• 보건의료산업학회지
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• 제11권4호
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• pp.115-132
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• 2017

Objectives : The purpose of this study was to investigate the depressive change and predictors of chronic illnesses and to examine whether depressive change predictors are different according to chronic disease types. Methods : Data from the 1st to the 10th year of the Korean Welfare Panel of 5,023 adults over 20 years of age who were treated for chronic diseases for more than three months were examined. We assessed demographic, sociological, and socioeconomic factors including depression predictors of chronically ill patients, and analyzed the data using latent growth modeling and multiple group analysis. Results : Depression symptoms of chronically ill patients gradually decreased, showing a linear relationship across time. In addition, multiple group analysis was performed for each type of chronic disease. Conclusions : We described the phenomenon of depression in chronically ill patients, and discussed the practical and policy interventions required to improve depression in chronically ill patients.

• 한국사회복지학
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• 제48권
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• pp.150-178
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• 2002

The elderly have higher potential for contracting chronic diseases and suffering from development of a complication. Also, the extended old age period leads the elderly to demand more medical services. All those facts indicate that the elderly need more medical services than any other age groups. Consequently, medical care for the elderly with chronic diseases causes high costs burden. However, there is few studies researching the financial burden of chronic illness of the elderly. This study aimed to 1) understand how much the elderly with chronic diseases pay for medical expenses; 2) find out some specific factors related to health care financial burden; 3) suggest the alternative policies to decrease excessive financial burden of caring for the elderly with chronic illness. National Health and Nutrition Survey, which was surveyed by the Korea Institute for Health and Social Affairs in 1998, was used in this study. 4,707 persons with chronic diseases out of 5385 persons over age 60 were selectively sampled. Using SPSSWIN, correlation analysis, T-test, ANOVA and Regression were used as statistical methods in this study. Stepwise multiple regression was employed to analyze the data with a ratio of health care expenditure to income(financial burden) as a dependent variable. Out of Korean old people, 87% had the chronic diseases and their health care financial burden rate showed the average of 17.9%, which meaned they expended almost 20% income to buy medical services. The variables having a great influence on financial burden were monthly income, activity, limitation and single household of an old person. The excessive financial burden was experienced by people who had more than 4 activity limitations(37.1%) and were in the lowest Income level(32.6%), and single household of an old person(31.4%). The new policies should be considered to 1) reduce the financial burden in these groups and to develop the sliced medical cost system considering the characteristics of chronic illness and income level; and 2) develop the medical management system to care for the elderly with chronic illness.

• 가정의학회지
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• 제39권6호
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• pp.364-369
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• 2018

Background: Compared with other chronic diseases, hearing loss is generally overlooked from the perspective of disease burden. However, hearing loss is emerging as an important issue in the current society. The objective of this study was to investigate disease burdens and marginal utilities associated with hearing loss and other chronic diseases. Methods: This study analyzed the cross-sectional data of 32,986 participants aged 19 years and older who completed the Korea National Health and Nutrition Examination Surveys between 2009 and 2013. Additionally, this study used the pure tone audiometric test, European Quality of Life-Five Dimensions Questionnaire, and chronic disease status. The data were analyzed using a multiple linear regression method. Results: The data of 23,297 people who underwent a pure tone audiogram and completed the European Quality of Life-Five Dimensions Questionnaire were used in this analysis. The marginal utility of hearing loss ranked fifth among nine chronic diseases. The estimated loss of quality-adjusted life years associated with hearing loss was -93.69 years per 100,000 people, which is similar to other chronic diseases. Conclusion: This study assessed the marginal utilities and public burdens of hearing loss and eight chronic diseases in a South Korean population. Although the values may vary depending on country and race, this study may provide an indispensable foundation for more detailed studies on hearing loss.

