• Title/Summary/Keyword: Medical service factors

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Cohort Study Protocol: A Cohort of Korean Atomic Bomb Survivors and Their Offspring

  • Seong-geun Moon;Ansun Jeong;Yunji Han;Jin-Wu Nam;Mi Kyung Kim;Inah Kim;Yu-Mi Kim;Boyoung Park
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.1
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    • pp.1-11
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    • 2023
  • In 1945, atomic bombs were dropped on Hiroshima and Nagasaki. Approximately 70 000 Koreans are estimated to have been exposed to radiation from atomic bombs at that time. After Korea's Liberation Day, approximately 23 000 of these people returned to Korea. To investigate the long-term health and hereditary effects of atomic bomb exposure on the offspring, cohort studies have been conducted on atomic bomb survivors in Japan. This study is an ongoing cohort study to determine the health status of Korean atomic bomb survivors and investigate whether any health effects were inherited by their offspring. Atomic bomb survivors are defined by the Special Act On the Support for Korean Atomic Bomb Victims, and their offspring are identified by participating atomic bomb survivors. As of 2024, we plan to recruit 1500 atomic bomb survivors and their offspring, including 200 trios with more than 300 people. Questionnaires regarding socio-demographic factors, health behaviors, past medical history, laboratory tests, and pedigree information comprise the data collected to minimize survival bias. For the 200 trios, whole-genome analysis is planned to identify de novo mutations in atomic bomb survivors and to compare the prevalence of de novo mutations with trios in the general population. Active follow-up based on telephone surveys and passive follow-up with linkage to the Korean Red Cross, National Health Insurance Service, death registry, and Korea Central Cancer Registry data are ongoing. By combining pedigree information with the findings of trio-based whole-genome analysis, the results will elucidate the hereditary health effects of atomic bomb exposure.

Use of SGLT2 inhibitor/metformin fixed dose combination in Korea (SGLT2 저해제/metformin 고정용량복합제의 국내 사용 현황)

  • Choi, Ha Eun;Lee, Ji Won;Je, Nam Kyung;Jeong, Kyeong Hye
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.1
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    • pp.13-19
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    • 2022
  • Background: The use of combination therapy and fixed-dose combination therapy is increasing for the treatment of type 2 diabetes. Sodium glucose cotransporter-2 inhibitor (SGLT2i) is a drug class used in combination with metformin. Methods: Type 2 diabetes patients on SGLT2i/metformin combination therapy were extracted from the 2019 Health Insurance Review & Assessment Service-National Patients Sample. On July 1, 2019, SGLT2i and metformin fixed-dose combination (SGLT2i/metformin FDC) and two-pill combination (TPC) groups were identified, and a chi-square test and multiple logistic regression were performed. Results: Of total 2,992 patients, 1,077 (36%) were prescribed SGLT2i/metformin FDC and 1,915 (64%) were prescribed TPC. We found that the most common comorbidities were in the order of dyslipidemia, gastrointestinal disease, and hypertension. Multiple logistic regression analysis showed that the use of SGLT2i/metformin FDC was lower than TPC in patients with diabetic neuropathy (OR=0.76, p=0.008). Clinic (OR=2.09, p<0.001) and general hospital (OR=1.40, p=0.019) showed higher tendency to prescribe SGLT2i/metformin FDC compared to tertiary hospital. The tendency of prescribing SGLT2i/metformin FDC was lower in Kyeonggi (OR=0.79, p=0.037), Gyeongsang (OR=0.77, p=0.025) and Chungcheong (OR=0.68, p=0.007) than Seoul. Conclusion: Factors related to the use of SGLT2i/metformin FDC in patients with type 2 diabetes were complication, medical institution and region. The tendency to prescribe SGLT2i/metformin FDC was relatively higher in clinics than in tertiary general hospitals and in Seoul than in other regions.

Factors associated with tobacco and alcohol use (저소득층의 음주 및 흡연 관련 요인)

