• Journal of Preventive Medicine and Public Health
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• v.40 no.6
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• pp.461-466
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• 2007

Objectives : The purpose of this study was to examine the determinants of sterilization in South Korea. Methods : This study was based on the data from the Korea National Fertility Survey carried out in the year 2000 by the Korea Institute of Health and Social Affairs. The subjects of the analysis were 4,604 women and their husbands who were in their first marriage, in the age group of 15-49 years. The data were analyzed by multiple logistic regression analysis. Results : Consistent with the findings of previous studies, the woman#s age and the number of total children increased the likelihood of sterilization. In addition, the year of marriage had a strong positive association with sterilization. Interestingly, the number of surviving sons tended to increase the likelihood of sterilization, whereas the woman#s education level and age at the time of marriage showed a negative association with sterilization. Religion, place of residence, son preference, and the husband#s education level, age and type of occupation were not significant determinants of sterilization. Conclusions : The sex of previous children and lower level of education are distinct determinants of sterilization among women in South Korea. More studies are needed in order to determine the associations between sterilization rate and decreased fertility.

• Journal of Preventive Medicine and Public Health
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• v.53 no.5
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• pp.307-310
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• 2020

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has placed unprecedented pressure on healthcare systems, even in advanced economies. While the number of cases of SARS-CoV-2 in Africa compared to other continents has so far been low, there are concerns about under-reporting, inadequate diagnostic tools, and insufficient treatment facilities. Moreover, proactiveness on the part of African governments has been under scrutiny. For instance, issues have emerged regarding the responsiveness of African countries in closing international borders to limit trans-continental transmission of the virus. Overdependence on imported products and outsourced services could have contributed to African governments' hesitation to shut down international air and seaports. In this era of emerging and re-emerging pathogens, we recommend that African nations should consider self-sufficiency in the health sector as an urgent priority, as this will not be the last outbreak to occur. In addition to the Regional Disease Surveillance Systems Enhancement fund (US$600 million) provided by the World Bank for strengthening health systems and disease surveillance, each country should further establish an epidemic emergency fund for epidemic preparedness and response. We also recommend that epidemic surveillance units should create a secure database of previous and ongoing pandemics in terms of aetiology, spread, and treatment, as well as financial management records. Strategic collection and analysis of data should also be a central focus of these units to facilitate studies of disease trends and to estimate the scale of requirements in preparation and response to any future pandemic or epidemic.

• Journal of the Korean Dietetic Association
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• v.17 no.3
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• pp.229-242
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• 2011

The purpose of this study was to investigate the status of the safety system and safety education in institutional foodservices in the Changwon and Masan areas. The survey was conducted from February 1 to March 31, 2009 via questionnaires that were sent to 300 dietitians, and 142 dietitians responded. It was determined that most of the safety managers were 'dietitians (87.1%)', whereas facilities/equipment managers consisted of 'dietitians (45.7%)', 'department of facilities management in the organization (36.4%)' and 'outsourced company of facilities management (17.9%)'. Out of the 11 safety practices, seven safety practices showed less than 50% of total implementation ratio, which meant that the safety systems were not functioning properly. Except for 'non-skid shoes (85.9%)', other safety equipment was seldom used. The survey respondents recognized that safety education was very necessary (4.47 points); however, they responded so-so (3.46 points) to the question of whether or not the actual frequency and time spent on safety education were enough. The average time spent on safety education was 28 minutes 11 seconds. Regarding the difficulties in performing safety education, 'not many safety education materials and media (3.44 points)', 'not many varieties in the subjects and contents for safety education (3.40 points)', and 'not much organizational support on safety education (3.33 points)' showed higher scores than 'lack of education time due to workload (3.20 points)'. The following were cited as education materials that should be developed as it is currently difficult to obtain relevant information and data: 'root causes of musculoskeletal injury and preventive measures (15.8%)', 'healthcare and disease preventive exercises for employees who do simple and repetitive works (14.9%)', and 'instruction on safe handling of chemicals (12.7%)'

• Korea Journal of Hospital Management
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• v.21 no.2
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• pp.37-49
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• 2016