• 대한물리치료과학회지
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• 제30권4호
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• pp.17-28
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• 2023

Background: The purpose of this study is to examine the multiple-parallel mediation effects of self-esteem and body-image on the relationship between peer attachment and happiness in children with chronic diseases. In addition, this study aims to provide a basis for supporting psychological services alongside therapeutic services as a way to increase the overall happiness of children with chronic diseases. Design: This study utilized data from the 2020 Panel Study on Korean Children. Methods: The survey method was conducted as a survey by investigators, and the number of cases used in the study was 363. Results: First, children's peer attachment is associated with higher levels of overall happiness. Second, it can see that peer attachment not only increases self-esteem, but also leads to a positive perception of one's own body-image. Third, it can be seen that peer attachment, high self-esteem, and positive perception of body-image increase children's overall happiness. Finally, it can be seen that peer attachment can increase children's happiness through self-esteem and body-image Conclusion: It is thought that a more positive prognosis can be expected when psychological support is provided together with therapeutic treatment in providing medical services for children with chronic diseases.

• 대한치과의사협회지
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• 제55권9호
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• pp.634-639
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• 2017

Oral ulcerative and/or vesicular diseases have similar characteristics of clinical phenotypes. Detailed and careful history taking is the cornerstone of the diagnosis of oral mucosal disease. Moreover, complete screening of review of system for patient is important. Through this article, the simple ulcerative, recurrent ulcerative, acute multiple ulcer, chronic multiple ulcerative diseases will be discussed. Clinicians have to keep in mind its differential diagnosis and management.

• 보건행정학회지
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• 제32권3호
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• pp.282-292
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• 2022

Background: Aging societies face social problems of increased medical expenses for older adults due to increased geriatric diseases. This study aims to analyze the relationship between the state change of multiple chronic conditions (MCC) and out-of-pocket medical expenses in the elderly aged 60 or older. Methods: The 2014-2018 Korean Longitudinal Study of Aging data were used for 2,202 elderly people. Four status change groups were established according to the change in the number of chronic diseases. The association between the change of MCC and the out-of-pocket medical cost was analyzed using the generalized estimating equation model analysis. Results: The average out-of-pocket total medical costs were 1,384,900 won for participants with MCC and 542,700 won for those without MCC, which was a statistically significant difference (p<0.0001). Compared to the reference group (simple chronic disease, SCD→SCD), the change in multiple chronic conditions significantly increased the total out-of-pocket medical expenses in MCC→MCC and SCD→MCC groups (MCC→MCC: 𝛽=0.8260, p<0.0001; SCD→MCC: 𝛽=0.6607, p<0.0001). Conclusion: In this study, it was confirmed that the prevalence of MCC increased with age, and the out-of-pocket medical cost increased in the case of MCC. Continuity of treatment can be achieved for patients with MCC, and the system and management of treatment for MCC are required to receive appropriate treatment.

• 한국융합학회논문지
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• 제10권7호
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• pp.1-6
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• 2019

현대사회는 1인가구가 증가함에 따라 불규칙한 식습관으로 인해 영양이 불균형하게 포진되어있다. 이러한 식습관은 위장질환, 소화기 질환 등 만성질환의 발병률을 증가시켰다. 본 논문은 위장질환 예방을 위한 다중회귀분석을 이용한 식이지식 예측을 제안한다. 제안하는 방법은 식이지식 예측을 통해 사용자의 위장질환과 식이영양을 관리하는 방법이다. 헬스 플랫폼에서 스마트 기기를 통해 수집된 사용자의 PHR을 통합한다. 통합된 데이터로부터 다중회귀분석을 이용하여 사용자의 식이와 활동량 변화를 분석한다. 사용자의 식이 성분과 소모 칼로리, 기초대사와 같은 상황정보를 입력으로 적절한 식이성분, 위장질환 수치의 변화를 예측하고 필요할 것으로 나타나는 영양성분을 사용자에게 권장한다. 이를 통해 현대인들은 균형 잡힌 식사를 통해 위장질환을 관리할 수 있다.

