• Title/Summary/Keyword: Status of National health insurance

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Factors Affecting Psychosocial Adjustment in Patients with Surgical Removal of Benign Breast Tumor (유방 양성종양 절제술 환자의 심리사회적 적응의 영향요인)

  • Kim, Hyunsook;Lee, Myoungha;Kim, Hyeyoung;Nho, Juhee
    • Women's Health Nursing
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    • v.24 no.2
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    • pp.163-173
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    • 2018
  • Purpose: To identify factors influencing psychosocial adjustment in patients with surgical removal of benign breast tumor. Methods: With a survey design, data were collected using the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), Body Image Scale, Physical Discomfort Scale, and Family Support Scale with patients who had had surgical removal of a benign breast tumor from September to November 2017. Data were analysed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression. Results: The mean scores for physical discomfort, body image, family support, and psychosocial adjustment were $1.57{\pm}0.51$, $0.37{\pm}0.64$, $3.62{\pm}0.67$, and $4.00{\pm}0.45$, respectively. Family support, body image, physical discomfort, number of surgical removal of benign breast tumor (twice), and cancer insurance status (yes) were verified as factors influencing psychosocial adjustment. These factors accounted for 57.4% of psychosocial adjustment. Conclusion: In this study, family support, body image, and physical discomfort were identified as significant predictors of psychosocial adjustment. Therefore, this study can be used as fundamental data to develop nursing intervention strategies in order to increase psychosocial adjustment in patients with surgical removal of a benign breast tumor.

Denture wearers' recognition for their oral health status, denture cleansing methods, and insurance health system (의치사용자의 구강건강, 의치관리 및 의치건강보험 인식에 대한 실태 조사)

  • Kim, Sunjai;Kim, Seong-Kyun;Noh, Kwantae;Ahn, Su-Jin;Baik, Sang-Hyun;Kim, Jee-Hwan;Yoo, Dong-Ki;Kim, Kyoung-Rok;Kwon, Kung-Rock
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.4
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    • pp.287-294
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    • 2018
  • Purpose: The aim of the present investigation was to understand the incidence, prevalence of denture stomatitis in denture wearers, who were over 60 years old, and use the results for a fundamental data to promote public awareness about denture stomatitis and its education tools. Materials and methods: From August 21 to September 8 2017, 500 denture wearers, who were more than 60 years old in Seoul and 4 other metropolitan cities (Busan, Daegu, Gwangju, and Daejeon), received questionnaires. The questionnaires included denture wearers' demographic distributions, specific dental treatment experiences, discomforts with current dentures, their oral health conditions, and the method of denture cleansing. Results: Thirty-two percent of 500 denture wearers responded that they have healthy oral conditions. Two hundred and eight respondents (41.6%) were aware of denture stomatitis. Only 131 (26.2%) were informed about the removable denture covered by national health insurance and 327 (65.4%) of denture wearers were using the improper denture cleansing methods. Conclusion: A large number of denture wearers still do not recognize the importance of proper treatment for denture stomatitis, insurance covered denture treatments, and adequate denture cleansing methods.

Grip Strength as a Predictor of Cerebrovascular Disease (뇌혈관질환의 예측인자로서의 악력)

  • Jung, Seok-Hwan;Kim, Jae-Hyun
    • Health Policy and Management
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    • v.29 no.3
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    • pp.303-311
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    • 2019
  • Background: Cerebrovascular disease is included in four major diseases and is a disease that has high rates of prevalence and mortality around the world. Moreover, it is a disease that requires a high cost for long-term hospitalization and treatment. This study aims to figure out the correlation between grip strength, which was presented as a simple, cost-effective, and relevant predictor of cerebrovascular disease, and cerebrovascular disease based on the results of a prior study. And furthermore, our study compared model suitability of the model to measuring grip strength and relative grip strength as a predictor of cerebrovascular disease to improve the quality of cerebrovascular disease's predictor. Methods: This study conducted an analysis based on the generalized linear mixed model using the data from the Korea Longitudinal Study of Ageing from 2006 to 2016. The research subjects consisted of 9,132 middle old age people aged 45 years or older at baseline with no missing information of education level, gender, marital status, residential region, type of national health insurance, self-related health, smoking status, alcohol use, and economic activity. The grip strength was calculated the average which measured 4 times (both hands twice), and the relative grip force was divided by the body mass index as a variable considering the anthropometric figure that affects the cerebrovascular disease and the grip strength. Cerebrovascular diseases, a dependent variable, were investigated based on experiences diagnosed by doctors. Results: An analysis of the association between grip strength and found that about 0.972 (odds ratio [OR], 0.972; 95% confidence interval [CI], 0.963-0.981) was the incidence of cerebral vascular disease as grip strength increased by one unit increase and the association between relative grip strength and cerebrovascular disease found that about 0.418 (OR, 0.418; 95% CI, 0.342-0.511) was the incidence of cerebral vascular disease as relative grip strength increased by unit. In addition, the model suitability of the model for each grip strength and relative grip strength was 11,193 and 11,156, which means relative grip strength is the better application to the predictor of cerebrovascular diseases, irrespective of other variables. Conclusion: The results of this study need to be carefully examined and validated in applying relative grip strength to improve the quality of predictors of cerebrovascular diseases affecting high mortality and prevalence.