The purpose of this study is to investigate the level of competition between Public Health Centers (PHCs) and private clinics (PCs) by examining the number of patients that used PHCs vs. PCs, estimating the total amount of revenue generated from outpatient services at both PHCs and PCs, thereby analyzing the financial impacts on PCs derived from the PHCs. We utilized 2011 National Inpatient Sample data (NIS). Using the 20 table containing general information on each individual claims, we integrate it with the 40 table which contains all the diagnostic codes for each claim. Then, we disaggregate the bundled claims into the original individual claims. Overall, 3.1% of outpatient visits are made at PHCs while the rest was made at the PCs (96.9%). Among the total claim costs of 6.34 billion USD (as of 2011), PHCs occupy 2.0% (124 million USD), and 98.0% are contributed to PCs (6.21 billion USD). The estimated economic losses of PCs due to PHCs are summarized as follow; the maximum potential loss is estimated at 198 million USD in total and 7,099 USD per clinic when we include all patient types; the minimum loss is estimated at 71 million USD in total and 2,540 USD per clinic where Medical Aid recipients and the elderly (aged 65 and over) are excluded. Our results confirm the potential economic effect on PCs due to PHCs providing outpatient services. PCs and PHCs are the most important players providing primary care in Korea. Unnecessary competition between PCs and PHCs is not desirable. Health authorities should carefully examine the healthcare services currently provided by PHCs and their impacts on PCs.

• Tuberculosis and Respiratory Diseases
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• v.67 no.5
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• pp.409-412
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• 2009

Background: Several large outbreaks have demonstrated the threat of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in close-contact environments, such as occurs during training and quartering of military recruits training. In South Korea, which is a hospital or healthcare-associated MRSA prevalent area, military service is compulsory for all healthy young men. We surveyed and determined the extent of CA-MRSA colonization in the upper respiratory tracts of Korean military recruits. Methods: The Korean military recruits who were enrolled in a military training facility from November 2004 to March 2005 were eligible for this study. Sputum or nasopharyngeal swap was obtained from randomly selected subjects who displayed upper respiratory tract symptoms. Results: Of the 181 participants, 32 participants (17.7%) were colonized with S. aureus, and 12 participants (6.6%) were colonized with MRSA. Among the cases that were colonized with S. aureus, 37.5% (12/32) were colonized with MRSA. Antimicrobial susceptibility testing showed resistant patterns that were suggestive of the CA-MRSA strains for all of the MRSA isolates. Conclusion: This study of Korean military recruits found a great deal of showed MRSA colonization in them, and the antimicrobial resistant profile that was suggestive of a CA-MRSA strain. Further efforts to prevent the spread of MRSA infections and careful monitoring for CA-MRSA outbreaks are warranted, especially in a high risk group such as military recruits.

• Journal of Society of Preventive Korean Medicine
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• v.16 no.3
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• pp.15-26
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• 2012

Objective : Only a few studies have investigated the life expectance and health related quality of life (HRQOL) about stroke patients. The purpose of this study is to analyze the life expectancy, preference based quality of life(QOL) and quality adjusted life years(QALYs) of stroke patients. Methods : We used data of 10,533 adults from 4th Korean national health and nutritional examination survey 2009 for evaluating HRQOL of stroke patients. We also analyzed the life expectancy for stroke patients using life table from national public health data. Finally we calculated the QALYs with and without stroke conditions and assumed the difference of QALYs. Results : The mean age of stroke patients was assumed to be 65. Lower income and less educated groups were prone to be exposed to the stroke conditions. Common comorbidities of stroke patients were ischemic heart attack, hypertension, diabetes and hyperlipidemia. The proportions of participants who reported problems in each of the five EQ-5D dimensions increased significantly at chronic stroke group. Participants with chronic stroke conditions had an almost 6-fold higher risk of impaired health utility(the lowest quartile of EQ-5D utility score) compared with non stroke participants, after adjustment of age, gender, income, education, comorbidity variables. The differences of life expectancy and QALYs between non-stroke and stroke group from the age of 65 till death were assumed to be 0.767 year and 3.103 QALYs. Conclusions : Although the authors analyzed the affecting factors of QOL and assumed the differences of life expectance and QALYs about stroke patients using domestic national data and statistic references, well designed cohort studies should be needed to prove the causal effects of affecting factors and to assume more correct QALY differences.

