• Journal of Preventive Medicine and Public Health
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• 제47권6호
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• pp.327-335
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• 2014

Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator's note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.

• 근관절건강학회지
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• 제19권3호
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• pp.373-382
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• 2012

Purpose: The purpose of the study was to compare levels of health-related quality of life (HRQOL) between fallers and non-fallers among community-dwelling elderly people. Methods: A cross-sectional comparative study was conducted with the secondary analysis of 2,067 elderly people registered in S-Gu Visiting Health Care Program in Seoul, South Korea. Participants were 206 fallers and 206 non-fallers who were age- and sex-matched with fallers. HRQOL was measured by SF-8 including physical component summary (physical HRQOL) and mental component summary (mental HRQOL). Results: There were more people in the faller group having more than or equal to three chronic diseases (p<.001), living in multiplex houses (p=.004), and being dependent by the activities of daily living (ADL) (p=.001) and instrumental ADL (IADL) levels (p<.001) than those in the non-faller group. Fallers had higher levels of depression than non-fallers (p<.001). Moreover, fallers had significantly lower levels of both physical HRQOL (p<.001) and mental HRQOL (p=.001), after adjusting for number of chronic diseases, ADL, IADL, depression, healthcare insurance, and living environment. Conclusion: Among the community-dwelling elderly people, falllers had lower levels of HRQOL than non-fallers, and such a difference remained even after the adjustment for covariates. Factors that underlie the different susceptibility to HRQOL need to be explored.

• 한국콘텐츠학회논문지
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• 제15권8호
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• pp.313-325
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• 2015

본 연구는 산재경험 고령자의 경제적 노후준비에 영향을 미치는 요인을 앤더슨모형을 적용하여 분석하고, 과거 산재당시 종사상지위에 따라 정규직 근로자와 비정규직 근로자로 구분해 경제적 노후준비의 영향요인을 분석하고자 하였다. 이를 위해 산재보험패널조사(PSWCI)의 1차년도 자료를 이용하여 로지스틱 회귀분석을 실시하였다. 연구결과, 선행요인에서는 학력이 높고 정규직인 근로자가 비정규직인 여성 근로자에 비해 경제적 노후준비 가능성이 높게 나타났다. 자원요인에서는 정규직, 비정규직 근로자 모두 근로소득이 많을수록 노후준비 가능성이 높게 나타났으나, 국민연금 가입여부는 경제적 노후준비에 도움을 주지못하였다. 비정규직 근로자에게는 건강보험 가입이 경제적 노후준비에 영향을 미치고 있었다. 욕구요인에서는 정규직과 비정규직 근로자 모두 산업재해로 인한 통증이 일상 및 삶을 방해하는 정도가 높을수록 경제적 노후준비에 취약함을 확인하였다. 이러한 연구결과를 토대로 하여 정책적 함의를 제시하였다.

• 한국산학기술학회논문지
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• 제19권1호
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• pp.497-505
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• 2018

이 연구의 목적은 중증질환자들을 대상으로 민간의료보험 가입자와 미가입자간의 특성을 파악하고, 가입 요인을 분석하기 위함이다. 연구도구는 2015년도 국민건강영양조사 자료를 이용하였으며, SPSS ver 23.0을 사용하였고, 연구 대상자는 19세 이상 중증질환자(암, 심장질환, 뇌혈관질환) 417명을 선정하였다. 분석방법은 민간의료보험 가입 현황과 차이를 파악하기 위해 교차분석을 실시하였고, 민간의료보험 가입에 미치는 요인을 분석하기 위해 이항 로지스틱 회귀분석을 실시하였다. 분석 결과 사회 인구학적 특성에서는 성별, 거주지, 혼인상태와 관계없이 나이가 젊을수록 높았다. 그리고, 사회 경제적 상태에서는 교육수준과 관계없이 가구소득이 높을수록, 의료급여대상자에 비하여 건강보험대상자의 가입률이 높았다. 건강행태에서는 주관적 건강 인식 및 걷기 실천과 무관하게 활동제한이 있는 집단의 민간의료보험 가입률이 낮았으며, 설명력은 51.7%이었다. 그러므로, 중증질환자 중 민간의료보험에 가입하지 못한 집단을 선별하여 생활환경 개선 및 지방자치단체의 지원을 촉구해야 할 것이다. 또한, 사회적 취약계층 및 건강행태에 제한 있는 집단을 대상으로 중증질환 예방을 위한 정부의 보건교육 또는 프로그램 제공 등 다양한 보건정책을 고려해야 할 것이다.

