• Journal of Environmental Health Sciences
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• v.43 no.6
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• pp.478-490
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• 2017

Objectives: The association of air pollution levels and land-use types with changes in the prevalence of allergic diseases (allergic conjunctivitis, allergic rhinitis, asthma, and atopic dermatitis) was investigated for seven metropolitan cities in Korea Methods: Data on daily hospital visits and admissions (of those under 19 years old) for 2003-2012 were obtained from the National Health Insurance Cooperation. Meteorological data on daily mean temperature, humidity, and air pressure were obtained from the Korea Meteorological Administration. Daily mean or maximum concentration data for five pollutants ($PM_{10}$, $O_3$, $NO_2$, $SO_2$, and CO) as measured at air quality monitoring sites operated by the Ministry of Environment were used. We estimated excess risk and 95% confidence intervals for the increasing interquatile range (IQR) of each air pollutant using Generalized Additive Models (GAM) appropriate for time series analysis. Results: In this study, we observed a significant association between the IQR increases of air pollutants and the prevalence risk of allergic diseases (allergic conjunctivitis, allergic rhinitis, asthma, and atopic dermatitis) in all metropolitan cities after adjusting for temperature, humidity, and air pressure at sea level. Among the air pollutants, $NO_2$ and $PM_{10}$ were associated with the prevalence of asthma, and $O_3$ was associated with only allergic conjunctivitis in regression analysis. However, in GAM analysis considering land-use, $O_3$ and $SO_2$ were associated with allergic conjunctivitis, PM10, O3, NO2, and CO were associated with allergic rhinitis, and $PM_{10}$, $O_3$ and $NO_2$ were associated with asthma in industrial area. Conclusion: This study found a significant association between air pollution and the prevalence of allergic related diseases in industrial areas. More detailed research considering mixed traffic-related air pollution (TRAP) and conducting meta-analyses combining data of the all cities is required.

• Tuberculosis and Respiratory Diseases
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• v.67 no.2
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• pp.88-94
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• 2009

Background: From November 2006, The national health insurance system in the Republic of Korea began to cover prescribed long-term oxygen therapy (LTOT) in patients with chronic respiratory insufficiency. This study examined the current status of LTOT after national health insurance coverage. Methods: Between November 1, 2006 and June 30, 2008, the medical records of patients who were prescribed LTOT by chest physicians were reviewed. The data was collected from 13 university hospitals. Results: 197 patients (131 male and 66 female) were prescribed LTOT. The mean age was 64.3${\pm}$13.0 years. The most common underlying disease was chronic obstructive pulmonary disease (n=103, 52.3%). Chest physicians prescribed LTOT using arterial blood gas analysis or a pulse oxymeter (74.6%), symptoms (14%), or a pulmonary function test (11.2%). The mean oxygen flow rate was 1.56${\pm}$0.68 L/min at rest, 2.08${\pm}$0.91 L/min during exercise or 1.51${\pm}$0.75 L/min during sleep. Most patients (98.3%) used oxygen concentrators. Only 19% of patients used ambulatory oxygen supplies. The oxygen saturation before and after LTOT was 83.18${\pm}$10.48% and 91.64${\pm}$7.1%, respectively. After LTOT, dyspnea improved in 81.2% of patients. The mean duration of LTOT was 16.85${\pm}$6.71 hours/day. The rental cost for the oxygen concentrator and related electricity charges were 48,414${\pm}$15,618 won/month and 40,352${\pm}$36,815 won/month, respectively. Approximately 75% of patients had a regular visit by the company. 5.8% of patients had personal pulse oxymetry. 54.9% of patients had their oxygen saturation checked on each visit hospital. 8% of patients were current smokers. The most common complaint with LTOT was the limitation of daily activity (53%). The most common complaint with oxygen concentrators was noise (41%). Conclusion: The patients showed good compliance with LTOT. However, only a few patients used an ambulatory oxygen device or had their oxygen saturation measured.

• Korean Journal of Community Nutrition
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• v.17 no.3
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• pp.341-352
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• 2012

It is well established that excessive sodium intake is related to a higher incidence of chronic diseases such as hypertension, stroke, coronary heart disease, cardiovascular disease and gastric cancer. Although the upper limit of the current sodium intake guideline by WHO is set at 2,000 mg/day for adults, sodium intake of Koreans is well over 4,700 mg/capita/day implying an urgent need to develop and implement sodium intake reduction policy at the national level. This study investigated the cost-effectiveness of the sodium intake reduction policy, for the first time, in Korea. Analyses were performed using most recent and representative data on national health insurance statistics, healthcare utilization, employment information, disease morbidity/mortality, etc. The socioeconomic benefits of the policy, resulting from reduced morbidity of those relevant diseases, included lower medical expenditures, transportation costs, caregiver cost for inpatients and income losses. The socioeconomic benefits from diminished mortality included reductions in earning losses and welfare losses caused by early deaths. It is estimated that the amount of total benefits of reducing sodium intake from 4.7 g to 3.0 g is 12.6 trillion Korean Won; and the size of its cost is 149 billion Won. Assuming that the effect of sodium intake reduction would become gradually evident over a 5-year period, the implied rate of average return to the sodium reduction policy is 7,790% for the following 25 years, suggesting a very high cost-effectiveness. Accordingly, development and implementation of a mid-to-long term plan for a consistent sodium intake reduction policy is extremely beneficial and well warranted.