Models for Predicting Five Jang Biological Ages with Clinical Biomarkers (임상 생체지표를 이용한 오장생체나이 추정 모델)

  • Kim, Tae-Hee;Kim, Seok;Bae, Chul-Young;Kang, Young-Gon;Cho, Kyung-Hee;Kwon, Su-Kyung;Park, Mei-Hua
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.15 no.2
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    • pp.175-190
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    • 2011
  • Objectives: Even though there has been no consensus on the concept of viscera organ between the oriental and western medicine, we tried to investigate the correlation between clinical biomarkers of five Jang and chronological age and develop the models for predicting five Jang biological ages by statistical analysis. Methods: We obtained data from about 120,000 subjects who visited health promotion centers for health promotion and disease prevention from January 2004 to June 2009. Participants were included if they were over 20 years old, and excluded if reported to have cardiovascular disease or other serious medical illness such as cancer, malignant hypertension, uncontrolled diabetes, cardiopulmonary insufficiency, liver disease, pancreatic disease or renal disease. Among the clinical biomarkers obtained, we selected the biomarkers which were associated with the function of 5 Jang in previous studies, or showed statistically significant correlation with age. Multiple regression models were used for building prediction models of biological age after adjusting for potential confounders for men and women, respectively. Pearson correlation coefficient was calculated to examine the linear relationship between age and various biomarkers, and multiple regression analysis was used for building the prediction models of five Jang biological ages for men and women, respectively. All statistical data analysis was performed by using SPSS Version 12.0 software and statistical significance was obtained if p<0.05. Results: For males, the best models were developed using 12, 2, 8, 3, and 4 biomarkers for predicting biological ages of heart, lung, liver, pancreas, and kidney, respectively (R2 = 0.57, 0.43, 0.11, 0.24, and 0.93, respectively). Similar to males, for the females, 10, 2, 8, 3, and 4 biomarkers were selected as the models respectively (R2 = 0.76, 0.44, 0.14, 0.38, and 0.89, respectively). Conclusions: As we have developed for the first time the models for predicting five Jang biological ages with common clinical biomarkers, it is expected that these models may be used as clinical supplementary tools in the evaluation of aging status and functional decline of five Jang according to age in health promotion centers and private clinics. At the same time, it is considered that the use as objective tools to evaluate aging status and functional decline of each Jang.

A Study on the Status of Management Structure to Dental Laboratory in Chun-Buk (치과기공소(齒科技工所)의 운영구조(運營構造) 실태(實態)에 관(關)한 조사연구(調査硏究))