• 한국직업건강간호학회지
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• 제16권2호
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• pp.168-176
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• 2007

Purpose: This study was to investigate the factors influencing on the quality of life (QOL) among herniation of nucleus pulposus (HNP) patients caused by occupational accidents. Method: 203 patients of HNP were recruited. 106 patients were occupationally injured workers who benefited from workmen's compensation scheme (PWCS group), and 43 patients were non-occupationally injured workers benefiting from national health insurance (PNHI group). Questions of QOL items were used by Korean version of SBQOL (SmithKlein Beecham's Qality of Life). Result: The quality of life of PWCS group measured by SBQOL was significantly lower than that of PNHI group. In PWCS group, SBQOL was significantly lower in patients with 40s of their age, 5 years or longer of treatment duration, no expectation of return to work, no expectation of recovering subject's health, and with loss of employment than rest of the patients in each category. Expectations of recovering subject's health showed to be affect factors on QOL both the PWCS and PNHI groups. Conclusion: It suggested that betterment of expectation of recovering patient's health and an administrative system for returning to work of the occupationally injured HNP patients during treatment be necessary for improvement of their quality of life.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.269-273
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• 2016

Presently, the world population of the elderly is growing. By improving health hygiene and welfare indicators, mortality and birth rates decrease and life expectancy increases, making the present century the century of elderly. Aging is one of the main risk factors for development of cancer, which itself is the second cause of death in old people. This study was conducted to assess the prevalence of cancer in the elderly covered by the Islamic Republic of Iran Broadcasting (IRIB) insurance program and to obtain suitable programs for cancer screening and early detection, increase patient survival, improve elderly care and to reclaim the cost of treatment in comparison to the national and international statistics. This is a cross-sectional study conducted on all elderly patients diagnosed with malignancy based on their pathology reports. In this study, of the total 75,500 patients covered by IRIB insurance, 17.2% belonged to the elderly group, males accounting for 53.3%. The most common cancers in old men were prostatic cancer (61.3%), colon cancer (10.3%) cancer of the hematologic system, bladder cancer (9.6%), lung cancer (9.1%), thyroid cancer (3.9%) and brain tumors (1.3%). In the elderly women, the most common cancers were breast cancer (80.1%), colon cancer (5.1%), thyroid cancers (4.4%), bladder and hematologic system malignancies (3.6), lung cancer (2.9%) and brain tumors (0.7%). In addition, the prevalence of cancer was almost the same as national and international statistics. With the exception of non-melanoma skin cancer no difference was shown in prevalence of cancer between IRIB elderly patients and the other groups of cancer patients in Iran.

• 보건행정학회지
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• 제23권4호
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• pp.358-368
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• 2013

Background: There are some data to support the theory of a protective effect of parenthood against suicide, as proposed by Durkheim in 1897. We conducted this study to examine the relationship between children characteristics and suicidal ideation among Korean married women. Methods: The data were obtained from the Korean National Health and Nutrition Examination Surveys IV, conducted in 2007-2009, respectively (3,202 married women aged 20-49 years). The children characteristics are the age of the youngest child and the number of children living with subject. Data were analyzed by using logistic regression with SAS 9.2. Results: The risk for suicidal ideation was higher among married women having a young child (aged <7 years). It had strong effect on suicidal ideation in non-employee subjects. The odds ratio for suicidal ideation of women having a youngest child aged 2-3 years compared with reference groups was 1.673 with statistical significance. But the association of suicidal ideation with number of children shows insignificant. Conslusion: The findings suggest a different result with the theory, the protective effect of being a parent of young child on suicide risk for women, first suggested by Durkheim and supported by previous studies and the need for further prospective investigation that lead to policies according children characteristics aimed at improving married women's life.