• Journal of Preventive Medicine and Public Health
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• v.43 no.3
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• pp.193-204
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• 2010

Objectives: The objective of this study was to analyze the causal relationship between smoking and depression using longitudinal data. Methods: Two waves of the Korea Welfare Panel collected in 2006 and 2007 were used. The sample consisted of 14 426 in 2006 and 13 052 in 2007 who were aged 20 and older. Smoking was measured by smoking amount (none/$\geq$ two packs). Depression was defined when the summated CESD (center for epidemiological studies depression)-11 score was greater than or equal to 16. The causal relationship between smoking and depression was tested using logistic regression. In order to test the causal effect of smoking on depression, depression at year 2 was regressed on smoking status at year 1 only using the sample without depression at year 1. Likewise, smoking status at year 2 was regressed on depression at year 1 only using those who were not smoking at year 1 in order to test the causal effect of depression on smoking. The statistical package used was Stata 10.0. Sampling weights were applied to obtain the population estimation. Results: The logistic regression testing for the causal relationship between smoking and depression showed that smoking at year 1 was significantly related to depression at year 2. Smoking amounts associated with depression were different among age groups. On the other hand, the results from the logistic regression testing for the opposite direction of the relationship between smoking and depression found no significant association regardless of age group. Conclusions: The study results showed some evidence that smoking caused depression but not the other way around.

• Health Policy and Management
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• v.28 no.1
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• pp.48-52
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• 2018

Background: The current study evaluated the hospital utilization and characteristics of patients who received health care services for acute cerebral infarction outside their own residential area. Methods: Using the 2014 national patient survey data, information on 2,982 patients diagnosed with acute cerebral infarction through emergency department were retrieved for the analyses. Multiple logistic regression was performed to investigate the characteristics associated with using hospitals outside residential area among patients diagnosed with acute cerebral infarction. Results: Fifteen point nine percent of patients admitted for acute cerebral infarction utilized hospitals outside their residential area. Patients residing in a province were 7.7 times more likely to utilize hospitals located outside their residential areas compared to those living in Seoul metropolitan city. Patients living in Gangwon and Jeolla were 0.26 times and 0.48 times more likely to go to hospitals in different geographical areas. Also, patients within the age group of 80 years and over were 0.65 times less likely to be admitted to hospitals outside their residential area compared to those in their 40s-50s. Conclusion: The use of hospitals outside patient's residential area is shown to be substantial, given that the acute cerebral infarction requires immediate recognition and treatment. The findings on the geographical differences in the hospital utilization suggest further investigation.

• Journal of Preventive Medicine and Public Health
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• v.52 no.6
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• pp.416-426
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• 2019

Objectives: In recent years, transboundary air pollution from mainland East Asia has led to growing concerns about air pollution in Japan. Air pollution is reportedly associated with the exacerbation of respiratory diseases. In this study, we assessed the effects of air pollution on respiratory symptoms and the health status of participants with and without chronic respiratory diseases. Methods: Participants (n=2753) with and without chronic respiratory diseases who visited healthcare facilities in Japan during February from 2010 to 2015 filled out a self-report questionnaire regarding their symptoms and perceived health status. Participants were followed up during April-May and June-July. Results: Oxidant concentrations were associated with respiratory symptoms, overall health, and quality of life (QoL). Suspended particulate matter (SPM) and particulate matter <$2.5{\mu}m$ levels were associated with physical fitness; SPM was also associated with QoL. Recent experience of an Asian sand dust event had a significant effect on allergic symptoms, change in health, and QoL. Conclusions: Respiratory symptoms were more strongly affected by oxidants than by other pollutants. Significant associations of air pollutants were found with a comprehensive range of items related to perceived health status, including overall health and QoL. Although the effects of air pollutants on respiratory symptoms and health status were more apparent among patients with respiratory diseases, the adverse effects of air pollutants were significant even among participants without such conditions.

• Journal of Preventive Medicine and Public Health
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• v.54 no.3
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• pp.182-189
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• 2021

Objectives: This study investigated the relationship between sleep quality during pregnancy and preterm birth. Methods: This longitudinal study was conducted between August 2018 and May 2019. The participants were 150 pregnant women who had been referred to 7 healthcare centers in the city of Qazvin, Iran and met the inclusion criteria. The Petersburg Sleep Quality Index, the Epworth Sleepiness Scale, and 2 questions about daytime sleep status and a demographic questionnaire were administered at 14-18 weeks and 28-32 weeks of gestation. Data were analyzed using the Mann-Whitney test, the Fisher exact test, and univariate and multivariable logistic regression. Results: In the present study, poor sleep quality affected 84.7% of the participants at 14-18 weeks and 93.3% at 28-32 weeks of gestation. The final model for preterm birth prediction incorporated age and the Petersburg Sleep Quality Index score in the second and third trimesters. Preterm birth increased by 14% with each unit increase in age. With each unit increase in the Petersburg Sleep Quality Index score in the second and third trimesters, preterm birth increased by 42% and 28%, respectively, but the p-values of these factors were not significant. Conclusions: Although a significant percentage of pregnant women had poor sleep quality, no significant relationship was found between sleep quality during pregnancy and preterm birth.