• Title/Summary/Keyword: Medical Cost

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Factors Affecting Breast Cancer Screening Behavior in Japan - Assessment using the Health Belief Model and Conjoint Analysis

  • Tsunematsu, Miwako;Kawasaki, Hiromi;Masuoka, Yuko;Kakehashi, Masayuki
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.6041-6048
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    • 2013
  • Background: Japanese women in their 40s or older have been encouraged to attend breast cancer screening. However, the breast cancer screening rate in Japan is not as high as in Europe and the United States. The aim of this study was to identify psychological and personal characteristics of women concerning their participation in breast cancer screening using the Health Belief Model (HBM). In addition, the attributes of screening more easily accepted by participants were analyzed by conjoint analysis. Materials and Methods: In this cross sectional study of 3,200 age 20-69 women, data were collected by an anonymous questionnaire. Questions were based on HBM and personal characteristics, and included attitudes on hypothetical screening attributes. Data of women aged 40-69 were analyzed by logistic regression and conjoint analysis to clarify the factors affecting their participation in breast cancer screening. Results: Among responses collected from 1,280 women of age 20-69, the replies of 993 women of age 40-69 were used in the analysis. Regarding the psychological characteristics based on HBM, the odds ratios were significantly higher in "importance of cancer screening" (95%CI: 1.21-2.47) and "benefits of cancer screening" (95%CI: 1.09-2.49), whereas the odds ratio was significantly lower in "barriers to participation before cancer screening" (95%CI: 0.27-0.51). Conjoint analysis revealed that the respondents, overall, preferred screening to be low cost and by female staff members. Furthermore, it was also clarified that attributes of screening dominant in decision-making were influenced by the employment status and the type of medical insurance of the women. Conclusions: In order to increase participation in breast cancer screening, it is necessary to disseminate accurate knowledge on cancer screening and to reduce barriers to participation. In addition, the attributes of screening more easily accepted were inexpensive, provided by female staff, executed in a hospital and finished in a short time.

Factors Influencing the Use of Dental Services by Foreign Tourists in Thailand

  • Chongthanavanit, Papon;Kheokao, Jantima
    • Asian Journal for Public Opinion Research
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    • v.5 no.2
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    • pp.63-83
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    • 2018
  • This exploratory research investigated the factors that influence foreign tourists' decision to use dental services in Thailand. The questionnaire was used to collect data from foreign tourists who used dental services in a hospital or dental clinic in Thailand. Data from 233 respondents completed questionnaires were analyzed using frequency distribution, percentages, mean, and standard deviation. The findings revealed that respondents were most likely to be Asian (54.5%) followed by European (33.9%), females (64.8%) aged between 26-35 years (39.1%), business owners (45.9%), and came to Thailand with friends (47.6%). Regarding travel purposes and contact with dental services, most of them travel for pleasure (52.89%) and contact the clinic directly through the Internet(63.95%) The health/medical services used included health check-up (34.48%), dental services (29.22%), and day spa/massage (23.23%). The dental treatment that respondents had completed or planned to do included dental check-up (29.87%), tooth cleaning (26.68%), and tooth whitening (11.41%). Based on the influence of $_7P$ factors towards the respondent's decision to use the dental service, it was found that the average mean score range from 4.33-4.15 which were at the high to the very high level of influence to their decisions. The people factor had the highest average mean score (mean 4.33, SD= 0.604)followed by the price factor (mean 4.32, SD= 0.651), which both had the highest level of influence. The physical evidence factor had the lowest mean score (mean 4.15, SD+0.752) which was at the high level of importance. It should be noted that the factor concerning the modern technology and dental equipment (mean 4.33, SD=0.606) and factor on the quality of service (mean 4.43, SD= 0.598) had the highest mean score followed by the total cost of the trip including services being reasonable (mean 4.37, SD=0.582). Regarding the country factor, it was found that this factor also had highest influence level (mean 4.30, SD=0.67) and affordability had the highest mean score (mean 4.39, SD=0.614).