• Journal of Preventive Medicine and Public Health
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• v.32 no.3
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• pp.383-394
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• 1999

Objectives: This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. Methods: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. Results : In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. Conclusions: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area.

• Women's Health Nursing
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• v.6 no.3
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• pp.383-397
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• 2000

This study of purpose was to define the relationship between the stress and climacteric symptoms of middle-aged women in order to provide basic data for the development of women's health care program as nursing intervention. The research tools used were a Soon-Young Park's stress questionnaire (4 points scale) and a self diagnostic MENSI scale (3 points scale) developed by a research team of Ill-Yang Pharmacy Co. This research was conducted in Korea in Muan-Gun. Chonnam province, from 22th November to 20th December 1999. The research used a survey design. Seven hundred eleven healthy middle-aged women, aged 40 to 64, and were a convenience sample by stratified ratio using the matching fixed residential and aging blocks. The data were analyzed by GLM. Pearson correlation coefficient and Scheffe test using SAS/ PC+. The results were summarized as follows : 1. The percentage of psychological stress with the following items was: fatigue and enervation, 70.0%; nervous, 61.8%; weakness, 58.5%; The percentage of physical stress with the following items were ; fatigue of eye. 82.3%; backache, 78.0%; headache, 73.8%. 2. The level of psychological stress was 40% of below average level (0-5 points), 31.7 of average level (6-12points), 20.8% of precaution level (13-19 points), and 7.5% of warning level (over 20points). The level of physical stress were 20.1% of below average level (0-5 points), 34.8 of average level (6-12 points), 29.4 of precaution level (13-19 points), and 15.7% of warning level (over 20 points). There were higher physical stress level than psychological stress level of the subjects. 3. The percentage of climacteric symptoms with the following items were : numbness, 75.3%; forgetfulness, 71.0%; pain of joints, 71.0%. The level of climacteric symptoms were 61.8% of mild level 1(10-15 points), 33.0% of moderate level (16-30 points), 5.2% of severe level (over 31 points). 4. There were high positive correlations significantly between the climacteric symptoms and the psychological stress (r=.564. P<0.000), and between the climacteric symptoms and the physical stress of the subjects(r=.678, P<0.000). 5. There were significant differences in the climacteric symptoms of the subjects among below average level, average level, precaution level, and warning level of the psychological stress (F=74.108. P<0.000. Scheffe test). 6. There were significant differences in the climacteric symptoms of the subjects among below average level, average level and precaution level, and warning level of the physical stress ((F=128.181, P<0.000, Scheffe test). In summary, climacteric symptoms complained by middle-aged women are high positive correlated to the level of the stress. Also climacteric symptoms were affected by stress.

• Journal of Korean Academy of Nursing
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• v.29 no.4
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• pp.743-754
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• 1999

The purpose of this descriptive study was to identify the homecare needs of patients with cancer and to provide a basis of interventions. One hundred and two patients at one general hospital in Gyeongnam responded to a questionnaire developed on the basis of care needs perceived by nurses caring for hospitalized patients with cancer. The questionnaire was a Likert type 5 point scale with 56 items on five need categories ; 1) informational 2) physical care : 3) emotional care 4) socioeconomic care and 5) special care needs. Internal consistency of this questionnaire was Cronbach's $\alpha$＝.9101 for total items. The data was collected from March 1st to May 31th, 1998, by two graduate nurses. In the data analysis, mean & standard deviation were calculated to identify the degree of care need of each item, and the t-test & ANOVA were done to determine the effects of patients' demographic background on their care needs. The findings are summarized as follows ; 1) The mean score of total of need items was 3.048. Of the four need categories the highest score was informational at 3.4, followed by emotional care, 3.063, physical care, 2.623, and socioeconomic care, 2.599. 2) In the informational need category there were four subcategories with 19 items. Medication and pain control had the highest score, 3.755 ; second was diet and exercise, 3.613 ; third was disease and treatment process, 3.337 ; and last was personal hygiene and infection prevention at 2.687. 3) In the physical care need category there was nine items, IV infusion for nutrition and management of treatment complication was above 3.2 points and the remaining items were in the 2.847-2.070 score ranges. 4) In the emotional care need category there were seven items. The highest need was in support for relationships with health personnel, 3.673. The need for support of religions beliefs and support for having a religion were low at about 2 points. 5) In the socioeconomic care need category there were six items. Support for medical insurance expansion and financial support were above 3 points. Legal support and support for caring of children were low in the care needs. 6) In the special care need category the there were 15 items. Informational need about immunization and informational need about effects of disease on growth and development were high, above 4.1 points. Need for decubitus care and prevention, sitz bath and incontinence care were low, below 2 points. 7) There were significant differences in degree of care need according to admission rate, education level, marital status, religion and caregiver's religion. In conclusion, homecare needs perceived by hospitalized patient's with cancer was moderate, but informational need was higher than direct care need, leading to the conclusion that the provision of sufficient information to patients with cancer at discharge is needed. Nursing interventions should be developed considering the patient's background.

