• Title/Summary/Keyword: Medical Expenditure

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The Effects of Low-Calorie Diet with Raw-Food Formula on Obesity and Its Complications in the Obese Premenopausal women

  • Chang, Yu-Kyung;Park, Yoo-Sin;Park, Mi-Hyoun;Lee, Jung-Ho;Kim, So-Hyung
    • Journal of Community Nutrition
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    • v.4 no.2
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    • pp.99-108
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    • 2002
  • Recently interests on raw-food diets are rapidly increasing in relation to chronic diseases prevention in Korea, but studies on raw-food diets have been hardly performed by nutritionists. This study was performed to investigate the effects of low-calorie diets using a raw-food formula in the form of freeze-dried powder on obesity and its complications in the obese women (body mass index (BMI) $\geq$ 25kg/㎡) for eight weeks. Forty premenopausal women (mean BMI 28.04kg/㎡, mean age 28.33years old) participated in this diet intervention, and were controlled by eating 1 regular meal, 1-2 snacks and 2 raw-food formula (140kcal/pack) meals a day within the 1500-1300kcal ranges. Anthropo-mentric measurements, body compositions, physical exercise, and obesity-related risk factors were assessed before (the initial), during (the 4th week) and after (the 8th week) the study. All the data was analyzed by paired t-test, repeated measures ANOVA, and nonparametric rank test at p<0.05 level. Obesity was significantly increased during this study, and it was decreased in weight (-4.59%, p<0.000), BMI (-4.56%, p<0.000), body fat percent (-6.18%, p<0.000), fat mass (-10.19%, p<0.000), waist and hip circumferences(-5.69%, p<0.000 and -2.55%, p<0.000) and WHR (-3.24%, p<0.000). Energy expenditure of physical exercise was increased as much as 70kca1/day during the study (p=0.000), but it did not have any correlations with weight loss and changes of body compositions. Biochemical measurements including blood triglyceride(p <0.006) and leptin(p<0.000) levels were significantly decreased, LDL cholesterol level was increased(p<0.05), but all the blood lipid levels were in the normal ranges. Fatty liver echogenicity and menstrual irregularity were improved after the diet intervention(p<0.000 and p<0.034). In conclusion, this B-week low-calorie diet intervention using raw-food formula was effective for obese premenopausal women in reducing obesity and its risk factors so as not to proceed towards comorbidities. However, the variation of blood lipid levels should be observed for a longer Period.

A Study on the Status of Nutrition Support in Bone Marrow Transplantation Patients (골수이식 환자의 영양지원 실태에 관한 연구)

  • Kim, Jeong-Nam;Im, Hyeon-Suk;Song, Seung-Eun
    • Journal of the Korean Dietetic Association
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    • v.4 no.1
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    • pp.65-75
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    • 1998
  • Recently, the number of patients who received Bone Marrow Transplantation(BMT) has been increased dramatically and the diseases for which BMT if efficacious are increasing. Adequate nutritional card for BMT patients is crucial for the success of BMT because nutritional deficiency could provoke deteriorative effects. However, little is known about nutritional status among BMT patients in Korea. This study was conducted to assess oral and parenteral intake of BMT patients and compare the change of nutritional status before and after BMT. Twenty-two BMT patients who were admitted to the Severance hospital from December in 1995 to September in 1997 participated in the study. Total calorie requirements were calculated for each patients individually and nutritional support for each patients consisted of oral and parenteral feeding. To assess oral intake of BMT patients, each patients recorded the amount of food they have eaten from 6 days before BMT to 28 days after BMT. The medical records of each patients were used to assess parenteral intake. To compare the nutritional status before and after BMT, the results of anthropometric and biochemical test from 14 days before BMT to 28 days after BMT were used. At the time of admission, the patients were in allowable nutritional status and their total calorie intake was 93% of total calorie requirement. When the preparative regimen for BMT was started, the patients' oral intake was dramatically decreased below 400kcal/day. Even though their oral intake was increased after BMT, their oral intake at the 4th week after BMT was only 752kcal/d, which is only 35.8% of total calorie requirement. The patients' mean oral intake during BMT period (from 6 days before BMT to 28 days after BMT) was only 439kcal/d. Although Total Parenteral Nutrition(TPN) was added when the preparative regimen was started, the patients' mean total caloric intake during BMT period was 111% of basal energy expenditure and 83% of total calorie requirement. The mean total protein intake was only 58% of total protein requirement. In the comparison of nutritional status between pretransplant phase and posttransplant phase in BMT patients, their body weight and serum albumin level were significantly decreased(p<0.001). These results show inadequacies in nutritional intake among BMT patients, and indicate the need of TPN during BMT period.

