• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.107-116
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• 1994

The United States adopted DRG based prospective payment system (PPS) in order to control the inflation of health care costs. No study used statistical test while many studies reported the cost containing effect of the PPS. To study impacts of the PPS on the Medicare expenditure, this study set the following three hypotheses (1) The PPS decelerated the increase in the hospital expenditure (Part A), (2) the PPS accelerated the increase in the expenditure of outpatients and physicians (Part B), (3) the increase in total expenditure was decelerated inspite of the spill over (substitution) effect because saving in the Part A expenditure were greater than losses in the Part B expenditure. The dependent variables are per capita hospital expenditure, per capita Part B expenditure, and per capita total expenditure for the Medicare beneficiaries. An intervention analysis, which added intervention effect to the time series variation on the Box-Jenkins model, was used. The observations included 120 months from 1978 to 1987. The results are as follows : (1) The annual increase in the per capita Part A expenditure was $5.11 after the implementation of DRG where as that before the PPS had been $11.1. The effect of the reduction ($5.99) was statistically significient (t=-3.9). (2) The spill over (substitution) effect existed because the annual increase in the per capita Part B expenditure was accelerated by $1.73 (t=1.91) after the implementation of the PPS. (3) The increase in the total Medicare expenditure per capita was reduced by $4.26 (t=-2.19) because the spill over effect was less than cost savings in the Part A expenditure.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5345-5349
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• 2013

Background: This study developed and measured the effects of a cervical cancer prevention program for married women immigrants. Materials and Methods: A nonequivalent control group pre-test/post-test design was used with a group of married women immigrants registered at the multi-cultural center in the city of "J." Data on for 30 participants in the intervention group and 27 participants in the control group (N=57) were used for analysis. The intervention group attended a 4-session cervical cancer prevention program. Results: The knowledge of the intervention and control groups about cervical cancer post-intervention was significantly different (F=12.55, p<0.001). The perceived susceptibility score before and after the experiment, for the intervention group, and 29.4 and 28 for the control group, was significantly different (t=2.063, p=0.043). After the program, cancer prevention behavior was significantly different in the intervention group (t=2.646, p=0.010). Conclusions: The results obtained in this study indicate that the cervical cancer preventive program was effective in increasing cervical cancer knowledge, perceived susceptibility, and cancer prevention behavior.

• Journal of Preventive Medicine and Public Health
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• v.51 no.6
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• pp.320-325
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• 2018

Objectives: This pilot study tested the effectiveness of a brief alcohol-related intervention delivered by the social media app WeChat to teach about ethanol-induced facial flushing and increase the willingness of students who see another student flushing to suggest that he or she should reduce or stop drinking. In the context of Chinese drinking culture, it is sometimes socially difficult to refuse a drink, even when experiencing physical discomfort, such as flushing. Methods: Classrooms of students in a medical university in China were randomly assigned to the intervention or control group. Students in the intervention group were invited to view 3 alcohol education lessons on WeChat during a 2-week period. A pretest and posttest before and after the 2-week period assessed changes in students' willingness to intervene if they saw someone flush while drinking. Data were collected about students' alcohol use and their ratings of the lessons. Results: Mixed-design analysis of variance yielded a significant time-by-treatment interaction effect on the variable of willingness to suggest that a flushing person stop or slow down their drinking, and the change was significant between the intervention and control groups. One-way analysis of covariance yielded a significant treatment effect at the posttest, after controlling for the pretest score. Students rated the lessons above the midpoint of the scale for being informative, interesting, and useful. Conclusions: The pilot study showed that a brief alcohol-related intervention delivered by WeChat could produce a measurable positive change in the willingness of university students to suggest that a student who flushes should stop drinking. This pilot study also suggested improvements for future lessons and evaluation design.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.12
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• pp.5165-5172
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• 2016

Background: Stomach cancer is one of the five most common cancers in Iran. This study examined the effectiveness of a mobile telephone short-message service (SMS) based-education intervention using Health Belief Model (HBM) variables in improving dietary behavior in terms of stomach cancer prevention among a sample of Iranian female college students. Materials and Methods: In this quasi-experimental study, 124 female college students in the dormitories of Yazd University, Yazd, Iran were randomly selected and assigned to either the intervention (n=62) or the control group (n=62). Information (data) regarding HBM variables and dietary behavior related to stomach cancer prevention was collected by a self-administrated questionnaire. Forty eight messages were designed and sent to the participants' phones in the intervention group during the 48-day intervention period. Two groups were followed-up one month after the intervention delivered via SMS. Results: There were significant differences in HBM variables (except for the perceived severity) and the preventive dietary behaviors for stomach cancer in the intervention group compared to the comparison group following the education intervention delivered via SMS. Conclusions: SMS-delivered nutrition education intervention can be a practical strategy to improve dietary behavior related to stomach cancer prevention.

• Journal of Preventive Medicine and Public Health
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• v.28 no.2 s.50
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• pp.450-461
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• 1995

This paper tested by using Micro TSP, an empirical econometric analysis to approve officially a hypothesis of price elasticity of the demand for medical care services in Korean national medical insurance and the economic effect of health care delivery system with time-series datas of Medical Insurance Statistical Yearbook$(1981\sim1993)$. The results suggest that the Korean medical insurance system shows moral hazard due to the change of coinsurance and the economic effect according to intervention of the health care delivery system, but it is different by insurers regardless of the same structure of the medical insurance scheme.

