• 보건행정학회지
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• 제30권1호
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• pp.100-111
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• 2020

Background: Few studies have examined the performance of the public long-term care insurance (LTCI) from the perspective of geographic equity. This study investigated regional variations and associated factors in the supply and utilization of nursing home care within and also between Japan and Korea. Methods: A comparative dataset was developed by extracting data from 2013-2015 LTCI statistics yearbooks and Organization for Economic Cooperation and Development regional statistics, as well as other comparable data in Japan and Korea. The unit of analysis was the prefecture in Japan and the province in Korea. We computed variation indices and conducted regression analyses for regional variations within each country and decomposition analyses to examine the variations between the countries. Results: The overall regional supply and use of nursing home care were higher in Japan, but the regional variations in Korea were larger than in Japan. In both countries, the nursing home supply was negatively associated with the proportion of older people with independent living. Nursing home use was also negatively associated with the supply of hospital beds and home care agencies in Korea; the relationship was the opposite in Japan, however. The country-based differences were more likely to be explained by differences in the distributions of the variables included in the analytical model than country-specific characteristics. Conclusion: Regional-level nursing home supply and use were unequal in both countries, and the contributing factors were not the same. Policy efforts are needed to advance regional equality in long-term care (LTC) and collaboration between health and LTC institutions for frail older people, especially in Korea.

• 보건의료기술평가
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• 제6권2호
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• pp.100-105
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• 2018

Objectives: The purpose of this research is to investigate regional variations of mastication difficulty rates in the elderly over 65 in 229 primary autonomous districts in Korea and explore relevant characteristics. For the research data, local community health survey conducted in 2015 and data from Ministry of the Interior and Safety, Ministry of Health & Welfare, National Health Insurance Service and Statistics Korea were used. Methods: Frequency analysis was conducted for general characteristics and mastication difficulty rates of each region, and distribution of mastication difficulty rates was displayed for each town, city and province by mapping them. Extremal quotient (EQ), coefficient of variation (CV) values were calculated for regional variations, and logistic regression analysis was performed to reveal the relationship between each independent variable and mastication difficulty rates. Results: The average of standardized mastication difficulty rate was 46.78%, and regional variations were significant with EQ 3.46, CV 0.18. Characteristic factors that have significant effects on mastication difficulty rate included sex ratio, elderly population and the number of dentists per 10000 people. Conclusion: As a result, there were variations among mastication difficulty rates in 229 primary local governments across the country, and the distribution of health care resources by the characteristics of the local environment by region affected mastication difficulty rates. Accordingly, it is required to provide political supports to overcome regional inequality of oral health levels and develop cooperative system between local governments and local dentists.

• 한국유기농업학회지
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• 제27권3호
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• pp.307-325
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• 2019

This study aims to analyze the regional variations in which appear during the formation process of educational community in rural villages from the perspective of regional innovation theory. The study results revealed that the activities to form an educational community of the Songak village significantly influenced the variations across the social, economic and environmental aspects beyond an innovation of public education within the region based on interrelation between schools and villages. In other words, the activities including interactions and group learnings have been actively promoted among the various relevant stakeholders, thereby resulting in a variety of positive variations such as expanded regional welfare base, activated voluntary residents community gatherings based on the unity and cooperation, broadened socioeconomic opportunities, satisfaction on educational and cultural desires, and construction of healthy ecological environment in the region. Therefore, it is thought that regional development policy suitable for each region needs to be established by embracing the fact that activities to form a village educational community entail significant implication and value as the comprehensive regional innovation activities across the entire domains in each region.

