• Title/Summary/Keyword: Medical Insurance

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The Risk of Fracture with Taking Alpha Blockers for Treating Benign Prostatic Hyperplasia (양성전립선비대증 증상 조절을 위해 투여되는 알파차단제의 골절위헙)

  • Lee, Joong-Yub;Choi, Nam-Kyoung;Jung, Sun-Young;Kim, Ye-Jee;Seong, Jong-Mi;Oh, Seung-June;Park, Byung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.3
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    • pp.165-170
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    • 2009
  • Objectives : We evaluated the risk of fracture associated with hypotension-related adverse drug reaction caused by taking alpha blockers to treat benign prostatic hyperplasia (BPH). Methods : We used the Health Insurance Review and Assessment Service database from January 1st 2005 to June 30th 2006 for this study. The male patients with BPH and who had a prescription for alpha blockers following any fractures were defined as the cases. We set the 20 day long hazard period prior to the index date and the four control periods whose lengths were same with hazard period. After 1:4 matching of the hazard and control periods, conditional logistic regression was used to calculate the odds ratios for the risk of fractures as related to the alpha blocker exposure. Results : Doxazosin and tamsulosin showed the increased risk of fractures, whereas terazosin did not. After stratification using the defined daily doses, a protective effect was shown for the patients who took terazosin at the doses lower than 0.4 DDD and the hazardous effect at the doses higher than or equal to 0.4 DDD. There was no significant difference for the risk of patients taking tamsulosin at the doses higher than 1.0 DDD but there was a statistically significant increase in the risk at the doses higher than or equal to 1.0 DDD. Conclusions : Alpha blockers for BPH may increase the risk of fracture in elderly patients who have comorbidities and take the concomitant medications. Alpha blockers need to be prescribed with caution, although some have high prostate specificity.

Socioeconomic Costs of obesity for Korean Adults (한국인 성인 비만의 사회경제적 비용)

  • Moon, Ok-Ryun;Kim, Nam-Soon;Kang, Jae-Heon;Yoon, Tae-Ho;Lee, Sang-Yi;Lee, Sin-Jae;Jeong, Baek-Geun
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.1
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    • pp.1-12
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    • 2002
  • Objective : To estimate the socioeconomic costs of obesity in Korea,1998. Methods : The 1998 National Health and Nutrition Examination Survey(1998 NHNES) data was used and 10,880 persons who had taken health examinations were selected for study. Essential hypertension, NIDDM(non insulin-dependent diabetes mellitus), dyslipidemia, osteoarthritis, coronary heart disease, stroke were included as obesity related disease. The data of direct costs of obesity was obtained from the National Federation of Medical Insurance. The category of indirect costs was the loss of productivity caused by premature death and admission, time costs, traffic costs, nursing fees due to obesity. Multiple logistic regression model was developed to estimate prevalence odds ratio by obesity class adjusted demographic and socio-ecnomic factors and calculate PAF(Population Attributable Fraction) of obesity on obesity related disease. And we finally calculated the socioeconomic costs of obesity in relation to BMI with PAF. Results : The direct costs of obesity were 2,126 billion${\sim}965$ billion Won in considering out of pocket payment to uninsured services, and the indirect costs of obesity were 2,099 billion${\sim}1,086$ billion Won. Consequently, in considering out of pocket payment to uninsured services, the socioeconomic costs of obesity were 4.225 billion${\sim}2,050$ billion Won, which corresponded to about $0.094%{\sim}0.046%$ of GDP and $1.88%{\sim}0.91$ of total health care costs in Korea. Conclusions : Obesity represents a major health problem with significant economic implications for the society. This results are conservative estimates as far as all obesity related disease and all health care and indirect costs were not included due to missing information. further studies are needed to caculate socioeconomic costs of obesity more exactly.

