in women but 24.5% in men. In a model adjusted for all covariates, the self-rated health status showed significant association with the self-rated oral health status. For example, in men, the risk of having 'not good' self-rated health was high in people having 'poor' (odds ratio [OR], 5.31; 95% confidence interval [CI], 2.34-12.03) self-rated oral health status and in those having 'fair' (OR, 4.03; 95% CI, 1.68-9.70) in comparison with those having 'good' self-rated oral health status. Dental status regarding speaking difficulty seemed to be very important in influencing self-rated health status. For instance, in women, compared to people having 'no discomfort' speaking difficulty, the risk of having 'not good' self-rated health was high in people having 'not bad' (OR, 1.60; 95% CI, 1.14-2.24) and 'discomfort' (OR, 1.79; 95% CI, 1.30-2.47) speaking difficulty. The covariates significantly associated with the risk of having 'not good' self-rated health were: physical activity, chronic disease, stress, and body mass index in both sexes; health insurance type and drinking only in men; and economic activity only in women. Conclusion: Oral health status and behavioral factors were associated with self-rated health status among the elderly, differently by sex. This suggests that public health policies toward better health in the elderly should take their oral health status and oral health behaviors into account in a sex-specific way.

• Journal of Convergence for Information Technology
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• v.11 no.8
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• pp.42-52
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• 2021

This study was conducted to identify the influence of the discrimination experienced in daily life and social isolation on depression among older adults living in the community. This study was a secondary analysis of the data of 2017 Living Profiles of Older Adults Survey. The participants was a representative sample among the older adults 65 years and older. Data from 10,041 older adults were analyzed for this study. Hierarchical logistic regression analyses were used. When the discrimination experiences was added in model 1, the likelihood of being depressed was 1.95(1.60-2.36) times higher for those who experienced discrimination comparing with those who didn't experienced discrimination. When the social isolation was added in model 2, the likelihood of being depressed was 1.89(1.55-2.30) times higher in those who experienced discrimination. In addition, as the number of close friends, neighbors, and acquaintances decreased by one, the likelihood of being depressed increased by 1.14 times. Those who were isolated from family, friends, neighbors and acquaintances were 3.90 times more likely to be depressed. Therefore, social efforts are needed to reduce the experience of discrimination. Maintaining a social network or creating a new network will contribute to lowering the level of depression in older adults who have experienced discrimination.

• Journal of Korean Home Economics Education Association
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• v.32 no.4
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• pp.67-79
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• 2020

The purpose of the study were to analyze the patterns of adolescent suicide attempts, and to explore the effects of personal psychology (subjective depression, subjective stress), health status (BMI, subjective health perception), and subjective academic performance on the types of youth suicide attempts. For this research, data of 'The 15th Korea Youth Risk Behavior Survey' were analyzed employing a hierarchical logistic regression analysis. The findings are as follows. First, out of 1,731 youth suicide attempts 156 (9%) were impulsive and 1,575 (91%) were planned. Girls(67.3%) attempted suicide more than boys (32.5%), and middle school students (62%) attempted suicide more than high school students (38%). Second, the variables that significantly affect suicide attempt types were subjective depression, subjective stress, and subjective health perception, after controlling for gender, grade level, school type, and SES. The rate of planned suicide attempts was higher among those who experienced depression than among those who did not. In the case of subjective stress, adolescents who felt stressed were likely to commit planned suicide attempts. Those who attempted impulsive suicide showed 1.32 times higher subjective health perception scores than those who attempted planned suicide, indicating adolescents who perceived they were not healthy were more likely to attempt planned suicide. BMI and subjective academic performance did not have a significant effect on the types of youth suicide attempts. These findings suggested the necessity of systematic intervention in Home Economics classes or extra-curricular programs, to prevent potential youth suicide attempts.

• Journal of Family Resource Management and Policy Review
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• v.28 no.1
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• pp.39-53
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• 2024

This study examines how economic factors such as income, parental support, perceived social status, and financial distress are associated with marital intentions among unmarried young adults in their 20's and 30's. Data were collected by an online survey, and a total of 567 people participated nationwide. Results from a hierarchical logistic regression suggest that (1) women's income was associated with their marital intentions, but not men's; (2) perceived social status was associated with marital intentions among both men and women; (3) men's expected parental support for marriage was associated with marital intentions; and (4) when three subfactors of the material values were included in the analysis, among women, it was found that the use of possessions to judge one's own success and that of others was positively associated with their marital intentions, and the belief that possessions and the acquisition of materials lead to happiness and satisfaction was negatively associated with their marital intentions. Further discussion is provided about the interpretation and implications of the results.