Association of Polymorphism Harbored by Tumor Necrosis Factor Alpha Gene and Sex of Calf with Lactation Performance in Cattle

  • Yudin, N.S.;Aitnazarov, R.B.;Voevoda, M.I.;Gerlinskaya, L.A.;Moshkin, M.P.
    • Asian-Australasian Journal of Animal Sciences
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    • v.26 no.10
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    • pp.1379-1387
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    • 2013
  • In a majority of mammals, male infants have heavier body mass and grow faster than female infants. Accordingly, male offspring nursing requires a much greater maternal energy contribution to lactation. It is possible that the maternal-fetal immunoendocrine dialog plays an important role in female preparation for lactation during pregnancy. Immune system genes are an integral part of gene regulatory networks in lactation and tumor necrosis factor alpha ($TNF{\alpha}$) is a proinflammatory cytokine that also plays an important role in normal mammary gland development. The aim of this study was to evaluate the influence of the sex of calf and/or the -824A/G polymorphism in the promoter region of $TNF{\alpha}$ gene on milk performance traits in Black Pied cattle over the course of lactation. We also studied the allele frequency differences of -824A/G variants across several cattle breeds, which were bred in different climatic conditions. The G allele frequency decreased gradually over the course of lactation events in the Black Pied dairy cattle because of a higher culling rate of cows with the G/G genotype (p<0.001). In contrast to the genotypes A/A and A/G, cows with G/G genotype showed significant variability of milk and milk fat yield subject to sex of delivered calf. Milk yield and milk fat yield were significantly higher in the case of birth of a bull calf than with a heifer calf (p<0.03). The G allele frequency varies from 48% to 58% in Grey Ukrainian and Black Pied cattle to 77% in aboriginal Yakut cattle. Our results suggest that the $TNF{\alpha}$-824A/G gene polymorphism may have an influence on the reproductive efforts of cows over the course of lactation events depending on the sex of progeny. Allocation of resources according to sex of the calf allows optimizing the energy cost of lactation. This may be a probable reason for high G allele frequency in Yakut cattle breeding in extreme environmental conditions. Similarly, the dramatic fall in milk production after birth of a heifer calf increases the probability of culling for the cows with the G/G genotype in animal husbandry.

The Elderly Health and Dietary Management in Gyeonggi Province - Comparison with Gender Difference - (경기지역 노인의 건강과 식생활관리 I - 노인의 성별 비교 -)

  • Won Hyang-Rye;Rhie Seung-Gyo;Choi Mi-Yong
    • The Korean Journal of Community Living Science
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    • v.17 no.1
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    • pp.123-139
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    • 2006
  • The purpose of this study is to search how to promote health and improve nutrition and health care of the elderly people in rural area. Behaviors for health promotion and habits against health risk were surveyed. Dietary management was analyzed for surveyed nutrient intake by 24 hr -recall method. 242 subjects were collected in 12 cities or counties in Gyeonggi Province and 20 elderly people (10 male and 10 female) were selected out of 1 village in each district. Questionnaire for health behavior and dietary management was carried out by trained interviewers. Statistical analyses were made by SAS (version 8.1) and Chi-square tests and General Linear Models were used. Characteristics of the elderly people were 61-74 year-olds (68.2%), elementary school educated (78.4%), with spouse (51.7%), monthly living cost of 500-1,000 thousand won(43.4%), and monthly pocket money of 50-100 or 100-200 thousand won(33.5%, 26.5%). 41.4% of the subjects checked up medical examination regularly. The alcohol drinking status was significantly different according to gender: high no-drink rate of female (52.5%) and low no-drink rate of male (25.6%). Kinds of disease were different according to gender: higher proportion of cardiovascular disease(46.3%) and diabetes mellitus(8.1 %) in male and joint lumbago neuralgia(44.4%) and osteoporosis(8.6%) in female. Gastrointestinal complaints were nausea (69.0%) and chronic indigestion (17.8%). Constipation (12.0%) and vomiting (4.3%) were more frequent in female. Dietary management was good (3 meals per day: 93.4%., dining with family: 72.4%, regular mealtime: 72.4%, and 3-4 times of snacks per week: 44.9%) except side dish taking of 3-4 kinds only. However, almost one-third of the female elderly ate alone (30.6%) which was well compared with one-fifth of the male (19.7%). And food and nutrients intake were not significantly different according to gender except that male elderly's intake of energy and protein was lower than that of female's. The surveyed subjects had no difficulties in Activities of Daily Living (ADL), but some female elderly had some difficulties with Instrumental Activities of Daily Living (IADL) like working at home, using transport, and going shopping. These results suggest that low quality of life linked with low economic status of the rural elderly and that congregate meal at village hall would be required for the female elderly eating alone. For the undernourished male elderly, it would be needed to provide snacks and to establish nutrition and health surveillance system.