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Financial Projection for National Health Insurance using NHIS Sample Cohort Data Base (국민건강보험 표본코호트 DB를 이용한 건강보험 재정추계)

  • Park, Yousung;Park, Haemin;Kwon, Tae Yeon
    • The Korean Journal of Applied Statistics
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    • v.28 no.4
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    • pp.663-683
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    • 2015
  • The change of the population pyramid due to low fertility and rapid aging threatens the financial sustainability of National Health Insurance. We construct statistical models for prevalence rates and medical expenses using National Health Insurance Service (NHIS) sample cohort data from 2002-2013. We then project yearly expenditures and income of national health insurance until 2060 that considers various assumptions in regards to future population structure and economic conditions. We adopt a VECM-LC model for prevalence rates and the double exponentially smoothing method for the per capita co-payment of healthcare expense (in which the two models are institution-disease-sex-age specific) to project of national health insurance expenditures. We accommodate various assumptions of economic situations provided by the national assembly and government to produce a financial projection for national health insurance. Two assumptions of dependents ratios are used for the projection of national health insurance income to conduct two future population structures by the two assumptions of aging progresses and various assumptions on economic circumstances as in the expenditure projection. The health care deficit is projected to be 20-30 trillion won by 2030 and 40-70 trillion won by 2060 in 2015 constant price.

Analysis of Urban Dweller's Demand for Housing facilities to Settle Down in Rural Area (농촌정주를 위한 도시민 농촌주택 시설 수요분석)

  • Kim, Myo-Jung;Kim, Hye-Min;Heo, Jun
    • Journal of Korean Society of Rural Planning
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    • v.13 no.2
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    • pp.63-74
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    • 2007
  • This study aims to develop rural house maintenance technique by researching and analyzing the demand for rural house by urban retirees or urbanites who are planning to retire. The target for the survey consisted of urban retirees or urbanites who are planning to retire at the ages between 40 and 65, and were divided into group A, the attendants in rural-related education, and group B, the non-attendants in rural-related education. The contents of the survey included the plan and purpose for rural settlement, the utilization form or residential form of rural house and its expected size, necessary in-house facilities, necessary community facilities, improvement and maintenance factors of rural house, political and legal support for the application of rural house maintenance, etc. The results findings of this study are as follows; 1)For both group, the major purpose of rural settlement appeared to be 'for rural life', utilization form of rural house to be 'acquired ownership or use of empty house', residential form to be 'cohabitation', expected size to be 'under $20{\sim}30$ pung', and expenditure to be 'under $50{\sim}100\;million$'. 2)Most wanted necessary in-house facilities included backyard, multipurpose storage room for group A, and backyard, garden for group B. Necessary community facilities included boardwalk, sewage disposal unit for group A, and boardwalk, shop for group B. 3)Improvement factor for rural house showed 'poor insulation' as first factor for both groups, and for maintenance factor, 'backyard', 'under-floor heating' for group A, and 'environmental-friendly materials', 'backyard' for group B. 4)Most wanted overall political and legal support included 'support on land and real estate supply' for group A, and 'medical and transportation service' for group B. For both group, most wanted support when purchasing a house included 'provision of information on house and realestate purchase', and for legal support, 'legal support for guaranteed house and maintenance' as first factor. The results of this study could be utilized to restructure the rural residence, which would meet the diverse demand of both rural residents and urbanites by providing an opportunity for urbanites to enjoy rural life.

Relationship Between the Physical Activity Levels and Health Care Utilization in Korean Elderly (한국 노인의 신체활동 정도와 의료이용과의 관련성)

  • Kwak, Kwang-Il;Baek, Chang-Hee;Ryu, So-Yeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.1
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    • pp.617-626
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    • 2015
  • This study examined the relationship between the physical activity levels and health care utilization in Korean elderly based on the data from The fifth Korean National Health and Nutrition Examination Survey (K-NHANES V). As a result, physically active participants were 0.54 times (OR;95% CI, p<0.001) less likely to use inpatient health care and 0.73 times (OR;95% CI, p=0.040) less likely to use outpatient health care and 0.75 times (OR;95% CI, p<0.007) less likely to use drugstores than physically inactive participants, and the frequency of health care use was lower. In addition, physically minimal active participants were 0.64 times (OR;95% CI, p<0.001) less likely to use inpatient health care than physically inactive participants; the frequency of other health care facilities was lower. In conclusion, the relationship between being physically active and lower health care utilization among Korean elderly identified in this study. This suggests that being physically active is helpful to the elderly, not only in health promotion and improving quality of life, but also in reduced medical expenditure.

