The number of deliveries by cesarean section has increased internationally. However, The cesarean section rate is different by country to country. It is because each country has different social and cultural background and. practices its unique delivery policies. Hence, it is very important to understand the uniqueness that one country faces related with the cesarean section. In Korea, there have been many researches on the clinical. maternal. hospital and community factors and so on. However, few studies have attempted to reveal the physician factors in Korea because it is difficult to approach hospital records. So, in this study, the physician factors that influence the increase of cesarean section rate in Korea was investigated, and preliminary research agenda for policy establishment to keep the cesarean section rate from excessive increase was provided. In this study, all 2744 cesarean section deliveries performed by 36 physicians at the hospital was considered. and detailed delivery records of 12 months selected randomly from January 1996 to August 1998 was reviewed retrospectively. Chi-square analysis is used to examine the homogeneity of distribution of maternal, fetal, and clinical factors. In addition, multiple regression analysis is used to examine the effect of physician characteristics on the cesarean section rate. Physician characteristics as independent variable and the cesarean section rate as dependent variable was put in this analysis. Follows are the results of this study. 1) Total cesarean section rate is 34.8%. primary cesarean section rate is 12.5 % and repeated cesarean section rate is 22.3 %. Among the indications for the primary cesarean section, 15.6 % is for breech presentation. 40.2 % is for dystocia. 7.6 % is for fetal distress. and 36.6 % is for others. 2) There is positive correlation between physician's age and the cesarean section rate (p<0.001). And statistically significant correlation is found between the physician's educational attainment and the cesarean section rate (p<0.001). A physician with Ph.D degree has lower cesarean section rate than a physician with B.A only and M.A. degree (p<0.001). However. physician's gender, location of graduated university. position at the hospital, and the religious belief were not shown statistically significant relations with the cesarean section rate. 3) Among all cesarean sections in this study, only 15.4 % is performed during weekend. While 18.2 % is performed on monday only. This suggests that physicians may not prefer weekend operation of cesarean section. In addition, 86.1 % among all cesarean section operations is performed from 6 a.m. to 6 p.m. So the cesarean section rate could be related with a day of the week and a time of the day. From this results. there is a possibility that the physicians' personal comfort may influence the cesarean section rate.
Kim, Changhwan;Kim, Younhee;Yang, Dong-Wook;Rhee, Chin Kook;Kim, Sung Kyoung;Hwang, Yong-Il;Park, Yong Bum;Lee, Young Mok;Jin, Seonglim;Park, Jinkyeong;Hahm, Cho-Rom;Park, Chang-Han;Park, So Yeon;Jung, Cheol Kweon;Kim, Yu-Il;Lee, Sang Haak;Yoon, Hyoung Kyu;Lee, Jin Hwa;Lim, Seong Yong;Yoo, Kwang Ha
Tuberculosis and Respiratory Diseases
/
v.82
no.1
/
pp.27-34
/
2019
Background: Understanding the burden of disease is important to establish cost-effective treatment strategies and to allocate healthcare resources appropriately. However, little reliable information is available regarding the overall economic burden imposed by chronic obstructive pulmonary disease (COPD) in Korea. Methods: This study is a multicenter observational research on the COPD burden in Korea. Total COPD costs were comprised of three categories: direct medical, direct non-medical, and indirect costs. For direct medical costs, institutional investigation was performed at 13 medical facilities mainly based on the claims data. For direct non-medical and indirect costs, site-based surveys were administered to the COPD patients during routine visits. Total costs were estimated using the COPD population defined in the recent report. Results: The estimated total costs were approximately 1,245 million US dollar (1,408 billion Korean won). Direct medical costs comprised approximately 20% of the total estimated costs. Of these, formal medical costs held more than 80%. As direct non-medical costs, nursing costs made up the largest percentage (39%) of the total estimated costs. Costs for COPD-related loss of productivity formed four fifths of indirect costs, and accounted for up to 33% of the total costs. Conclusion: This study shows for the first time the direct and indirect costs of COPD in Korea. The total costs were enormous, and the costs of nursing and lost productivity comprised approximately 70% of total costs. The results provide insight for an effective allocation of healthcare resources and to inform establishment of strategies to reduce national burden of COPD.
The Journal of the Convergence on Culture Technology
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v.8
no.6
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pp.505-514
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2022
The Purpose of this study was to identify the influencing factors of oral health state and oral health-related quality of life in the elderly with hypertension. Data was collected from 108 elderly with hypertension registered at public health centers in K city, from January-February, 2020. The collected data was analyzed by using chi-square test, t-test, Pearson's correlation coefficient, stepwise regression of the SPSS 22.0 program. The positive factors influencing the oral health-related quality of life are subjective health status(β=.351, p=.002), BMI(β=.271, p=.024), age(β=-.260, p=.028) and it was explained to 46.0% of the variance. In other words, the higher subjective health status, the higher body mass index, the younger age make the higher oral health-related quality of life. Based on these results, education on the importance of maintaining oral health is necessary to improve the quality of life related to oral health in the elderly with hypertension.