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A study for middle-aged on oral health knowledge, oral health care and satisfaction with prosthetic treatment (중년층의 구강건강지식, 실천 및 보철치료 만족실태 조사)

  • Go, Eun-Jeong;Lee, Yong-Hwan;Park, Kwang-Hwan
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.5
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    • pp.671-683
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    • 2011
  • Objectives : The purpose of this study was to examine the oral health knowledge and actual oral health care of the selected subjects, their decision making about prosthetic treatment, the state and characteristics of their prosthetic treatment and their satisfaction with prosthetic treatment in an attempt to provide some information on the improvement of the quality of life related to oral health and the promotion of oral health. Methods : The subjects in this study were 250 people who received education in two different lifelong education institutions in the city of Busan. After a survey was conducted from May 23 to June 15, 2011, the answer sheets from 217 respondents were analyzed. Results : 1. As for the general characteristics of the respondents, the men(52.1%) outnumbered the women. Those who were in their 60 and up(47.5%) made up the largest age group, and the married people(65.4%) outnumbered the unmarried ones. By occupation, the company employees(20.3%) made up the biggest group. By education, the greatest group was high-school graduates(36.1%). By monthly mean income, the biggest group gained an income of 2.01 million won or more(36.9%). As to medical security, community-based insurance was most prevailing (36.9%). In terms of health promotion, the largest group worked out to stay fit(52.4%). 2. Regarding oral health knowledge, they had a good knowledge about the cause of dental caries(56.7%), but they weren't well aware of the right time for regular dental checkup(47.9%). In relation to oral health care, regular scaling wasn't prevailing(16.9%). 3. Regarding connections between the general characteristics and satisfaction with prosthesis, the less-educated respondents expressed significantly more dissatisfaction(p=0.015). By monthly mean income, those who had a smaller income were dissatisfied in general(p=0.028). Conclusions : The findings of the study illustrated that it's required to spread awareness of the importance of oral health among people in general, and that differentiated incremental oral health care should be provided for different age groups. In order to raise the satisfaction of patients with prosthesis, how to relieve their pain and anxiety and how to adjust prosthetic treatment cost properly should carefully be considered. In addition, the government should take measures to offer assistance for the low-income classes in preparation for an increase in the elderly population.

Analysis of the Payment Rates and Classification of Services on Radiation Oncology (치료방사선과 의료서비스에 대한 원가산정)

  • Shin Kyung Hwan;Shin Hyun Soo;Pyo Hong Ryull;Lee Kyu Chan;Lee Yoon Tae;Myoung Hee Bong;Yeom Yong Kwon
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.167-174
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    • 1997
  • Purpose : The main Purpose of this study is to develop new payment rates for services of Radiation Oncology, considering costs of treating patients. Material and Methods : A survey of forty hospitals has been conducted in order to analyze the costs of treating patients. Before conducting the survey, we evaluated and reclassified the individual service items currently using as Payments units on the fee-for-service reimbursement system. This study embodies the analysis of replies received from the twenty four hospitals. The survey contains informations about the hospitals' costs of 1995 for the reclassified service items on Radiation Oncology. After we adjust the hospital costs by the operating rate of medical equipment, we compare the adjusted costs with the current Payment rates of individual services. Results : The current payment rates were 5.05-6.58 times lower than the adjusted costs in treatment planning services, 2.22 times lower in block making service, 1.57-2.86 times lower in external beam irradiation services, 3.82-5.01 times lower in intracavitary and interstitial irradiation and 1.12-2.55 times lower in total body irradiation. Conclusion : We could conclude that the current payment system on Radiation Oncology does not only reflect the costs of treating patients appropriately but also classify the service items correctly. For an example, when the appropriate costs and classification are applied to TBI, the payment rates of TBI should be increased five times more than current level.