• Journal of Preventive Medicine and Public Health
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• v.43 no.5
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• pp.445-450
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• 2010

Objectives: Emotional support and a stress management program should be simultaneously provided to clients as effective preventive services for healthy behavioral change. This study was conducted to review various relaxation and meditation intervention methods and their applicability for a preventive service program. Methods and results: The author of this paper tried to find various relaxation and meditation programs through a literature review and program searching and to introduce them. The 'Relaxation Response' and 'Mindfulness Based Stress Reduction (MBSR)' are the most the widely used meditative programs in mainstream medical systems. Abdominal breathing, Progressive Musclular Relaxation (PMR), Relaxative Imagery, Autogenic Training (AT) and Biofeedback are other well-known techniques for relaxation and stress management. I have developed and implemented some programs using these methods. Relaxation and meditation classes for cancer patients and a meditation based stress coping workshop are examples of this program. Conclusions: Relaxation and meditation seem to be good and effective methods for primary, secondary and tertiary preventive service programs. Program development and standardization and further study are needed for more and wider use of the mindbody approach in the preventive service area of medicine.

• Journal of Preventive Medicine and Public Health
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• v.56 no.5
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• pp.481-484
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• 2023

Epidemiological models, also known as host-agent-vector-environment models, are utilized in public health to gain insights into disease occurrence and to formulate intervention strategies. In this paper, we propose an epidemiological model that incorporates both conventional measures and tobacco endgame policies. Our model suggests that conventional measures focus on relationships among agent-vector-host-environment components, whereas endgame policies inherently aim to change or eliminate those components at a fundamental level. We also found that the vector (tobacco industry) and environment (physical and social surroundings) components were insufficiently researched or controlled by both conventional measures and tobacco endgame policies. The use of an epidemiological model for tobacco control and the tobacco endgame is recommended to identify areas that require greater effort and to develop effective intervention measures.

• Journal of Preventive Medicine and Public Health
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• v.55 no.6
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• pp.586-594
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• 2022

Objectives: This study investigated the effectiveness of the social marketing mix approach in increasing students' knowledge about smoking, promoting positive attitudes toward smoking cessation, and decreasing smoking behavior. Methods: This quantitative research study incorporated a quasi-experimental method with a pretest-posttest non-equivalent group design. Using the purposive sampling technique, 152 smoking students were selected as participants. They were divided into 2 equal groups, with 76 students in the control group and 76 in the intervention group. The data were collected using questionnaires and analyzed with the chi-square test, independent t-test, Wilcoxon signed-rank test, and Mann-Whitney U-test. Results: The social marketing mix intervention was effective in increasing the students' knowledge about smoking (p<0.001), improving their attitude toward smoking cessation (p<0.001), and reducing their smoking behavior (p=0.014). Conclusions: This approach should be implemented by local governments to reduce smoking behavior in the community, especially among teenagers, in addition to instituting a smoking ban and applying fines.

• International conference on construction engineering and project management
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• 2022.06a
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• pp.465-472
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• 2022

Manual material handling is the one of the leading causes for musculoskeletal disorders (MSDs) and lower back discomfort. According to a study, construction formworkers suffer greater rates of muscular injuries and related illness due to manual activities. However, there is still a paucity of information on MSD, preventive posture issues, and corresponding solutions for construction aluminum formworkers. As a result, MSD and disregard of worker health and safety continue to exist at construction sites. Although preventive measures and strategies have been studied in previous research, we believe it is imperative to shed light on this problem through this study. This study aims to 1) implement a simple and cost-effective elevated bench to reduce MSDs, and 2) determine the rapid upper limbs assessment (RULA) and Ovako working posture analyzing system (OWAS) action catagory of workers in different postures to assess their MSD conditions and obtain an optimal position and posture using the Jack human modeling software and simulation tool. The study findings reveal a considerable reduction in MSD discomfort and which posture is acceptable in post-intervention instances.Thus results provide inexpensive and simple ergonomic interventions with favorable RULA and OWAS ratings that can be applied at construction sites. This study demonstrates workstation ergonomic intervention cases that can aid in understanding the urgency of applying existing research strategies into practice.

• Journal of Preventive Medicine and Public Health
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• v.42 no.4
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• pp.267-273
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• 2009

Objectives : To compare the performance of three comorbidity measurements (Charlson comorbidity index, Elixhauser s comorbidity and comorbidity selection) with the effect of different comorbidity lookback periods when predicting in-hospital mortality for patients who underwent percutaneous coronary intervention. Methods : This was a retrospective study on patients aged 40 years and older who underwent percutaneous coronary intervention. To distinguish comorbidity from complications, the records of diagnosis were drawn from the National Health Insurance Database excluding diagnosis that admitted to the hospital. C-statistic values were used as measures for in comparing the predictability of comorbidity measures with lookback period, and a bootstrapping procedure with 1,000 replications was done to determine approximate 95% confidence interval. Results : Of the 61,815 patients included in this study, the mean age was 63.3 years (standard deviation: ${\pm}$10.2) and 64.8% of the population was male. Among them, 1,598 2.6%) had died in hospital. While the predictive ability of the Elixhauser's comorbidity and comorbidity selection was better than that of the Charlson comorbidity index, there was no significant difference among the three comorbidity measurements. Although the prevalence of comorbidity increased in 3 years of lookback periods, there was no significant improvement compared to 1 year of a lookback period. Conclusions : In a health outcome study for patients who underwent percutaneous coronary intervention using National Health Insurance Database, the Charlson comorbidity index was easy to apply without significant difference in predictability compared to the other methods. The one year of observation period was adequate to adjust the comorbidity. Further work to select adequate comorbidity measurements and lookback periods on other diseases and procedures are needed.