  • Chung, Kyung-Pung;Kim, Jong-In
    • Journal of Technologic Dentistry
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    • v.13 no.1
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    • pp.79-97
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    • 1991
  • To improve the management of dental laboratory through the research on the actual condition, this study posed questions on 36 dental laboratories. The results are as follows : 1. The establishment of dental laboratory in Chunbuk was increased between in 1980 and 1986. Especially it has been more increased since 1989. According to the proportion of population the number of the dental laboratories in Chunbuk was much more than that of other provinces and took the first place in september 1990. 2. The ratio between the unlicensed dental technician and the licensed was 24.83% and 67.11% each . The former must be replaced by the licensed. And the latter ought to try to improve their culture and technique. 3. Overtime payment must be paid for those who work above eight hours. 4. It takes 5 days at a minimum for the production of dental prosthesis with both stability and esthetics. 5. Every Saturday afternoon, Sunday and national holiday must be free. 6. Bonus must be paid 600% a year at a minimum. The system of retirement allowance should be active. All dental technicians ought to be affliated with their labor union and medica insurance. 7. Such dental restoration as porcelain and crown and bridge prosthesis must by increased to a degree between 30% and 50% at a minimum and the reduction system of charge for a dental technique has to be abolished. 8. The general working conditions of dental laboratory, especially pay and working hour must be improved. 9. To advance the service improvement of dental treatment and the banishment of illegal one, the medical insurance of crown and bridge prosthesis must be generally practised. 10. Ill case of the staff cull:lloyulent of dental laboratory, minimem wage system must be observed. 11. Directing dentist system on the ertablisment of dental laboratory must be abelished or wholly improved.

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Dental Utilization Associated Factors among Elderly (노인의 치과의료서비스 이용에 영향을 미치는 요인)

  • Ahn, Eunsuk;Hwang, Ji-Min;Shin, Myong-Suk
    • Journal of dental hygiene science
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    • v.15 no.1
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    • pp.60-66
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    • 2015
  • The purpose of this study was to examine the relationship of predisposing, enabling, need factors and oral health care factors to the dental utilization in 4,521 senior citizens based on the 5th National Health and Nutrition Examination Survey data. As for the relationship of predisposing, enabling and need factors to the necessity of denture, higher academic credential and higher income level that were respectively one of predisposing and need factors led to a higher necessity of denture, and the relationship of these factors was statistically significant. As to influential factors for their dental utilization in Model 1, there were significant differences according to gender, marital status and whether to subscribe to private health insurance or not. In Model 2, the need factors of Model 1 were adjusted. As a result, the respondents who didn't receive any unsatisfactory dental treatment made 1.35-fold more dental utilization, and the respondents who complained about mastication difficulty made 1.34-fold more dental utilization. There were significant differences according to gender, age, marital status, academic credential, whether to subscribe to private health insurance, unsatisfactory dental treatment experience and mastication difficulty. Age, unsatisfactory dental treatment experience and whether to complain about mastication difficulty or not made statistically significant differences to the dental utilization in Model 3 that involved oral health status. The above-mentioned findings illustrated that the predisposing factors, the enabling factors and the need factors exerted an influence on the elderly dental utilization. As there are a variety of factors to affect elderly dental utilization, its required to make an effort to boost the accessibility of the elderly to dental service in order to improve their oral health of the elderly.

The Development of Evaluation Criteria Model for Discriminating Specialized General Hospital (종합전문요양기관 인정기준 모형 개발)

  • Chun Ki Hong;Kang Hye-Young;Kang Dae Ryong;Nam Chung Mo;Lee Gye-Cheol
    • Health Policy and Management
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    • v.15 no.4
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    • pp.46-64
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    • 2005
  • This study was conducted to verify the current criteria and classification system used to determine specialized general hospitals status. In this study, we proposed a new classification system which Is simpler and more convenient than the current one. In the new classification system clinical procedure was chosen as the unit of analysis in order to reflect all the resource consumption and the complexities and degree of medical technologies in determining specialized general hospitals. We developed a statistical model and applied this model to 117 general hospitals which claim their national insurance through electronic data interchange(EDI). Analysis based on 984 clinical procedures and medical facilities' characteristic variable discriminated specialized general hospital in present without misclassification. It means that we can determine specialized general hospital's permission In new way without using the current complicated criteria. This study discriminated specialized general hospital by the new proposed model based on clinical procedures provided by each hospital. For clustering the same types of medical facilities using 984 clinical procedures, we executed multidimensional scale analysis and divided 117 hospitals into 4 groups by two axises : a variety of procedure and the Proportion of high technology Procedure. Therefore, we divided 117 hospitals into 4 groups and one of them was considered as specialized general hospital. In discriminating analysis, we abstracted proportion of 16 clinical procedures which effect on discriminating the specialized general hospital in statistical system also we identify discriminating function which include these variables. As a result, we identify 2 discriminating functions, one is for current discriminating system and the other two is for new discriminating system of specialized general hospital.