• Journal of agricultural medicine and community health
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• v.37 no.2
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• pp.84-95
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• 2012

Background: In Korea, private health insurance has neglected to induce externality on national health insurance by moral hazard. Therefore, we conducted this study in order to explore the influence of private health insurance on unnecessary medical utilization among patients with cervical or lumbar sprain. Method: The study examined a population of 449 patients (admission, 384; out-patient; 85) diagnosed with simple cervical or lumbar sprain without neurological symptoms at 20 small hospitals or clinics in Gwangju and Jeollanam provinces from Jul. 1 to Aug. 31 2008. The data were collected using structured, self-administrated questionnaire which collected information such as whether or not the patient was admitted (as a dependent variable), whether or not they had private health insurance (as a independent variable), and covariates such as socio-demographic characteristics, the factors related to the sprain, and characteristics of the insurance provider. Results: From hierarchical multiple logistic regression analysis, it was found that the admission rate of patient with private health insurance was higher than that those without it (Odds ratio=3.31, 95% Confidence interval; 1.14-9.58), meaning that private health insurance was an independent factor influencing the admission of patients with these conditions. Other determinants of admission were patient age and physician referral. Conclusions: This study is the first empirical study to explore the influence of private health insurance on inducing moral hazard in admission services, specifically among patients with cervical or lumbar sprain. Regulation of benefits provided by private health insurance may be necessary, as the effect of this moral hazard may mean existence of externality.

• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.235-261
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• 2018

The Medical law stipulates regulations about the physician's duty to inform to contribute to patient's self-determination. This law was most recently revised on December 20, 2016, and came into effect on June 21, 2017. There has been much controversy about this, and it has been questioned whether or not it will be effective for physicians to comply with the duty to inform. Therefore, this study investigated perceptions of physicians of whether they observed the duty to inform and their legal judgment about that duty, and analyzed how the revision of the medical law may have affected the legal cognition of physician's duty to inform. This study was conducted through an online questionnaire survey involving 109 physicians over 2 weeks from March 29 to April 12, 2018, and 108 of the collected data were used for analysis. The questionnaire was developed by revising and supplementing the previous research (Lee, 2004). It consisted of 41 items, including 26 items related to the experience of and legal judgment about the duty to inform, 6 items related to awareness of revised medical law, and 9 items on general characteristics. The data were analyzed using SAS 9.4 program and descriptive statistics, Chi-square test, Fisher's exact test and Binary logistic regression were performed. The results are as follows. • Out of eight situations, the median number of situations that did not fulfill the duty to inform was 5 (IQR, 4-6). In addition, 12 respondents (11%) answered that they did not fulfill the duty to inform in all eight cases, while only one (1%) responded that he/she performed explanation obligations in all cases. • The median number of the legal judgment score on the duty to inform was 8 out of 13 (IQR, 7-9), and the scores ranged from a minimum of 4 (4 respondents) to a maximum of 11 (3 respondents). • More than half of the respondents (n=26, 52%) were unaware of the revision of the medical law, 27 (25%) were aware of the fact that the medical law had been revised, 20(18%) had a rough knowledge of the contents of the law, and only 5(5%) said they knew the contents of the law in detail. The level of awareness of the revised medical law was statistically significant difference according to respondents' sex (p<.49), age (p<.0001), career (p<.0001), working type (p<.024), and department (p<.049). • There was no statistically significant relationship between the level of awareness of the revised medical law and the level of legal judgment on the duty to inform. These results suggest that efforts to improve the implementation and cognition of physician's duty to inform are needed, and it is difficult to expect a direct positive effect from the legal regulations per se. Considering the distinct characteristics of medical institutions and hierarchical organizational culture of physicians, it is necessary to develop a credible guideline on the duty to inform within the medical system, and to strengthen the education of physicians about their duty to inform and its purpose.