• Communications for Statistical Applications and Methods
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• 제29권3호
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• pp.373-391
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• 2022

The distribution of observations in most econometric studies with spatial heterogeneity is skewed. Usually, a single transformation of the data is used to approximate normality and to model the transformed data with a normal assumption. This assumption is however not always appropriate due to the fact that panel data often exhibit non-normal characteristics. In this work, the normality assumption is relaxed in spatial mixed models, allowing for spatial heterogeneity. An inference procedure based on Bayesian mixed modeling is carried out with a multivariate skew-elliptical distribution, which includes the skew-t, skew-normal, student-t, and normal distributions as special cases. The methodology is illustrated through a simulation study and according to the empirical literature, we fit our models to non-life insurance consumption observed between 1998 and 2002 across a spatial panel of 103 Italian provinces in order to determine its determinants. Analyzing the posterior distribution of some parameters and comparing various model comparison criteria indicate the proposed model to be superior to conventional ones.

• The Korean Journal of Pain
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• 제11권2호
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• pp.273-282
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• 1998

Background: Twelve years have passed since the Korean Pain Society was organized. Nowadays, there are so many problems to be solved in pain clinics including health insurance, pain education and public information etc. in Korea. The present study was designed to evaluate the current status of pain clinics in Korea. Methods: Eight hundred twenty regular members of Korean Pain Society were surveyed by questionnaire in October 1997. We compared the general characteristics, contents of diseases in pain clinic, treatment Methods, patients satisfaction, pain educations, problems in pain treatments, requests to Korean Pain Society among the 138 respondents. Results: Thirty seven percents of the respondents worked at university hospitals, 39% at non-university hospitals and 24% at private pain clinics. The most common diseases treated in pain clinics was low back pain(32% in university and non-university hospital and 28% in private pain clinic respectively). However, cancer pain was 10% in university and non-university hospital and 0.7% in private pain clinic. Epidural block was the most frequently used procedure in chronic pain treatments. And 74.6% of the respondents were studied and learned in Korea and Japan. And then, current problems in pain management and requests to Korean Pain Society were medical insurance problems, pain education and public information of pain clinics. Conclusions: These results suggest that the Korean Pain Society should make an effort to solve these current problems in order to activate pain medicine and increase the quality of life for those suffering from pain.

• 의료법학
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• 제15권2호
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• pp.345-366
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• 2014

Because the health care or medical sector has such characteristics as publicity, professionality, and exclusivity, it cannot be left to the free market system. As a consequence, the state has restricted the establishment of medical institutions in order to protect the life and health of people. Also, the medical law has regulated to permit the establishment of medical institutions by only medical personnel and a few corporate bodies and to ban the establishment of medical institutions under disguised ownership as well as double opening of medical institutions by medical personnel. Nevertheless, there are still many cases that non-medical personnel have dominantly established medical institutions under disguised ownership of other medical personnel or nonprofit corporation. Because they are willing to recover their investment costs as soon as possible, these illegally established medical institutions are likely to make patients undergo unnecessary tests or to perform the excessive treatments and, as a result, are likely to cause infringement on the health and lives of the people. In addition, even if the misconduct is uncovered, the rate at which the costs already paid is very low and, as a result, the damages are straightly connected to the people's loss. On the other hand, there are also increasing number of cases that medical personnel or nonprofit corporations are establishing medical institutions against the medical law regulations. The examples of this illegality are also the double opening of medical institutions and the establishment of medical institutions under disguised ownership by medical personnel or nonprofit corporations. And the damages in these cases may not differ from those in the above cases. In this study, regarding medical law regulations restricting opening a medical institution, I will review the intent of those regulations, the type of violations and criminal punishments, and the possibility of recovery from unlawful profit by the National Health Insurance Act. And then, I would like to find a way for rational improvement of each.