• Quality Improvement in Health Care
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• v.28 no.1
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• pp.45-54
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• 2022

Purpose: The study aims to identify the theme list and priority criteria of patient safety theme reports in South Korea. Methods: The survey was conducted twice, and the importance of each criterion and theme was measured on a nine-point scale using the Delphi technique by a panel of 19 patient safety experts. The criteria included severity, universality, preventability, and organizational-social impact. Descriptive statistics such as frequency, percentage, mean, standard deviation, median, and interval quartile range were used to analyze the data. Results: The parameters were assigned a weighted average of 35% for severity, 20% for universality, 30% for preventability, and 15% for organizational-social impact, respectively. The final top three rankings were surgery safety, blood transfusion safety, and medication safety. In addition to expert opinion, for the theme that is selected based on the priority ranking, one to five sub-topics can be derived from the theme based on the priority ranking, societal demands, or the yearly priority list of patient safety incidents. Conclusion: It is recommended that the official patient safety center distribute the report in the form of a summary that can be utilized nationwide at medical institutions, government institutions, and other places. Updates, as well as accumulated theme reports, will serve as the baseline data for the proposal of the system and for the policy designed to implement and improve institutions' safety practices as a standard of domestic patient safety practice guidelines.

• The Journal of the Korea Contents Association
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• v.22 no.3
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• pp.354-360
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• 2022

Metabolic disease is a disease with a prevalence of 26% in Korean, and has three of the five states of abdominal obesity, hypertension, hunger glycemic disorder, high neutral fat, and low HDL cholesterol at the same time. This paper links the consumer panel data of the Rural Development Agency(RDA) and the medical care data of the National Health Insurance Service(NHIS) to generate a classification model that can be divided into a metabolic disease group and a control group through food consumption characteristics, and attempts to compare the differences. Many existing domestic and foreign studies related to metabolic diseases and food consumption characteristics are disease correlation studies of specific food groups and specific ingredients, and this paper is logistic considering all food groups included in the general diet. We created a classification model using regression, a decision tree-based classification model, and a classification model using XGBoost. Of the three models, the high-precision model is the XGBoost classification model, but the accuracy was not high at less than 0.7. As a future study, it is necessary to extend the observation period for food consumption in the patient group to more than 5 years and to study the metabolic disease classification model after converting the food consumed into nutritional characteristics.

• Journal of Korean Foot and Ankle Society
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• v.23 no.3
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• pp.121-130
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• 2019

Purpose: To investigate the spatial distribution of diabetes-related lower limb amputations and analyze the relationship between the spatial distribution of diabetes-related lower limb amputations and regional factors. Materials and Methods: This study was performed based on the data from the Korean Health Insurance Review and Assessment Service, in 2016. The unit of analysis was the administrative districts of city·gun·gu. The dependent variable was the age- and sex-adjusted incidence of diabetes-related lower limb amputations and the regional variables were selected to represent two aspects: socioeconomic factors, and health and medical factors. Along with traditional ordinary least square (OLS) regression analysis, geographically weighted regression (GWR) was applied for spatial analysis. Results: The age- and sex-adjusted incidence of diabetes-related lower limb amputation varied according to region. OLS regression showed that the incidence of diabetes-related lower limb amputation had significant relationships with the health and medical factors (number of healthcare institution and doctors per 100,000 population). In GWR, the effects of regional factors were not consistent. Conclusion: The spatial distribution of the incidence of diabetes-related lower limb amputations and the effects of regional factors varied according to the regions. The regional characteristics should be considered when establishing health policy related to diabetic foot care.

• The Journal of the Korea Contents Association
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• v.15 no.3
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• pp.303-317
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• 2015

Although the public health centers have been initiating health education recently, it is not extending as expected and the participation of the program is low. The reason is that the office workers have few opportunities to receive health education since there are few public health centers in relation to the population. Much time is required for travel and attendance of the classes. In order to solve this problem, the aim is to increase participation in health education, improve the overall public health awareness, expand the number of health education locations to reduce medical expenses, vitalize the lifelong educational health programs, and improve the national health insurance. In order to research about the health education expansion plan for public health improvement, a study focused on men and women above age 20 who need health education. The research sample was selected through random sampling that targeted people who participated in the health programs or the health education. The period of this survey was from September 1st to September 30th, 2014. A total of 509 participants completed the survey data for the actual analysis to propose the health education expansion plan for the public health improvement.