• 한국농촌간호학회지
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• 제15권2호
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• pp.41-48
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• 2020

Purpose: This study was a descriptive study to identify the factors affecting the dementia prevention behavior of elders in rural communities. Methods: The participants in this study were 125 elders aged 60 or older who lived in Eup or Myeon areas of P city. For data analysis, SPSS/WIN 22.0 was used to perform descriptive statistics, t-test, ANOVA, Pearson correlation, and linear multiple regression and mediated effects. Results: Scores for dementia recognition, dementia attitude and dementia prevention behavior averaged 5.6±2.50 points in the 0~11 range, 38.8±4.59 in 14~56 and 20.2±3.59 in 10~30 respectively. Dementia recognition (a), dementia attitude (b), dementia prevention behavior (c) and the number of chronic diseases of the elders (d) were positively or negatively correlated with each other (rab=.29, p<.01; rbc=.26, p<.01; rac=.36, p<.01; rad=-.29, p<.01; rcd=.19, p<.05). Factors affecting dementia prevention behavior were dementia recognition, dementia attitude, and degree of dementia interest. When the number of chronic diseases affects dementia prevention behavior, dementia recognition has a mediating effect. Conclusion: In order to prevent dementia among elders in rural areas, appropriate management of chronic diseases and provision of appropriate dementia-related education and information to enhance dementia recognition should be provided.

• Journal of Preventive Medicine and Public Health
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• 제23권3호
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• pp.345-357
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• 1990

Accumulated data on medical care utilization among the insured in Korea Medical Insurance Corporation can explain the health status of the population. The purpose of this study was to analyze a change of the disease-mix and utilization pattern by controlling the size of the population enrollment. Major findings of the study are as follows : 1. The changes of inpatient disease-mix a. Utilization rate was 139.2% in 1988 against 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. Meanwhile, disease groups seen less often were infections and parasistic diseases, diseases of blood and bloodforming, diseases of the digestive system etc. c. Utilization rate was up 106.3% in 1988 compared to 1985, and diseases above that average level were ill-defined intestinal infections, chronic liver disease and cirrhosis, diabetes mellitus, essential hypertension, etc. d. The disease-mix by institution in 1988 compared to 1985 shows that chronic disorders rank high in general hospitals whereas opthalmologic, obstetric, and orthopedic diseases rank high in private clinics. 2. The changes of outpatient disease-mix a. Utilization rate was up 175.2% in 1988 compared to 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. And disease groups seen less often were infections and parasistic diseases, diseases of the respiratory system, diseases of the genitourinary system. etc. c. Utilization rate was up 104.0% in 1988 compared to 1985, and diseases above that average level were gastric ulcer, diseases of hard tissues of teeth, etc. And diseases seen below that average level were acute nasopharyngitis(common cold). acute upper respiratory infections of multiple or unspecified sites, etc. It was concluded that medical care utilization level was increased, and that, from 1980 to 1988, disease-mix shifted to the chronic disorders. Chronic disorders accounted for more medical care utilization in general hospitals.

• 융합정보논문지
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• 제11권6호
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• pp.154-161
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• 2021

본 연구는 요양병원에서 응급실로 전입된 노인의 복합만성질환 유무에 관한 특성 및 연관성을 분석하였다. 2019년 1월 1일부터 12월 31일까지의 국가응급진료정보망 자료에서 만성질환으로 응급실에 내원한 환자 중 장기요양병원에서 전입된 고령 환자들의 수는 13,608건이었다. 복합만성질환자 중 75세 이상이 79.9%이며, 복합만성질환으로 입원한 비율은 74.0%로 나타났다. 응급실 재실시간은 복합만성질환 유무에 따라 차이가 있었으며(P<0.001), 복합만성질환의 유병률은 응급실 내원환자와 응급실 경유 입원환자의 교차비(Odds ration, OR)에서 광주(OR 8.899 vs. 8.142)와 전북(OR 13.865 vs. 10.676)이 높게 나타났다. 이와 같이 본 연구는 복합만성질환의 유무에 대한 환자들의 특성들이 연령과 지역 등에 따라 서로 다르다는 것을 보여주었다.