• The Korean Journal of Health Service Management
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• v.9 no.2
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• pp.81-88
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• 2015

The purpose of this study was to compare the risk-adjusted in-hospital mortality for craniotomies between logistic regression and multilevel analysis. By using patient sample data from the Health Insurance Review & Assessment Service, in-patients with a craniotomy were selected as the survey target. The sample data were collected from a total number of 2,335 patients from 90 hospitals. The sample data were analyzed with SAS 9.3. From the results of the existing logistic regression analysis and multilevel analysis, the values from the multilevel analysis represented a better model than that of logistic regression. The intra-class correlation (ICC) was 18.0%. It was found that risk-adjusted in-hospital mortality for craniotomies may vary in every hospital. The agreement by kappa coefficient between the two methods was good for the risk-adjusted in-hospital mortality for craniotomies, but the factors influencing the outcome for that were different.

• The Korean Journal of Applied Statistics
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• v.27 no.1
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• pp.89-102
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• 2014

In this study, we analyze the effect on the smoking status in the Seoul Metropolitan area using a multilevel logistic model with Community Health Survey data from the Korea Centers for Disease Control and Prevention. Intraclass correlation coefficient (ICC), profiling analysis and two types of predicted value were used to determine the appropriate multilevel analysis level. Sensitivity, specificity, percentage of correctly classified observations (PCC) and ROC curve evaluated model performance. We showed the applicability for multilevel analysis allowed for the possibility that different factors contribute to within group and between group variability using survey data.

• Journal of the Architectural Institute of Korea Planning & Design
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• v.35 no.8
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• pp.101-109
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• 2019

Korea's transportation paradigm is shifting from a vehicle-oriented transportation plan to a pedestrian-friendly environment that emphasizes walking safety. However, the level of pedestrian traffic accidents in Korea is still high and serious. The purpose of this study is to investigate factors affecting the severity of pedestrians traffic accidents using the multilevel logistic regression model based on 2015-2017 pedestrian accidents data provided by the Traffic Accident Analysis System(TAAS). The main results of the multilevel logistic regression model showed that 89% of pedestrian traffic accidents in Seoul were explained by individual characteristics such as drivers and pedestrians, and 11% were explained by neighborhood environmental characteristics. The results are as follows : In the individual characteristics such as pedestrians and drivers, the older the pedestrians and the drivers, the higher the traffic accident severity. The severity of traffic accidents was high when the pedestrians were female and the drivers were male. In the case of accident types, traffic accidents were more serious in the cases of heavy vehicles, inclement weather, and occurring at intersections and crosswalks. The results of the neighborhood environmental characteristics are as follows. The intersection density and the crosswalk density tended to reduce the severity of traffic accidents. On the other hand, the traffic light density and the school zones were founded to related to the higher level of traffic accident severity. This study suggests that both individual and neighborhood environmental characteristics should be considered together to prevent and reduce the severity of pedestrian traffic accidents.

• The Journal of the Korea Contents Association
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• v.13 no.5
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• pp.342-353
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• 2013

Objectives: It attempted to analyze influencing factors on the utilization of outpatient services which were adopted to predisposing, enabling, and need factors in Anderson model. Methods: The current study analyzed "2007 Korean National Health Nutrition Survey" data, which selected 3,335 people nationwide by proportional systematic sampling. This study analyzed data of persons who used outpatient services in two weeks. It adopted Anderson Model to control contextual factors including socioeconomic factors. The study compared means and fitted logistic regression models and multilevel model. Results: The logistic regression model showed that persons purchased private medical insurance were less likely to use outpatient services than the persons did not purchase private medical insurance. Persons with hypertension and diabetes mellitus, overweight, and problem drinkers were more likely to use outpatient services. Persons with high school graduates or higher in education level and experience of accidents or intoxications were more likely to use outpatient services according to the multilevel analysis of mixed model which treated region as random effect. Conclusion: Higher level of perceived stress increased the probability to use outpatient service than lower level of perceived stress. As number of days a person had exercised increased, the probability to use outpatient service decreased. Overweight and problem alcohol drinking increased the probability of outpatient service use. Further research should be conducted to find more factors influencing outpatient service use.