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Factors Associated with a Prolonged Length of Hospital Stay in Patients with Diabetic Foot: A Single-Center Retrospective Study

  • Choi, Sang Kyu;Kim, Cheol Keun;Jo, Dong In;Lee, Myung Chul;Kim, Jee Nam;Choi, Hyun Gon;Shin, Dong Hyeok;Kim, Soon Heum
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.539-544
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    • 2017
  • Background We conducted this study to identify factors that may prolong the length of the hospital stay (LHS) in patients with diabetic foot (DF) in a single-institution setting. Methods In this single-center retrospective study, we evaluated a total of 164 patients with DF, and conducted an intergroup comparison of their baseline demographic and clinical characteristics, including sex, age, duration of diabetes, smoking status, body mass index, underlying comorbidities (e.g., hypertension or diabetic nephropathy), wound characteristics, type of surgery, the total medical cost, white blood cell (WBC) count, C-reactive protein (CRP) levels, erythrocyte sedimentation rate, and albumin, protein, glycated hemoglobin, and 7-day mean blood glucose (BG) levels. Results Pearson correlation analysis showed that an LHS of >5 weeks had a significant positive correlation with the severity of the wound (r=0.647), WBC count (r=0.571), CRP levels (r=0.390), DN (r=0.020), and 7-day mean BG levels (r=0.120) (P<0.05). In multiple regression analysis, an LHS of >5 weeks had a significant positive correlation with the severity of the wound (odds ratio [OR]=3.297; 95% confidence interval [CI], 1.324-10.483; P=0.020), WBC count (OR=1.423; 95% CI, 0.046.0-356; P=0.000), CRP levels (OR=1.079; 95% CI, 1.015-1.147; P=0.014), albumin levels (OR=0.263; 95% CI, 0.113.3-673; P=0.007), and 7-day mean BG levels (OR=1.018; 95% CI, 1.001-1.035; P=0.020). Conclusions Surgeons should consider the factors associated with a prolonged LHS in the early management of patients with DF. Moreover, this should also be accompanied by a multidisciplinary approach to reducing the LHS.

Study on Anti-biofouling Properties of the Surfaces Treated with Perfluoropolyether (PFPE) (Perfluoropolyether (PFPE)로 처리된 표면의 생물오손 방지 특성 연구)

  • Park, Sooin;Kwon, Sunil;Lee, Yeongmin;Koh, Won-Gun;Ha, Jong Wook;Lee, Sang-Yup
    • Applied Chemistry for Engineering
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    • v.23 no.1
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    • pp.71-76
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    • 2012
  • Biofouling by marine organisms such as algae and barnacles causes lots of significant problems in marine systems such as a rise of the maintenance-repair cost for the ship and the marine structures. In this work, a fluoropolymer, perfluoropolyether (PFPE), was applied as an anti-biofouling coating material that prevents the adhesion of marine organisms and facilitates the removal of them. Water contact angles of various surfaces were tested to examine the hydrophobicity of the PFPE-modified surface. The PFPE-modified surface showed the water contact angle of $64.5^{\circ}$ which is a remarkable rise from $46.7^{\circ}$ of amine-treated surface. When the substrate was treated with PFPE, the adhesion on the of the barnacle and other marine organisms were repressed around 15% by the enhanced hydrophobicity. In addition, the removal the of the adhered marine organisms were better comparing to that of the surface prepared by PDMS. Surfaces of the substrate treated by PFPE were characterized through physical and chemical methods to analyze the biofouling results. Degree of biomolecular adhesion to the substrate was quantified by the measurement the fluorescence intensity of marine organisms dyed with green fluorescence. PFPE is expected to be applicable not only to anti-biofouling systems but also to medical devices where the prevention of protein adhesion is required.