This study was conducted to find out status of delivery environments, delivery attendants, and various immunization practices towards 513 babies who were born during the period from January 1, 1972 to December 31, 1974, in Dongnae Area, Shindong Myon, Chunseong Gun, Ganwon Do. The results and findings obtained from the study are summarized as follows : 1. Of all deliveries, 10.7% of the babies were reported born at the hospitals. 2. Deliveries attended by qualified professionals such as, doctors, midwives or public health nurses, were 22.2% of the total deliveries. Those who delivered alone without having anyone's assistants were as much as 9.7%, The percentage of the deliveries attended by the professional groups were increased year by year among the younger group mothers with the babies birth order being first or second place. 3. Sewing scissors were most frequently used as a tool for cutting the umbilical cord indicating 87.5% in this area. Sterilized tools were used among 50.3% of the women. 4. The usage af vinyl sheet and cement bag paper were frequently used as a delivery sheet, indicating 32.3%. Delivery set which was distributed by the health center was used 18.0%. (excluded the deliveries attended by professional attendants) 5. Immunization practices for the infant were observed as relatively high rate: 92.8% of the infant received D. p. T., 81, 3u/o received against poliomyelitis, 52.8% for small pox, 78.9% with B. C. G., and 18.5%against measles. The percentage af babies complected 3 times shot for D. P. T. and 2 times shot for poliomyelitis vaccine turned out be to 67.8% and 87.5%, respectively.
Purpose: The purpose of this study was to examine the effects of cardiocerebrovascular disease prevention program for older adults who were members of a elderly school located in Y city on knowledge of cardiocerebrovascular disease, depression, and physiological parameters. Methods: Nonequivalent control group pretest-posttest design was employed. A total of 50 older people living in Y city were assigned into an experimental group (n=26) or a control group (n=24). The experimental group participated in a 8-weeks cardiocerebrovascular disease prevention program from October 10 to December 2 in 2016. Data were analyzed with SPSS/WIN 21.0 using descriptive statistics, $x^2$ test, Fisher's exact test, and t-test. Results: The results indicated significant differences between the experimental group and control group in the scores of knowledge of cardiocerebrovascular disease (t=-4.60, p<.001), depression(t=3.65, p=.001), physiological parameters including systolic blood pressure (t=6.58, p<.001), diastolic blood pressure (t=4.56, p<.001), and blood glucose level (t=3.04, p=.004). Conclusion: The cardiocerebrovascular disease prevention program have a significant effect on the change of knowledge of cardiocerebrovascular disease, depression, and physiological parameters for elderly school participants.
The purpose of this study was to estimate primiparas' perceptions of their newborns and compare the changes of their perceptions related to feeding methods between the time I (post-partum 2nd-3rd day) and the time ll (post-partum 1st month). At the time Ⅰ, bottle-feeding method was 100% because mothers were separated from their babies. At the time Ⅱ, the methods of feeding were breast-feeding(29.7%), bottle-feeding(30.7%), mixed feeding(39.6%) .The subjects of this study were 101 primiparas. Data were collected between May to October 1994, using the Neonatal Perception Inventory devised by Broussard(1963) and added by Lee Ja Hyurg(1986) .The results of this study are as follows : 1. There was no significant difference of primiparas' perceptions of their newborns according to general characteristics. 1) The younger tended to estimate that newborns were less capable, and perceived that it would be more difficult for them to take care of babies. 2) There was no difference of mothers' perceptions of their babies according to having a job or not. 3) The lower educated tended to estimate that newborns were less capable, and perceived that it would be more difficult for them to take care of babies. 2. There were some changes of primiparas' perceptions of their babies related to feeding methods between the time I (post-partum 2nd-3rd day) and the time Ⅱ (post-partum 1st month).1) At the time Ⅰ, Breast-feeding mothers estimated that newborns were less capable, and perceived that it would be more difficult for them to take care of babies. But they showed positive perceptions at the time Ⅱ (P<0.05, p<0.1) 2) At the time Ⅰ, Bottle-feeding mothers tended to estimate that newborns were more capable, and perceived that it would be more easy for them to take care of babies. But they showed negative perceptions at the time Ⅱ 3) For breast-feeding mothers, positive-positive group was 53%, positive-negative group was 20%, negative-positive group was 10%, negative-negative group was 17%. For bottle-feeding mothers, positive-positive group was 55%, positive-negative group was 32%, negative-positive group was 10%, negative-negative group was 3%.