Determinants of Utilization of Oriental Medical Services and Policy Implications (한방의료이용의 결정요인과 정책개선방안)

  • Byun Jin-Suk;Lee Sun-Dong;Kim Jin-Hyun
    • Journal of Society of Preventive Korean Medicine
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    • v.3 no.2
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    • pp.1-23
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    • 1999
  • The purpose of this paper is to survey the current status of service utilization in oriental medicine, to identify the determinants of consumers' decision in the service utilization, and then suggest policy implications for promoting the consumers' utilization. A multiple regression model was adopted to analyze the factors that influence consumer's decision in purchasing the oriental medical services. Data used in this research relied on National Survey Data conducted by Korea Institute of Health and Social Affairs, and sampling survey. The results could be summarized as follows.: 1. the number of visits to oriental medical institutions has shown an overall increase during the last decade since the inception of health insurance for oriental medical services. It still, however, revealed a relatively iow figure to western medical services. 2. the main factors, after controlling demographic variables, that determine consumers' selection between oriental medical services and western medical services are considered to be price, belief in effectiveness of services, waiting time for service. Implications for policy recommendation include 1. to reduce a barrier to service utilization by discounting dramatically the price of herb medicine, which is believed to be crucial in expanding market share, 2. to encourage consumer's belief in clinical effectiveness through a specialization in competitive services compared with wertern medicine, 3. to keep the affirmative image among consumers alive through an active participation of oriental medical doctors in community activities, 4 to change the health care system in favor of oriental medicine in the long run.

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Telemedicine in Japan and Role of the Community-based Occupational Therapy (일본의 원격의료현황과 지역사회작업치료의 역할)

  • Kim, Do-Hoon;Yoon, Tae-Hyung
    • The Journal of Korean society of community based occupational therapy
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    • v.5 no.2
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    • pp.23-30
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    • 2015
  • Objective : The aim of this study is to analyze the telemedicine in Japan and discuss the role of the community-based occupational therapy. Methods : This study was collected and analyzed data on telemedicine status in Japan. It examined the definition and forms of telemedicine and analyzed for the appearance to the background telemedicine in Japan. Thus, we discussed the role of the community-based occupational therapy. Results : Due to increased medical costs, low fertility rate and aging in Japan, it had provided the telemedicine as a more efficient form of health care services. Also, telemedicine emerged due to the lack of doctors, development of medical technology, and regional deviation between rural and urban area. In the case of Korea, similar to Japan, therefore, there is a demand for the telemedicine. Conclusion : With regard to telemedicine, occupational therapy in community-based rehabilitation is expected to be able to treat for patients as health care professionals. Therefore the reform of the educational system is needed for this.

A Comparative Study of Predictive Factors for Hypertension using Logistic Regression Analysis and Decision Tree Analysis

  • SoHyun Kim;SungHyoun Cho
    • Physical Therapy Rehabilitation Science
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    • v.12 no.2
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    • pp.80-91
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    • 2023
  • Objective: The purpose of this study is to identify factors that affect the incidence of hypertension using logistic regression and decision tree analysis, and to build and compare predictive models. Design: Secondary data analysis study Methods: We analyzed 9,859 subjects from the Korean health panel annual 2019 data provided by the Korea Institute for Health and Social Affairs and National Health Insurance Service. Frequency analysis, chi-square test, binary logistic regression, and decision tree analysis were performed on the data. Results: In logistic regression analysis, those who were 60 years of age or older (Odds ratio, OR=68.801, p<0.001), those who were divorced/widowhood/separated (OR=1.377, p<0.001), those who graduated from middle school or younger (OR=1, reference), those who did not walk at all (OR=1, reference), those who were obese (OR=5.109, p<0.001), and those who had poor subjective health status (OR=2.163, p<0.001) were more likely to develop hypertension. In the decision tree, those over 60 years of age, overweight or obese, and those who graduated from middle school or younger had the highest probability of developing hypertension at 83.3%. Logistic regression analysis showed a specificity of 85.3% and sensitivity of 47.9%; while decision tree analysis showed a specificity of 81.9% and sensitivity of 52.9%. In classification accuracy, logistic regression and decision tree analysis showed 73.6% and 72.6% prediction, respectively. Conclusions: Both logistic regression and decision tree analysis were adequate to explain the predictive model. It is thought that both analysis methods can be used as useful data for constructing a predictive model for hypertension.