• 한국임상약학회지
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• 제28권4호
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• pp.308-319
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• 2018

Background: Some mental illnesses such as depression are known to be one of the risk factors of suicide and proper antidepressant therapy can reduce suicidal behavior. Objectives: This study aimed to analyze regional variations in antidepressant consumption and adherence, suicide rate, prevalence of suicide related mental disorders, and access to relevant healthcare services. Methods: Cross-sectional analyses were conducted using National Patients Sample data compiled by the Health Insurance Review and Assessment Service between 2014 and 2016. We included patients who had a diagnosis record of suicide related mental disorders during the study period. Cause of death statistics and National health and medical statistics were used to identify suicide rate and distribution of healthcare service. We conducted visual analyses, chi-squared tests, independent t-tests and correlation analyses to demonstrate regional variations. Results: Between 2014 and 2016, the average prevalence of suicide related mental disorders was 5.4 per cent. Suicide rate and prevalence of suicide related mental disorders were higher in Gangwon, Chungcheong, and Jeolla (p < 0.001), and lower in Seoul (p < 0.001) than the national average. Unexpectedly, regional variations in antidepressant consumption were seen in the limited area including Daejeon, Chungnam and Gyeongnam (p < 0.05). The number of mild patient-centered clinics was associated positively with antidepressant consumption (p < 0.01) and associated negatively with suicide rate (p < 0.01). Conclusion: There were some regional variations in prevalence of suicide related mental disorders, antidepressant adherence and suicide rate. The higher level of antidepressant therapy and the lower level of suicide rates were seen in regions with easy access to mild patient-centered clinics.

• The Korean Journal of Ecology
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• 제24권6호
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• pp.359-364
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• 2001

Regional variations of Dictyostelid cellular slime molds were examined using molecular data. The intertranscribed spacer regions including the 5.8S ribosomal DNA of 2 species(D. purpureum, P. violaceum) of Cellular Slime Molds were sequenced and analyzed. Among 13 strains of D. purpureum and 12 strains of P. violaceum analyzed, each two strains were obtained from ATCC and the others were isolated from the forest soils in Korea. The sequences of the 5.8S ribosomal DNA were conserved among the strains of the same species, but unexpectedly highly variable among species. A high level of genetic diversity was found which was best resolved at the genus/species level as well as the family level by sequence data from the ITS 1 and ITS 2 regions. According to the sequence alignments by CLUSTAL X and the phylogeographic analyses by PAUP, 12 strains of P. violaceum were divided into three groups among which there were no difference of the morphological characteristics. Among 13 strains of D. purpureum, genetic variations were related to two morphological types, the temperate and subtropical type. There was no variation pattern according to geography in Korea, but there were some variations between Korea and other countries.

• Journal of Preventive Medicine and Public Health
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• 제26권3호
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• pp.430-441
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• 1993

The objectives of this study are two-fold : to identify geographic variations in the rate of tonsillectomy and adenoidectomy (T&A) and appendectomy and analyze the socioeconomic variables and health resources which affect geographic variation in the rate. The nationwide three month's cases of the two surgical procedures in 1991 are obtained from the record of the National Federation of Medical Insurance. The analysis shows two to ten-fold variations in the regional rates for the performance of two common procedures such as T&A and appendectomy. T&A shows a bigger regional variations than appendectomy. As a result of multiple regression, the factor of bed supply has been found significant for the dependent variable of the rate of T&A. The finding of large variations in the rate of surgical procedures throughout the country would have important implications for allocating scarce resources and managing quality of care. Further analysis is needed for the elaboration of the above implications.

• 한국산학기술학회논문지
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• 제19권2호
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• pp.561-574
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• 2018

본 논문에서는 건강 불평등의 해소를 위하여 지리적 가중 회귀를 이용한 대사증후군 유병률의 지역별 변이 요인 및 관련 요인을 파악하고, 이를 통하여 지역의 효율적인 대사증후군 관리 사업 개발을 위한 적용방안을 마련하였다. 국민건강 보험공단 2015년 건강보험 통계연보 및 지역사회건강조사 등 기타 국가 기관 자료를 통하여 대사증후군 유병률과 사회경제적 수준의 사회구조적 요인, 그리고 물리적 환경, 건강행태, 이환, 정신건강, 예방관리, 의료이용의 중재 요인 지표를 수집하였다. 먼저 수집된 데이터를 바탕으로 대사증후군 유병률의 변이수준을 측정하는 지표인 EQ (Extremal Quotient)와 CV(Coefficient of Variations)를 이용하여 지역 간 변이가 존재함을 확인한 후, 공간적 이질성 및 의존성 등의 공간적 변이 고려가 가능한 지리적 가중 회귀(Geographically Weighted Regression)를 이용하여 대사증후군 유병률의 지역 간 변이 관련 요인을 분석하였다. 지리적 가중 회귀 분석 결과 대사증후군 유병률의 수준에 따라 주요 요인의 크기와 관리의 우선순위가 다름을 알 수 있었으며, 향후 지역별 대사증후군 관리의 목표와 우선순위 설정을 통한 관리 사업의 효과를 증대시킬 수 있는 방안마련이 가능함을 확인하였다.