• Journal of Preventive Medicine and Public Health
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• v.48 no.4
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• pp.195-202
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• 2015

Objectives: Receiving proper dental care plays a significant role in maintaining good oral health. We investigated the relationship between regional deprivation and dental care utilization. Methods: Multilevel logistic regression was used to identify the relationship between the regional deprivation level and dental care utilization purpose, adjusting for individual-level variables, in adults aged 19+ in the 2008 Korean Community Health Survey (n=220 258). Results: Among Korean adults, 12.8% used dental care to undergo examination and 21.0% visited a dentist for other reasons. In the final model, regional deprivation level was associated with significant variations in dental care utilization for examination (p<0.001). However, this relationship was not shown with dental care utilization for other reasons in the final model. Conclusions: This study's findings suggest that policy interventions should be considered to reduce regional variations in rates of dental care utilization for examination.

• Journal of Preventive Medicine and Public Health
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• v.47 no.5
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• pp.258-265
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• 2014

Objectives: To examine whether the nursing practice environment at the hospital-level affects the job satisfaction and turnover intention of hospital nurses. Methods: Among the 11 731 nurses who participated in the Korea Health and Medical Workers' Union's educational program, 5654 responded to our survey. Data from 3096 nurses working in 185 general inpatient wards at 60 hospitals were analyzed using multilevel logistic regression modeling. Results: Having a standardized nursing process (odds ratio [OR], 4.21; p<0.001), adequate nurse staffing (OR, 4.21; p<0.01), and good doctor-nurse relationship (OR, 4.15; p<0.01), which are hospital-level variables based on the Korean General Inpatients Unit Nursing Work Index (KGU-NWI), were significantly related to nurses' job satisfaction. However, no hospital-level variable from the KGU-NWI was significantly related to nurses' turnover intention. Conclusions: Favorable nursing practice environments are associated with job satisfaction among nurses. In particular, having a standardized nursing process, adequate nurse staffing, and good doctor-nurse relationship were found to positively influence nurses' job satisfaction. However, the nursing practice environment was not related to nurses' turnover intention.

• Journal of Preventive Medicine and Public Health
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• v.56 no.6
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• pp.504-514
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• 2023

Objectives: This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes. Methods: This study investigated patients with new prescriptions for hypertension and diabetes in Korea in 2019 with using data collected from general health screenings. A multilevel logistic regression model was applied to explore the relationship between patients' first prescribing institution and their medication adherence, defined as a medication possession ratio (MPR) over 80%. Results: The overall adherence rates were 53.7% and 56.0% among patients with hypertension and diabetes, respectively. The intra-class correlation coefficients were 13.2% for hypertension and 13.8% for diabetes (p<0.001), implying that the first prescribing institution had a significant role in medication adherence. With clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes). Among individual-level variables, female sex, older age, higher insurance premium level, and residing in cities were positively associated with adherence in both the hypertension and diabetes samples. Conclusions: This study showed that the prescribing institution had a significant relationship with medication adherence. When the first prescribing institution was a clinic, newly diagnosed patients were more likely to adhere to their medication. These results highlight the important role played by primary care institutions in managing mild chronic diseases.

• Journal of Veterinary Clinics
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• v.34 no.2
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• pp.140-145
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• 2017