An Epidemiological Study on the Complications caused by the Sterilization Program (불임시술의 합병증에 관한 역학적 연구)

  • Hong, Myung-Sun
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.138-153
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    • 1996
  • Intending to offer basic information for a prospective health services in Korea, this study is to investigate the complication caused by sterilization in goverment family planning program from 1962 to 1995. The results are as follows: 1. Total number of sterilization performed during the period from 1962 to 1995 were 1.367,772 cases of male sterilization and 2,889,635 cases of female sterilization. 2. Incidence of the complication caused by sterilization operation from 1980 to 1995 were 1,883(0.20%) out of 925,801 cases in vasectomies and 15,866(0.70%) out of 2,256,020 cases in tubal sterilizations. 3. Major complications in vasectomy were epididymities of 658 cases (34.9%), vas recanalization of 326 cases(17.3%), hematoma of 266 cases(14.1%), scrotal abscess of 184 cases(9.8%), sperm granuloma of 76 cases(4.0%),and other of 373 cases(19.8%). On the other hand, in tubal sterilization, ectopic pregnancy was the most significant complication of 15,078 cases (95.0%) among 15,866 total complications, followed by pelvic inflammatory diseases of 155 cases(0.9%), peritonities of 96 cases(0.6%), ovarian & tubal bleeding of 31 cases(0.2%), intestinal perforation of 16 cases (0.1%), uterine bleeding of 14 cases(0.1%), uterine cervix laceration of 1 case (0.1%), and other of 271 cases(1.7%), while 161 pregnancies(0.1%) were terminated and 43 cases(0.3%) with normal delivery. 4. The occurrence rate of the complication for each period showed that most of the complication cases by vasectomy occurred in a year after the operation -the cases were 1,256 (66.7%). 254 cases(13.5%) occurred between the next year and the 2nd year, 138 cases (7.3%) between the 2nd year and the 3rd year, 73 cases(3.9%) between the 3rd year and the 4th year, 52 cases(2.8%) between the 4th year and the 5th year, 31 cases(1.6%) between the 5th year and the 6th year, 79 cases(4.2%) over the 6th year. Tubal sterilization indicated that the occurred complication cases in a year were 2,175 cases(13.7%), 2,113 cases(13.3%) occurred between the next year and the 2nd year, 2,082 cases(13.1%) between the 2nd year and the 3rd year, 2,049 cases (12. 9%) between the 3rd year and the 4th year, 1,819 cases(11.5%) between the 4th year and the 5th year, 621 cases(10.2%) between the 5th year and the 6th year, 4,007 cases(25.3%) over the 6th year. 5. For the cost of complication treatment, total \7,928,229,000 were paid as medical expenditure in which \609,438,000 for vasectomy and \7,318,791,000 for tubal sterilization. Accordingly per capita expenses were \345,000 for vasectomy and \467,000 for tubal sterilization. As the proportion of government sterilization program was decreased after 1988, that of private sterilization program would be increased. So it is recommended to set a guideline for the private sterilization program and to continue government sterilization program for the lower class.

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The Impact of Population Aging on Energy Use and Carbon Emissions in Korea (인구 고령화가 에너지 사용과 탄소 배출에 미치는 영향)

  • Kim, Dong Koo;Park, Sunyoung
    • Journal of Environmental Policy
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    • v.13 no.2
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    • pp.99-129
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    • 2014
  • This research estimates the impact of population aging on energy use and carbon emissions by energy sources and by industrial sectors in Korea until 2035. For the estimation, the structural change in household consumption expenditure identified by the age-specific consumption pattern was analyzed in conjunction with energy and environment input-output tables. The estimation result presents that, despite the population aging, energy use and carbon emissions induced by household consumption continue to increase until 2026, and then that elevated levels of energy use and carbon emissions will be maintained for a considerable period of time. According to the estimation by energy sources, the use of natural gas will show substantial increase while the use of crude oil will switch to a downturn at a relatively early period. According to the estimation by industrial sectors, carbon emissions in the sectors with relatively high consumption share of old households such as medical health, dwelling, lighting, heating, air-conditioning, and food will have substantial increase, whereas those in the sectors associated with education, transport, catering, and accommodation services will turn downward relatively early. In addition, the study analyzes through policy simulation the impact of aging-related policy similar to the basic pension system, which is recently being discussed for legislation, on energy use and carbon emissions.

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A Prospect for Growth and Economic Size of Foods-for-Elderly Industry -Focused on Health Functional Foods and Foods for Special Dietary Uses- (고령친화식품산업의 성장과 규모 전망 -건강기능식품과 특수용도식품을 중심으로-)

  • Jin, Hyun Joung;Woo, Hee Dong
    • Journal of Food Hygiene and Safety
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    • v.27 no.4
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    • pp.339-348
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    • 2012
  • The purpose of this study is to predict the economic size of foods-for-elderly market, which will be valuable information for establishing related policy and backup system. After setting the scope of related industry, detailed information for current market situation was investigated and a systematic forecast for market changes in the future was performed. Economic growth, changes in consumer expenditure and economic status of the elderly, current subscription of medical insurance and saving for pension were reflected. In addition, a survey toward related firms was completed and changes in aged population and incidence of chronic disease in the elderly were taken into account. Results show that the annual growth rate of the market was predicted to be the minimum 4.54% through the maximum 8.32% from 2010 to 2025 and its market size was forecasted to be the minimum 7,073 ten million won through the maximum 10,976 ten million won. It is expected that the market of foods-for-elderly will grow rapidly with development of foods technology and fast increase of aged population. Especially, growth of health functional foods and foods for special dietary uses for elderly will be distinguished. However, it seems that related firms are on the hedge, watching current trend of the related industry. This may results in insufficient supply against the demand. Therefore, policy for foods-for-elderly should be introduced and systematically administered, including R&D support, standardization and authentication for foods-for-elderly, construction of related database system.