• Journal of Preventive Medicine and Public Health
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• 제48권4호
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• pp.195-202
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• 2015

Objectives: Receiving proper dental care plays a significant role in maintaining good oral health. We investigated the relationship between regional deprivation and dental care utilization. Methods: Multilevel logistic regression was used to identify the relationship between the regional deprivation level and dental care utilization purpose, adjusting for individual-level variables, in adults aged 19+ in the 2008 Korean Community Health Survey (n=220 258). Results: Among Korean adults, 12.8% used dental care to undergo examination and 21.0% visited a dentist for other reasons. In the final model, regional deprivation level was associated with significant variations in dental care utilization for examination (p<0.001). However, this relationship was not shown with dental care utilization for other reasons in the final model. Conclusions: This study's findings suggest that policy interventions should be considered to reduce regional variations in rates of dental care utilization for examination.

• 한국임상보건과학회지
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• 제1권1호
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• pp.9-17
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• 2013

Purpose. This study is to find the degree of variations and trends of hospital services utilization for hypertensive disease, and have done the comparative analysis of the factors affecting occurring some variations. For this, this study uses the data for patients-survey and health-survey of a regional society by Korea Institute for Heath and Social Affairs in 2008; The regional units are classified into 160 of medium size medical service areas. Methods. I understand the level of variation by using index of Extremal Quotient(EQ) and Coefficient Variation(CV), and analyze critical factors influencing some differences in hospital services utilization by using multi-regression model. Results. The main results are followed:The first, in case of rate of hospital services utilization according to standarization of sex and age by small area, I find the variations of EQ 5.3 and CV 0.3; In Ho-nam, especially, the variation of high rank of 10 of age shows higher distribution. The second, the results analyzing the factors influencing on hospital services utilization by multi regression model are that a number of bed hospitals is significant positive relationship and EQ-5D of health behavior is significant negative one. Conclusions. To increase equity of hospital services utilization for hypertensive disease, this study requests the appropriate supply management of bed hospitals by region, efficient allocation of resources, and revitalization of the health promotion program.

• 대기
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• 제20권3호
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• pp.343-353
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• 2010

A regional wind network with complex surface conditions must be designed with sufficient space and time resolution to resolve the local circulations. In this study, the spatial variations of the wind field observed in the Seoul and Jeju regional networks were evaluated in terms of annual, seasons, and months to assess the spatial homogeneity of wind fields within the regional networks. The coherency of the wind field as a function of separation distance between stations indicated that significant coherency was sometimes not captured by the network, as inferred by low correlations between adjacent stations. A meso-velocity scale was defined in terms of the spatial variability of the wind within the network. This problem is predictably most significant with weak winds, dull prevailing wind, clear skies and significant topography. The relatively small correlations between stations imply that the wind at a given point cannot be estimated by interpolating winds from the nearest stations. For the Seoul and Jeju regional network, the meso-velocity scale has typically a same order of magnitude as the speed of the network averaged wind, revealing the large spatial variability of the Jeju network station imply topography and weather. Significant scatter in the relationship between spatial variability of the wind field and the wind speed is thought to be related to thermally-generated flows. The magnitude of the mesovelocity scale was significantly different along separation distance between stations, wind speed, intensity of prevailing wind, clear and cloudy conditions, topography. Resultant wind vectors indicate much different flow patterns along condition of contributing factors. As a result, the careful considerations on contributing factors such as prevailing wind in season, weather, and complex surface conditions with topography and land/sea contrast are required to assess the spatial variations of wind field on a regional network. The results in the spatial variation from the mesovelocity scale are useful to represent the characteristics of regional wind speed including lower surface conditions over the grid scale of large scale atmospheric model.