Perspective on Population Characteristics and Health Problems of Koreans in 21st Century (21세기 초 한국의 인구구조 및 질병양상)

  • Kim, Joung-Soon
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.175-185
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    • 1994
  • In order to anticipate disease pattern and health problems of Koreans in the 1st part of 21st century (by the year 2020), transition of population characteristics, mortality and morbidity data during the last 30 years Koreans have experienced were reviewed. On the actual basis of epidemiologic transition process that has undergone during last 30 years since 1960 along with socioeconomic development and successful implementation of selective national health policies (family planning, medical insurance and etc.), following changes can be expected in the 21st century in Korea, under the assumption that the current rate of progress is maintained. The population of South Korea alone will be doubled the population of 1960 by the year 2013 : aged Population older than 65 years will be increased from 3.3% in 1960 to 11.4% in 2020 with increased average age of the population from 23.6 year in 1970 to 39.2 year in 2020; urban population from 28% in 1960 to 83% in 2005. GNP/capita has increased tremendously from U.S. $120 in 1970 to $6,749 in 1992, and the government estimated it would be 519,350 in 2010 and $29,460 in 2020. Growth and developmental indices of children, educational achievement and social status of women also showed a remarkable improvement and anticipated to make futher progress. Leading causes of mortality and morbidity have shown a striking change during the last 30 years, from infectious diseases to chronic degenerative diseases and man-made injuries. Occurrence of communicable diseases may become minimal although viral hepatitis, venereal diseases Including AIDS, and well adapted herpes virus infections will maintain their endemic level. Newly evolving infectious agents, however, should be carefully monitored because of rapidly changing environments and human behaviours. Tuberculosis may increase up to the epidemic level when AIDS prevails. Ischemic heart diseases may increase steadily with increasing occurrence of hypertension and diabetes mellitus whereas cerebrovascular diseases may be decreased slowly. Musculaskeletal diseases which contribute a lot to the disability of aged people may be a major health problems due to increased aged population. Mental diseases, particularly that caused by alcohol and drug abuse, and senile dementia may become a prominent health problem. On the other hand injuries caused by traffic and industrial accidents that have shown most striking increase till now may be decreased considerably by intensive intervention. The health policies in the 21st century will be oriented to the health promotion for good quality life rather than life-savings.

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A Case-Control Study of Primary Liver Cancer and Liver Disease History (간 질환력과 원발성 간암에 관한 환자-대조군 연구)

  • Kim, Dong-Hyun;Park, Byung-Joo;Yoo, Keun-Young;Ahn, Yoon-Ok;Lee, Hyo-Suk;Kim, Chung-Yong;Lee, Sang-Il;Lee, Moo-Song;Ahn, Hyung-Sik;Kim, Heon;Park, Tae-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.217-225
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    • 1994
  • The relationship between past liver disease history and the risk of primary liver cancer was analyzed in a hospital-based case-control study conducted in Seoul on 165 patients with histologically or serologically confirmed hepatocellular carcinoma and individually age- and sex-matched 165 controls in hospital for ophthalmologic, otologic, or nasopharyngeal problems. Significant association were observed for liver deseases occurring 5 or more years before liver cancer diagnosis [OR,4.9;95% confidence interval (CI), $1.6{\sim}14.0$) and family history of liver disease(OR, 9.0;95% CI, $2.1{\sim}38.8$). These associations were not appreciably modified by allowance for major identified potential confounding factors. From these results, it is possible to speculate that liver cell injuries caused by various factors might be a common pathway to developing primary liver carcinoma. Considering the significant effect of family history of liver diseases on PLCA risk after adjusting past liver disease history, there might be genetic susceptibility in the carcinogenic mechanism of liver cancer. Further investigations are needed to clarify the effect of family history of liver disease on PLCA risk.