Whiplash Injury Conditions of Rear-End Collisions at Low-Speed (저속 추돌사고에서 목 상해 조건에 대한 연구)

  • Kim, Myeongju;Yun, Ilsoo
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.18 no.2
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    • pp.58-76
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    • 2019
  • As the number of reported injuries has tended to increase over time, large hospitalization expenditure from excessive medical treatments and hospitalization, and insurance frauds associated with moral hazard in minor collisions have caused a global societal problem. Many occupants of rear-ended vehicles involved in rear-end collisions complain of whiplash injury, which is also known as neck injury, without any anatomical and radiological evidence. With only clinical symptoms, stating that a whiplash injury is a type of injury defined by the Abbreviated Injury Scale would be difficult. Therefore, this study focuses on minor rear-end collisions, where the rear-ender vehicle collides with the rear-ended vehicle at rest. The mathematics dynamic model is employed to simulate a total of 100 rear-end collision scenarios based on various weights and collision speeds and identify how the weights and speeds of both vehicles influence the risk of whiplash injury in occupants involved in minor rear-end collisions. The possibility of an injury is very high when the same-weight vehicles are involved in accidents at collision speeds of 15 km/h or higher. The possibilities are 36% and 84% with collision speeds of 15 km/h and 20 km/h, respectively, if weights are disregarded.

Health Management and Services of School-Nurse in Special Schools (특수학교의 보건관리)

  • Lee, Kyung Hee;Park, Jae Yong
    • Journal of the Korean Society of School Health
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    • v.4 no.2
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    • pp.176-192
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    • 1991
  • School nurses, in service of 102 special schools in Korea, were urveyed by mail questionnaires from February to March, 1991 and 77 of hem responded. Collected data were analyzed to establish the direction of health management in special school and to provide basic reference data for improving the quality of the management of school-nurses' services. The major findings are as follows: Out of special schools surveyed, 67.5% is private school and 83.2% is located in city. The average number of classes, students, and educational personnels per special school is 17.2, 194, and 28 respectively. The average age of school-nurses surveyed is 32.7. The proportion of graduates from the junior college and upward was 97.4%, the proportion of the married was 71.4%. Out of respondents, 71.4% has religion : 79.2% has past career in the fields of clinics or public health: 62.3% accompanishes independent services: 77.9% belongs to primary school. About 69% of nursing room in special schools surveyed is located at the first floor. Out of special school surveyed, 90.9% has no organization for school health programms: Only 18.2% entrusted everyone of school doctor, school dentist, and school pharmacists with school health. 46.8% of respondents didn't know about the annual budget for school health programmes. The average annual expenditure for school health programme per special school was 317,000F26. won and the purchase cost for medical supplies accounted for the larger part of them. The monthly average number of students utilizing school nursing room was 71 per school, annual utilization times of school nursing room was 4.4 per student and utilization due to injury was prevalent by 26.6% and there is some differences in using the school nursing room according to disabled area. Rate of referral to medical facilities was 1.4%. The leading reason of referral to medical facilities was high fever among those who have visual handicaps, fracture among those who have emotional disturbance, injury by trauma among others. Nine hundred fifty six students of students in special school surveyed have sufferd from epilepsy and prevalence rate of epilepsy was 6.4%. Only 22.6% of respondents replied that they had physical examination more than 2 times per year. Out of respnodents, 98.7% answered that they had health education and 67.1% of them ansered that they educated in a classroom, 98.7% of respondents emphasized need of sex education. Respondents put the most emphasis on the personal hygiene when they performed health education and they used broadcasting education in the area of visual handicaps, OHP or VTR in hearing handicaps, home correspondence or OHP VTR in other area importantly. About 47% of repondents answered that health education was the most difficult and they emphasized that definite guide on health management was requested. Respondents had self-confidence and high perfomance rate in most of school-nurses' services completely, but so they was not in area of evaluation of school health programmes, an examination of physical strength, evaluation of health education, management of school purification area, suture of wounds. In consideration of above findings, we may conclude that special education for school-nurse in special schools as well as improvement of definite guiding principles are requested to establish direction for health management in special schools and to improve the degree of quality for school-nurses' sevices in special schools.

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