The goal of this study was to investigate risk factors associated with porcine reproductive and respiratory syndrome (PRRS) in pig farms in the Republic of Korea using logistic regression and a multilevel model. A cross-sectional study was applied to 305 pig farms with a questionnaire-based interview by veterinarians between March 2014 and February 2015. The questionnaire comprised eight categories: proximity to neighbors, disinfection, visitors, vehicles, insecticides, wild animals, gilts, and feeding. In total, 61 questions in eight categories related to pig farm biosecurity were investigated. Farms were classified as PRRS stable or unstable based on the results of an antibody test and PCR. For univariate analysis, keeping production records with computers (OR = 0.283, 95% CI = 0.056 - 1.425), accredited farm with no use of antibiotics (OR = 0.412, 95% CI = 0.134 - 1.269), reviewing health record of semen prior to purchasing (OR = 0.492, 95% CI = 0.152 - 1.589), complete isolation of runt pigs (OR = 0.264, 95% CI = 0.084 - 0.829), compulsory registering for visitors (OR = 0.424, 95% CI = 0.111 - 1.612), keeping records of insecticide history (OR = 0.406, 95% CI = 0.089 - 1.846), routine on-farm monitoring by veterinarians (OR = 0.314, 95% CI = 0.069 - 1.423), and use of on-farm checklist for biosecurity monitoring (OR = 0.313, 95% CI = 0.063 - 1.553) were found to decrease the probability of PRRS infection. Multivariate and multilevel analysis revealed only two factors, complete isolation of runt pigs (OR = 0.165, 95% CI = 0.045 - 0.602 and OR = 0.208, 95% CI = 0.055 - 0.782) and compulsory registering for visitors (OR = 0.106, 95% CI = 0.017 - 0.655 and OR = 0.119, 95% CI = 0.017 - 0.809) were found to decrease the probability of PRRS infection. The intracluster correlation coefficient of a province for multilevel model was 0.05. The results of this study might facilitate biosecurity measures for individual farms to reduce the probability of PRRS infection.

• Health Policy and Management
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• v.32 no.1
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• pp.63-72
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• 2022

Background: Depression is a common disease around the world. Many studies are showing that mental health can be improved through physical activity, and daily regular exercise can reduce the negative effects of depression or depressive symptoms. In order to promote individual physical activity, a physical activity-friendly environment must precede. Therefore, this study attempted to confirm whether the number of sports facilities for all affects individual depression. Methods: Among the respondents to the 2018 Community Health Survey, data from 181,086 people excluding missing value were used. Descriptive and chi-square tests were performed to understanding the general characteristics of individual level variables. A multilevel logistic regression was conducted to confirm the effect of individual and regional level variables on depressive symptoms. Results: As a result of confirming the effect of individual characteristics on depressive symptoms, it was confirmed that both socioeconomic and health behavior factors had an effect. Similar results were shown in a model that considered regional level variables, and in the case of the number of sports facilities per population, people who belongs to smaller areas were more likely to have depressive symptoms (odds ratio, 0.98; 95% confidence interval, 0.97-0.99). Conclusion: As a result of the analysis, it was confirmed that both individual level and regional level variables had a significant effect on depressive symptoms. This suggests that not only individual level approaches but also regional level approaches are needed to improve individual depressive symptoms In particular, it may be possible to consider to increase the number of sports facilities in areas where the prevalence of depressive symptoms is high and the number of sports facilities is insufficient.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.5
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• pp.104-115
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• 2016

Objective: This study was conducted in order to investigate the effects of individual patient behavior regarding the health and medical care level on their therapeutic compliance for people diagnosed with high blood pressure by a physician, in order to evaluate the impact of treatment compliance. In this study, the therapeutic compliance was defined as the hypertension drug cure rate. The current blood pressure controls were persons about 30 years of age diagnosed with high blood pressure by their doctor one month fraction of the people who take more than 20 days (30 days). Methods: The data was analyzed by using the X2-test for different comparisons of the therapeutic compliance in the individual characteristics and using a two-stage multilevel logistic regression to identify the community variance of the related index of high blood pressure therapeutic compliance using the data from 229 adults over the age of 19 in a community health survey conducted in 2010. The Spss 18.0 statistical program was used with HLM 7 (hierarchical linear model) Results: It was found that the rate of therapeutic compliance was affected by the individual health behavior and health and medical care levels. Conclusion: In this study, although the odds ratio of the variable region of the high level of health care, I was able Unlike previous studies and focuses on the personal level of variation found variations in the local health care level was a significant. More studies on multilevel analysis are needed in the future considering regional level data.