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A Study on the Introduction Direction of Private Investigation Law (민간조사업법의 도입방향에 관한 연구)

  • Lee, Seung-Chal
    • Korean Security Journal
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    • no.17
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    • pp.255-276
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    • 2008
  • The important items, which should be considered in Private Investigation Law, can include subjects, licenses, the scope of business, qualifying examinations, and supervisory and penal provisions. The subjects of Private Investigation Law should be permitted to be both natural persons and juridical persons in terms of providing various services, but should be permitted to be juridical persons and should be administered on a license system, even in order to ensure public interests. Concretely, the introduction scope of Private Investigation Law can be regulated to include the followings: that is, investigating the whereabouts identification of runaways and missing children, investigating the personal identification, habit, way of action, motivation, whereabouts identification, real child confirmation, association, transaction, reputation, and personality of specific persons or specific groups, investigating the whereabouts identification of missing persons, owners of government-vested properties or renounced properties, investigating the whereabouts of lost properties or stolen properties, investigating the causes of fire, character defamation, slander, damage, accident, physical disability, infringement on real estate or movable property, and investigating all sorts of accidents including traffic accidents, insurance accidents, and medical malpractices. In the qualifying examination, examinees' age should be restricted to be over age 25. The person, who is exempted from its primary examination, should be restricted to be the person, who has the career of over 20 years in related fields, in consideration of its equity with other certificates of qualification. In the supervisory institution, as the policy institution is the supervisory institution in many countries including France (the police) and Japan (public security committee), so the National Policy Agency should be the supervisory institution in consideration of management aspects. In the penal regulations, especially, we should clarify the management of personal information (personal information protection, personal information management), and so should prevent the infringement of people's basic rights, and then should ensure the public interest.

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Investigation of Healthy Life Practices among Korean Males and Females in relation to Dyslipidemia Using data from the 2012 Korea National Health and Nutrition Examination Survey (한국인 남녀에서 이상지질혈증 관련 건강생활 실천 규명 -국민건강영양조사 2012년 자료 이용-)

  • Lee, Sun-Hee;Seomun, GyeongAe
    • Journal of Digital Convergence
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    • v.14 no.1
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    • pp.327-338
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    • 2016
  • The purpose of the present study is to determine the occurrence of dyslipidemia and the effects of health life practices among Korean males and females. The study subjects were 4,036 persons aged at least 19 years, as selected from the health questionnaire data out of the third year data(2012) Korea National Health and Nutrition Examination Survey. They were divided into a dyslipidemia group of 2,092 subjects (male 1,042, female 1,050) and a normal group of 1,944 subjects (male 740, female 1,204) by applying the dyslipidemia treatment guidelines of the Korean Society of Lipidology and Atherosclerosis. In the present study, the SPSS 18.0 program was used to conduct t-tests, a ${\chi}^2-test$, and a logistic regression analysis of descriptive statistics. Therefore, dyslipidemia-related healthy life practice programs should apply the characteristics of Korean males and females that show differences in serum lipid concentrations and to this end, continued studies, and national-level customized education applying the effects of healthy life practices is considered necessary.

Comparisons of voice quality parameter values measured with MDVP, Praat, and TF32 (MDVP, Praat, TF32에 따른 음향학적 측정치에 대한 비교)

  • Ko, Hye-Ju;Woo, Mee-Ryung;Choi, Yaelin
    • Phonetics and Speech Sciences
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    • v.12 no.3
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    • pp.73-83
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    • 2020
  • Measured values may differ between Multi-Dimensional Voice Program (MDVP), Praat, and Time-Frequency Analysis software (TF32), all of which are widely used in voice quality analysis, due to differences in the algorithms used in each analyzer. Therefore, this study aimed to compare the values of parameters of normal voice measured with each analyzer. After tokens of the vowel sound /a/ were collected from 35 normal adult subjects (19 male and 16 female), they were analyzed with MDVP, Praat, and TF32. The mean values obtained from Praat for jitter variables (J local, J abs, J rap, and J ppq), shimmer variables (S local, S dB, and S apq), and noise-to-harmonics ratio (NHR) were significantly lower than those from MDVP in both males and females (p<.01). The mean values of J local, J abs, and S local were significantly lower in the order MDVP, Praat, and TF32 in both genders. In conclusion, the measured values differed across voice analyzers due to the differences in the algorithms each analyzer uses. Therefore, it is important for clinicians to analyze pathologic voice after understanding the normal criteria used by each analyzer when they use a voice analyzer in clinical practice.