A Characteristics of the Vulnerable Area for Emergency Medical Service in Daejeon by Analysis of Geographic Information System (지리정보시스템(GIS)으로 분석한 대전광역시 응급의료서비스 취약지 특성)

  • Hwang, Ji-Hye;Na, Baeg-Ju;Lee, Dong-Woo;Hong, Jee-Young;Lee, Moo-Sik
    • Proceedings of the KAIS Fall Conference
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    • 2010.05b
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    • pp.859-862
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    • 2010
  • 본 연구는 대전광역시의 응급의료서비스 취약지를 도출하고 취약지역의 보건학적 특성 및 응급의료서비스 취약여부와의 관련성을 분석하여 응급의료 관련 정책의 의사결정에 유용한 기초자료로 제공하기 위한 연구이다. 응급의료서비스 취약지 도출은 Arc GIS의 공간분석 방법 중 가중분석(Cost Weighted distance) 방법으로 응급의료센터로부터의 접근성 분석을 하였으며, 응급의료서비스 취약지의 보건학적 특성 및 응급의료서비스 취약여부와의 관련성은 SPSS 17.0을 이용하여 비모수 t-검정 및 다중회귀분석을 시행하였다. 본 연구의 주요 결과는 다음과 같다. 연구지역의 응급의료기관 분포는 동구와 유성구, 대덕구는 지정된 응급의료센터가 없으나 서구와 중구는 응급의료센터가 2개소 이상 위치하고 있어 응급의료기관 분포가 편중되어 있으며, GIS를 활용하여 응급의료센터와의 접근성 분석을 수행한 결과, 대전광역시 자치구별 전체 면적 대비 응급의료서비스 취약지의 비율이 높은 자치구는 동구가 41.2%로 가장 높았다. GIS를 활용하여 행정동별 응급의료서비스 취약지를 분석한 결과, 대덕구 신탄진동, 동구 대청동과 산내동, 유성구 구즉동과 노은2동, 서구 기성동, 중구 산성동으로 나타났으며, 응급의료서비스 취약지 중 기성동, 대청동이 노인 인구밀도가 높게 나타났다. 응급의료서비스 취약여부에 따른 보건학적 특성별 차이를 분석한 결과, 국민기초생활수급권자, 장애인등록자, 농업인구 비율의 평균은 취약지가 비취약지에 비해 높았으며 통계적으로 유의한 차이를 보였다(p<0.01). 응급의료서비스 취약여부를 종속변수로 하고 지역별 보건학적 특성을 독립변수로 하여 로지스틱 회귀분석을 시행한 결과, 농업인구 비율과 국민기초생활수급권자 비율이 높았으며 이는 통계적으로 유의하여 응급의료서비스 취약여부를 설명할 수 있는 변수인 것으로 나타났다(p<0.01, p<0.05). 이상의 결과를 종합하면 대전광역시 5개 자치구의 행정동 중 응급의료서비스 접근 불평등지역이 도출되었고 이러한 지역은 보건학적 특성 중 농업인구 비율과 국민기초생활수급권자의 비율이 높았으며 이는 통계적으로 유의하여 응급의료서비스 취약여부와 관련성이 있는 것으로 나타났다. 향후 효율적인 응급의료 자원 분배를 위해서는 GIS를 활용한 의사결정이 필요하며, 응급의료서비스 이용의 형평성을 증진시키기 위해서 응급의료서비스의 사각지대에 놓여있는 지역의 보건학적 특성을 고려한 정책이 시행되어야 할 것으로 사료된다.

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A Study on Development of Residential-linked Pension Insurance for Rural Living after Retirement - Decisive insuring factors and the service demand of potential consumers - (은퇴 후 농촌거주를 위한 주택연동형 연금보험 개발에 관한 기초연구 - 잠재 수요자의 보험가입조건 및 서비스 요구도 분석)

  • Hong, Hyung-Ock;Kim, Jung-In;Im, Sang-Bon
    • 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.