  • Choi, Eun-Jin;Kim, Chang-Woo
    • Korean Journal of Health Education and Promotion
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    • v.25 no.5
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    • pp.39-51
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    • 2008
  • The objectives of this study were to analyze the socio-economical factors related to smoking and drinking behaviors using the Korea Welfare Panel data. The key variables were sex, age, frequency of health and medical facilities visit, subjective health level, smoking level, drinking level, depression symptoms, and low income level. Since the health variables in the Welfare Panel data were limited, the analysis was exploratory. In male population of those older than 30 years old, low income group people were more likely to smoke cigarettes than the general income population. In the result of the Chi square analysis, the smoking rate showed significantly different relationships with the different age groups, gender and income level. According to the descriptive analysis, persons with low income level were more likely to experience health risk behaviors and showed more medical service utilization. The utilization of the local public health centers was 4.6% for the Bow income level and 1% for the general level. The higher smoking rate was associated with the younger age, and the lower income. The smoking rate in the age category from 20 to 29 was 23.3% for the general level and 25% for the low income level. On the other hand, the drinking rate was even higher in the general families. The rates of non use of alcohol was 36.7% in the general families and 58.4% for the low income families. For both smoking and high risk drinking issues, demographic and sociological variables such as sex, age, education levels and income levels were analyzed, and there wer significant relationships. Health risk factors were serious for males, with age groups of 20's and 30's, lower education level, and in a low income family. In general, females were more unhealthy. The rates of smoking and drinking were higher in the low income level. Even in the health and nutrition survey results in 2005, persons in the low income class were experiencing poorer health in health level or the degree of action restriction. Since the effects of the health promotion could not be measured in a short period of time, it has not been easy to create the basis for the substantial effects. Factors related to health risks needs to be continuously studied using data from diverse field.

Comparison of Effectiveness about Image Quality and Scan Time According to Reconstruction Method in Bone SPECT (영상 재구성 방법에 따른 Bone SPECT 영상의 질과 검사시간에 대한 실효성 비교)

  • Kim, Woo-Hyun;Jung, Woo-Young;Lee, Ju-Young;Ryu, Jae-Kwang
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.9-14
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    • 2009
  • Purpose: Nowadays in the nuclear medicine, many studies and efforts are being made to reduce the scan time, as well as the waiting time to be needed to execute exams after injection of radionuclide medicines. Several methods are being used in clinic, such as developing new radionuclide compounds that enable to be absorbed into target organs more quickly and reducing acquisition scan time by increase the number of Gamma Camera detectors to examine. Each medical equipment manufacturer has improved the imaging process techniques to reduce scan time. In this paper, we tried to analyze the difference of image quality between FBP, 3D OSEM reconstruction methods that commercialized and being clinically applied, and Astonish reconstruction method (A kind of Iterative fast reconstruction method of Philips), also difference of image quality on scan time. Material and Methods: We investigated in 32 patients that examined the Bone SPECT from June to July 2008 at department of nuclear medicine, ASAN Medical Center in Seoul. 40sec/frame and 20sec/frame images were acquired that using Philips‘ PRECEDENCE 16 Gamma Camera and then reconstructed those images by using the Astonish (Philips’ Reconstruction Method), 3D OSEM and FBP methods. The blinded test was performed to the clinical interpreting physicians with all images analyzed by each reconstruction method for qualitative analysis. And we analyzed target to non target ratio by draws lesions as the center of disease for quantitative analysis. At this time, each image was analyzed with same location and size of ROI. Results: In a qualitative analysis, there was no significant difference by acquisition time changes in image quality. In a quantitative analysis, the images reconstructed Astonish method showed good quality due to better sharpness and distinguish sharply between lesions and peripheral lesions. After measuring each mean value and standard deviation value of target to non target ratio with 40 sec/frame and 20sec/frame images, those values are Astonish (40 sec-$13.91{\pm}5.62$ : 20 sec-$13.88{\pm}5.92$), 3D OSEM (40 sec-$10.60{\pm}3.55$ : 20 sec-$10.55{\pm}3.64$), FBP (40 sec-$8.30{\pm}4.44$ : 20 sec-$8.19{\pm}4.20$). We analyzed target to non target ratio from 20 sec and 40 sec images. And we analyzed the result, In Astonish (t=0.16, p=0.872), 3D OSEM (t=0.51, p=0.610), FBP (t=0.73, p=0.469) methods, there was no significant difference statistically by acquisition time change in image quality. But FBP indicates no statistical differences while some images indicate difference between 40 sec/frame and 20 sec/frame images by various factors. Conclusions: In the circumstance, try to find a solution to reduce nuclear medicine scan time, the development of nuclear medicine equipment hardware has decreased while software has marched forward at a relentless. Due to development of computer hardware, the image reconstruction time was reduced and the expanded capacity to restore enables iterative methods that couldn't be performed before due to technical limits. As imaging process technique developed, it reduced scan time and we could observe that image quality keep similar level. While keeping exam quality and reducing scan time can induce the reduction of patient's pain and sensory waiting time, also accessibility of nuclear medicine exam will be improved and it provide better service to patients and clinical physician who order exams. Consequently, those things make the image of department of nuclear medicine be improved. Concurrent Imaging - A new function that setting up each image acquisition parameter and enables to acquire images simultaneously with various parameters to once examine.