The Influence of Asian Dust, Haze, Mist, and Fog on Hospital Visits for Airway Diseases

  • Park, Jinkyeong;Lim, Myoung Nam;Hong, Yoonki;Kim, Woo Jin
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.326-335
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    • 2015
  • Background: Asian dust is known to have harmful effects on the respiratory system. Respiratory conditions are also influenced by environmental conditions regardless of the presence of pollutants. The same pollutant can have different effects on the airway when the air is dry compared with when it is humid. We investigated hospital visits for chronic obstructive pulmonary disease (COPD) and asthma in relation to the environmental conditions. Methods: We conducted a retrospective study using the Korean National Health Insurance Service claims database of patients who visited hospitals in Chuncheon between January 2006 and April 2012. Asian dust, haze, mist, and fog days were determined using reports from the Korea Meteorological Administration. Hospital visits for asthma or COPD on the index days were compared with the comparison days. We used two-way case-crossover techniques with one to two matching. Results: The mean hospital visits for asthma and COPD were $59.37{\pm}34.01$ and $10.04{\pm}6.18$ per day, respectively. Hospital visits for asthma significantly increased at lag0 and lag1 for Asian dust (relative risk [RR], 1.10; 95% confidence interval [CI], 1.01-1.19; p<0.05) and haze (RR, 1.13; 95% CI, 1.06-1.22; p<0.05), but were significantly lower on misty (RR, 0.89; 95% CI, 0.80-0.99; p<0.05) and foggy (RR, 0.89; 95% CI, 0.84-0.93; p<0.05) days than on control days. The hospital visits for COPD also significantly increased on days with Asian dust (RR, 1.29; 95% CI, 1.05-1.59; p<0.05), and were significantly lower at lag4 for foggy days, compared with days without fog (RR, 0.85; 95% CI, 0.75-0.97; p<0.05). Conclusion: Asian dust showed an association with airway diseases and had effects for several days after the exposure. In contrast to Asian dust, mist and fog, which occur in humid air conditions, showed the opposite effects on airway diseases, after adjusting to the pollutants. It would require more research to investigate the effects of various air conditions on airway diseases.