Purpose: The purpose of this study is to explore mother's perception and practice of Taegyo. In addition, belief factors toward Taegyo oriented Korean mother-fetus interaction are identified in order to obtain baseline data for the development of Taegyo oriented program enhancing mother-fetus interaction. Method: The sample consisted to 186 pregnant women who visited public health center or hospital for prenatal care. Self-reporting questionnaire devised by investigator was used. Data were analyzed by SPSS win program and contents analysis was used. Result: Although mothers intended to a pregnancy, many of them were perceived negatively toward pregnancy. The study revealed that most of pregnant women continued cultural practices related to Taegyo, they focused on mother-fetus interaction behavior-such as listen to the music, reading a book, talk to fetus, stroke the fetus- with being altered traditional beliefs toward Taegyo or Taemong. Most of pregnant women had Taemong and believed a it's predictive functions. Beliefs toward mother-fetus interaction were classified to 6 factors, pregnancy, Taemong. fetus, practice behavior, infant's abilities and mother-fetus interaction behavior. The scores of belief toward mother-fetus interaction and each factors of pregnancy, fetus, practice behavior, infant's ability were statistically significant different depending upon husbands education. Also pregnancy factor in belief toward mother-fetus interaction was statistically significant different depending upon the number of children, child birth, experience of abortion, premature birth. Conclusion: Developing Taegyo oriented program enhancing the mother-fetus interaction need to include the elements of being facilitated maternal identity formation and maternal confidence for the pregnant women. In addition, it should be developed the program concerning with the characteristics of the pregnant women.
The mortality and morbidity caused by injury and poisoning has been major public health problem in Korea. This study was carried out to get information indispensable in developing prevention srategies peculiar to korean rural area. In this study 1.499 people of 496 households. who are living in five rural villages of Chooncheon City. Kang-Won Province. were interviewed in accordance with structured questionaire in 1996. The results obtained are summarized as follows: 1. The age-standardized annual incidence rates of injury and poisoning per 100 persons surveyed were 4.2 in males and 1.9 in females. The difference between sex was statistically significant. 2. The places where most of injuries and poisonings occurred were road 66.7% among males. road 31.6% among females. 3. The occurrence of the injuries and poisonings were clustered in intensive farming season in both males and females. 4. The laceration and stab wound were the most frequent nature of injuries in males and the fracture was the most frequent nature of injuries in females. The fracture. sprain were more frequent among males but sprain and contusion were more frequent among females. 5. Incidence rates of injuries and poisoning by cause were higher in traffic accidents among males. though falls among females. The cause specific incidence rate by age was high in traffic accident for 30-59 year age group. and for the aged people older than 60 years. 6. In the management pattern, 78.8% of the injuries and poisoning were received medical care in hospitals and clinics, and the duration of the treatment over 4 weeks in 37.0%. The results obtained indicate that organized community effort is urgently required to prevent injuries and poisonings in rural area.
Background: The present study was conducted to determine knowledge level of technicians working in hospitals about testicular cancer (TC) and self-examination of testicles (TSE) and to determine levels of consciousness and implementation status about TSE. Materials and Methods: This cross-sectional study was conducted with technicians working in hospitals (n=243) between $2^{nd}$ January-$31^{st}$ May 2012 at private and governmental hospitals in urban Kayseri. Healthy control subjects (n=235) who were similar to technicians in terms of age, education level and income status were also included to the study. Chi-square test was used in comparison of categorical variables. Results: Technicians were significantly more aware of TC than controls, but the latter were found to have significantly more information about TSE. There was no significant difference between the two groups in terms of knowing how to do TSE and 80% of both groups were unaware this exam. Of technicians, 19.8% and of controls, 25.5% did TSE, the difference being statistically insignificant. First reason for not doing TSE was "not-knowing" among technicians (48.1%) while it was "ignorance" among controls (66.8%). Of technicians doing TSE, 37.5% did as it came to their mind while 51.7% of controls performed TSE several times in the previous year. Technicians were significantly more afraid of getting TC than controls (p=0.037). Conclusions: It was determined in the present study that rates of TSE were similar between technicians and controls. However compliance with the recommended frequency and right method was low. Consequently, public health education should be planned and applied in order to increase the knowledge of TC and TSE.
Purpose: The purpose of this study was to examine the effectiveness of Participatory Action-Oriented Training (PAOT) programs in korean manufacture workers with metabolic syndrome for three years. Methods: A total of 890 workers with risks of metabolic syndrome were recruited from one workplace. The experimental group (n=51) received PAOT program for the preventive management on metabolic syndrome, while the control group (n=51) received conventional program. Results: In the experimental group who participated in PAOT program, percentage of achieved action plans was 73.4% at three months, 75.8% at six months, 82.8% at three years. After three years, the rate of risk factor in the experimental group has significantly decreased from $1.94{\pm}1.77$ to $0.76{\pm}1.25$ for moderate exercise, and from $1.72{\pm}2.01$ to $1.04{\pm}1.59$ for the strenuous exercise. Systolic and diastolic blood pressure has significantly decreased from $125.06{\pm}11.83$ to $117.65{\pm}19.94$, from $83.45{\pm}13.38$ to $76.39{\pm}8.09$ mmHg. In addition, risk factor score also decreased from $3.31{\pm}0.61$ to $1.41{\pm}0.89$. Conclusion: To improve the effectiveness of PAOT program for the management of risk factors of metabolic syndrome, there is a need to continue implement programs and analyze the long-term effects are required in the workplace.
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