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Factors Affecting Occupation Awareness for Dental Hygienist in High School Students (고등학생의 치과위생사에 대한 직업 인지 관련 요인)

  • Cho, Young-Sik;Hwang, Hye-Rim;Joo, Seung-Mi;Choi, Jung-Yoon;Hwang, Mi-Ra
    • Journal of dental hygiene science
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    • v.11 no.4
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    • pp.293-297
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    • 2011
  • The purpose of this study was to evaluate recognition of occupation title for dental hygienist in high school students. Total 210 students of one high school completed a self-reported questionnaire on sociodemographic characteristics, dental service utilization and occupation title awareness for health care personnels. Female and science tract students showed higher level of awareness for dental hygienist but showed no differences according to dental service utilization pattern. The study showed association between occupation recognition for dental hygienist and other health technicians. But there were no association between occupation awareness for dental hygienist and dentist, nurse. Gender, occupation recognition for medical laboratory technologists and physical therapist affect occupation recognition for dental hygienist.

Analyzing association between low-density lipoprotein reduction by statin and adherence to medication using national health insurance service-national sample cohort (NHIS-NSC) (표본코호트기반 고지혈증 약제의 저밀도 콜레스테롤 감소량 및 투약순응도 분석)

  • Kim, Kyu-Jin;Jun, Chi-Hyuck;Lee, Hyeseon;Kim, Hun-Sung
    • Journal of the Korean Data and Information Science Society
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    • v.28 no.5
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    • pp.1027-1041
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    • 2017
  • Hyperlipidemia, the status of blood with high level of low-density lipoprotein cholesterol (LDL-C), is known as a main cause of coronary artery diseases such as myocardiac infarction or brain infarct. Statin is the representative prescription to hyperlipidemia and the effects of it depend on the patient's individual conditions such as health-caring habits or adherence to medication. The main effect of statin is reducing LDL-C, which should reach the target range based on National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) guideline. In this research, the reduction of LDL-C and attainment to patient's target range are considered effects of statin. The association between factors - individual conditions and adherence to medication of patients - and the effects of statin is analyzed with National Health Insurance Service-National Sample Cohort (NHIS-NSC).

Analysis of the relationship between lifestyle habits and glycosylated hemoglobin control based on data from a Health Management Plan

  • Wang, Ya-Chun;Wang, Chi;Shih, Ping-Wen;Tang, Pei-Ling
    • Nutrition Research and Practice
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    • v.14 no.3
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    • pp.218-229
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    • 2020
  • BACKGROUND/OBJECTIVES: Type 2 Diabetes mellitus (T2DM) is a hereditary disease that is also strongly dependent on environmental factors, lifestyles, and dietary habits. This study explored the relationship between lifestyle habits and glycosylated hemoglobin management in T2DM patients to provide empirical outcomes to improve T2DM management and patient health literacy. SUBJECTS/METHODS: This study enrolled 349 diabetic patients with more than 5 care visits to a Diabetes Mellitus care network under the Health Management Plan led by Taiwan Department of Health (DOH). Based on relevant literature, an Outpatient Record Form of Diabetes Mellitus Care was designed and lipid profile tests were conducted for data collection and analysis. RESULTS: When modeling the data, the results showed that the odds for HbA1c > 7.5% in T2DM patients duration over 10 years was 3.785 (P = 0.002) times that in patients with disease duration of fewer than 3 years. The odds of HbA1c > 7.5% in illiterate patients was 3.128 (P = 0.039) times that in patients with senior high school education or above. The odds of HbA1c > 7.5% in patients with other chronic illness was 2.207 (P = 0.019) times that in participants without chronic illness. Among 5 beneficial lifestyle habits, the odds of HbA1c > 7.5% in patients with 2 or 3 good habits were 3.243 (P = 0.003) and 3.424 (P = 0.001) times that in patients with more than 3 good habits, respectively. CONCLUSION: This empirical outcome shows that maintaining a good lifestyle improves T2DM management and patients' knowledge, motivation, and ability to use health information. Patients with longer disease duration, education, or good lifestyle habits had optimal HbA1c management than those in patients who did not. Thus, effective selfmanagement and precaution in daily life and improved health literacy of diabetic patients are necessary to increase the quality of T2DM care.