호스피스 자원봉사활동의 실태 및 지원에 관한 연구 - 대전ㆍ충청권을 중심으로

  • Hwang, Yeong-Suk;Mo, Seon-Hui
    • Korean Journal of Hospice Care
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    • v.5 no.1
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    • pp.14-25
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    • 2005
  • This study was conducted to examine the present state, types of services, difficulties, education programs, motivation, satisfaction and attitude of hospice volunteers and also to suggest supporting programs for the volunteer. For these purposes, a questionnaire was distributed among the 200 hospice volunteers in ten hospice organizations in Daejeon and Chungcheong province. In this research, 85.5% of the respondents were women and most of them were housewives in their forties and fifties. The majority of hospice volunteers had an education background of more than high school. Christianity (94%) was the dominant religion of volunteers. Among the service area of the hospice, emotional caring, such as listening closely and establishing empathy were the most frequently done by the respondents and the next one was spiritual care. Hospice volunteers who had started with altruistic motivation show more dynamic activities in emotional, spiritual, physical caring and so on, than those with non-altruistic motivation. Most of the respondents expressed that they felt a hospice volunteer was valuable. However they had a hard time to overcome the sorrow coming from sharing empathy with the dying patients. Those who had started with altruistic motivation usually took part in two times per a week and had more positive attitude. Volunteers who had been working more than five years showed better attitude than those who had been working less than three years. The longer the voluntary services, the more positive attitude experienced by volunteers. Hospice volunteers encountered the most considerable difficulty with lack of background knowledge and their actual capability. Insufficiency of time was the next reason for the considerable difficulty of the hospice volunteer. On the other hand, those who served more than twice per week replied that lack of background knowledge and their capability were the least considerable difficulty. Insufficiency of time was the reason of difficulty for male volunteers, as well as for females under thirty and those in their forties and fifties respectively. Generally most of the hospice volunteers (70%) were satisfied with their services and they usually satisfied with physical caring, spiritual caring, hospice's family caring. The less difficulty in voluntary services, more satisfaction for the volunteers in the end. There is a positive correlation between a attitude of the hospice volunteer and frequency of voluntary services while the volunteers' difficulty affect negatively their attitude as well as the frequency of voluntary services. Most of the hospice volunteers want to have more education about basic skills, volunteer's attitude and role, spirituality, the way of attending on the hospice and so on. Most of them considered discussion and sharing different cases as the most effective method. They also wish to had more supporting programs for the hospice volunteers(in the order of their needs) such as regular events, newsletters, personal concern, social meetings among the volunteers, insurance and minimum expenses. Based on the study results, more programs should be run in order to activate the voluntary services regardless of their gender and education background. A continuous practical supporting policy and education programs are required in order to provide special education and training courses considering every field of voluntary services. Expanding the role of the volunteers allows them more opportunities to take part in voluntary services and th activate participation. It is necessary to establish a new hospice system as a part public medical system, which can not only facilitate the voluntary services for a hospice but also enhance professional hospice volunteers. Finally, experts are needed to operate the voluntary services effectively.

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Respite Care와 영적케어의 고찰

  • Sin, Min-Seon
    • Korean Journal of Hospice Care
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    • v.5 no.1
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    • pp.50-62
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    • 2005
  • The elderly people was over 8.3% in 2003. This seament is projected to grow to 14.4% by 2019(Aged society) and over 20% by 2026(Super aged society). As the elderly population is increasing and young population is declined social issues around elderly care are emerged in Korea. As a result of that, they are in the condition of poor system of the welfare of the old and it is the worst one in Korea. And because of the worst financial independence and difficulty in Korea, welfare facilities and medical instruments are so insufficient and deteriorated, so the quality of service is getting low. Furthermore the mortality of cancer is rapidely increased in recent years. So it is expected that the number of families who are caring for terminal cancer patient will be increased. We can not solve those problems only with government's policy such as to secure ample budget and to enlarge the aged welfare institutions. Definitely, to acheve the suggetions persistence concern about old people is most important, and family, community and national government should be linked to accomplish to goal. Accordingly, for this study attempts to provide conceptual framework of the respite care, spiritual care and home hospice, nursing home for the elderly. And this study is to discuss the necessity and effect about the construction of housing welfare infrastructure and to make a cooperation and linkage system among the aged welfare institutions, government and the aged welfare programs. As is well known, the issue of the increasing aged people is neither a matter of individuals nor of the family, but rather a complex matter of whol society. Therefore it can be resolved by the active participation of government. Conclusively this study tries to provide an direction of the improvement with regard to the welfare policy for the elderly. The study is as follwos: Chapters 1: The theological base, conception, essentiality, respite care, spiritual care and home hospice, nursing home for the elderly. Chapters 2: Definitions of respite care, spiritual care, hospice, patient of termina cancer and quality of life. And relations between respite care and nursing home. Chapters 3: The necessity of long-term care insurance and the perspectives of spiritual care. Chapters 4: Conclusions and summarizing(The directions of improvement of welfare policy for the elderly). To sum up, the problems of the aged people has not effects only to the aged people. This means that the problems of aged is the problems of the young generation today. Because young generation will be the old generation in the near future.

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