An indicator for managing the regional variations in approval rates of long-term care (LTC) service (지역별 장기요양 인정의 차이 관리지표 개발)

  • Han, Eun-Jeong;Lee, JungSuk;Park, Seyoung;Jang, Soomok;Jung, Inkyung
    • The Korean Journal of Applied Statistics
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    • v.30 no.3
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    • pp.391-401
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    • 2017
  • This study develops an indicator to manage regional variations of approval rates for long-term care (LTC) service. We used LTC insurance data for grade assessment that include 433,155 applicants from 227 LTC centers across Korea in 2015. The approval rate for each center was defined as the proportion of the numbers of approved applicants out of all applicants. We assumed that the approval rates depended on the characteristics of applicants. We estimated the 'standard' approval rates from a multiple linear regression analysis using the characteristics of applicants as independent variables. The difference between the observed and the standard rates was then defined as an indicator for deviation. A center having a large difference could be considered as a center with a potential error in grade assessment. We also examined if the characteristics of investigators affected the approval rates. We found that the socio-demographic characteristics of applicants and reapplication rate for LTC grade were independent factors affecting the approval rates. Centers having the management indicator values falling outside the middle 95% of the distribution were identified as centers with an error in grading. We expect that this study will contribute to enhancing reliability and equity in LTC grading.

The Determinants and Comparison of Health Behavior and Health Service by Private Medical Insurance on National Health-Nutrition Survey (국민건강영양조사 대상자들의 민간의료보험 가입 요인 및 가입여부에 따른 건강행태·의료이용 비교)

  • Lee, Yong-Chul;Im, Bock-Hee;Park, Young-Hee
    • The Journal of the Korea Contents Association
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    • v.10 no.12
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    • pp.190-204
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    • 2010
  • This study firstly examined the socioeconomic and health factors associated with infiltration of private health insurance. Secondly, we compared health behavior, outpatient and inpatient use of private health insured with uninsured. The method of this study is that secondary analysis of the 2008 Korea National Health and Nutrition Survey was conducted for 7178 respondents aged 19 over. We use the logistic regression and t-test for data analysis. The first dependent variable was dichotomy which is divided to private health insured or uninsured and the second dependent variable was the presence and frequency of outpatient and inpatient use. The descriptive variables was gender, age, marital status, income, education, occupation, type of national health insurance, residential area, self confidence of health, prevalence rate of common disease, activity limitation, drinking and smoking status. The result of the major findings are as follows. First, 59 under aged person, married person, people in the higher brackets of income, national employee insured were more likely to infiltrate private health insurance. The poor self confidence of health, activity limitation, person with hypertension or allergic rhinitis and smoker were negatively related in infiltrating private health insurance. Second, private health insured did more preventive behavior such as self-paid health examination, cancer screening, regular exercise than uninsured. Third, private health insured was positively related with the presence of outpatient use and frequency of inpatient use

Study on the Growth Environment of 'Gangwha-mugwort' Through the Climatological Characteristic Analysis of Gangwha Region (강화지역의 기후특성 분석을 통한 '강화약쑥'의 생육 환경 연구)

  • Ahn, Joong-Bae;Hur, Ji-Na;Jung, Hae-Gon;Park, Jong-Ho
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.14 no.2
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    • pp.71-78
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    • 2012
  • Eupatilin, one of representative medical components of mugwort, can be efficiently extracted from the 'Gangwha Sajabalssuk'. The Eupatilin content may depend on environmental factors such as soil and regional climate in addition to a genetic factor and Gangwha region has a profitable environmental condition for the mugwort growth. In this study, the climatological characteristics of Gangwha was analyzed in order to find the environmental condition of mugwort containing high Eupatilin in term of atmospheric, oceanographic and land variables. The climate of Gangwha is characterized by the relatively low daily temperature and large diurnal variation with plenty of solar radiation, long sunshine duration and less cloudiness. According to our correlation analysis, the long sunshine duration and the large diurnal temperature variation are highly correlated with the Eupatilin contents. The result implies that Gangwha has the favorable conditions for the cultivation and the habitat of the high-Eupatilin concentrated mugwort. Because of the sea surrounding Gangwha Island with low salinity and moderate wind, the salt contained in sea breeze is relatively low compared to other regions. Furthermore, Gangwha has clean atmospheric environment compared to other regions because the concentrations of toxic gases harmful to crop growth such as nitrogen dioxide ($NO_2$), sulfite gas ($SO_2$) and fine dust (PM-10) are lower in the air. The ozone ($O_3$) concentration is moderate and within the level of natural production. It is also found that moderately coarse texture or fine loamy soils known as good for water drainage and for the growth and cultivation of the 'Gangwha-mugwort' are distributed throughout the areas around mountainous districts in Gangwha, coinciding with those of mugwort habitat.