• Nutritional Sciences
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• 제6권1호
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• pp.42-47
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• 2003

The objective of this study was to examine how circulating leptin concentrations and resting energy expenditures (REE) are related to body composition in obese adults, and to examine differences in these parameters according to gender. Twenty-three subjects, 6 males and 17 females, were recruited from patients with a body mass index (BMI) of greater than 27 at the Obesity Clinic of the K University Hospital. Anthropometric assessments and biochemical analyses were performed, and REEs were measured. In spite of having similar BMI values the plasma leptin levels of females (20.0$\pm$6.5 ng/ml) were significantly higher (p<.05) than those of males (14.2$\pm$6.1) ng/ml). In females, plasma leptin concentrations were found to be positively related to body weight. BMI, waist-hip ratio (WHR), fat mass (FM), body fat, and to the circumferences of forearm, waist and hip (p<.0001). However, in males, plasma leptin concentrations were positively related only to suprailiac thickness (p<.05). The higher plasma leptin levels in females compared to males may, at least partially. be explained by the females' higher subcutaneous fat mass. Plasma leptin concentrations appeared to reflect not only total fat mass but also regional fat distribution, especially in females. REE values of males (2254.3$\pm$256.2 kcal/day) were significantly higher (p＜.01) than those of females (1799.1$\pm$454.7 kcal/day). REE values for females were positively related to body weight, BMI, lean body mass (LBM), FM, body fat, and to the circumferences of waist and hip (p<.05); however, REE values for males were (positively) related only to LBM (p<.05). REE values were not related to plasma leptin concentrations for either males or females, indicating that the plasma level of leptin might not be a predictor for REE value.

• Journal of Preventive Medicine and Public Health
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• 제29권4호
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• pp.831-842
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• 1996

Demand for high quality medical care has recently been increasing in step with high level of income and education. Patients prefer the use of large general hospitals to small community hospitals. Large hospitals, usually located at urban area, expand their capacities to cope with the increasing demand, therefore, they easily secure revenue necessary for growth and development of hospitals. However, small community hospitals are facing with serious financial difficulties caused from the reduction of patients in one hand and the inflation of cost in another. If small rural hospitals were closed, the closure would have negative impacts on local economies in addition to the decrease in access to medical care. Community leaders should have an insight on the contribution of community hospitals to local economies. They could make a rational decision on the hospital closure only with the understanding of hospital's contribution to the community. This study is designed to develop an economic model to estimate the contribution of rural hospital to local economies, and also to apply this model with a specific hospital. The contribution of a hospital to local economies consists of two elements, direct effect and multiplier effects. The direct impacts include hospital's local purchasing power, employee's local purchasing power, and the consumption of patients coming from outside the community. The direct impact induces multiplication effect in the local economy. The seed money invested to other industries grows through economic activities in the region. This study estimated the direct effect with the data of expenditure of the case hospital. The total effect was calculated by multiplied the direct effect with a multiplier. The multiplier was drown from the ratio of marginal propensity of income and expenditure. Beside the estimation of the total impacts, the economic effect from the external resources was also analyzed by the use of the ratio of patients coming outside the region. The results are as follows. 1. The direct economic contribution of the hospital to the local economy is 1,104 million won. 2. The value of multiplier in the region is 2.976. 3. The total economic effect is 3,286 million won, and the multiplication effect is 2,182 million won. 4. The economic contribution from the external resources is 245 million won which is 7.5% of the total economic effect.

• 한국지역사회생활과학회지
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• 제21권1호
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• pp.53-69
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• 2010

The purpose of this study was to find how financial structures differ from the family life cycle. The data was drawn from the 2002 Korean Labor and Income Panel Study conducted by the Korea Labor Institute, and 1,957 households. The level of total income and subcategories of income were found to be significantly different from the family life cycle and showed tendencies to increase up to the period of child birth and then sharply dropped down during the retirement period. Household consumption expenditures in total and subcategories showed a U shape by family life cycle and were also found to be significantly different from the family life cycle. The consumption expenditure of dining out showed the highest level at the beginning of family establishment, whereas medical cost showed the highest level for later years. The level of total assets increased gradually from the family life cycle and a little decreased for the later years, and the level of real estate assets showed the highest ratio(90% over) out of total asset components of family life cycle.

• Journal of Preventive Medicine and Public Health
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• 제45권5호
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• pp.291-300
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• 2012

Objectives: We aimed to estimate the annual socioeconomic burden of coronary heart disease (CHD) in Korea in 2005, using the National Health Insurance (NHI) claims data. Methods: A prevalence-based, top-down, cost-of-treatment method was used to assess the direct and indirect costs of CHD (International Classification of Diseases, 10th revision codes of I20-I25), angina pectoris (I20), and myocardial infarction (MI, I21-I23) from a societal perspective. Results: Estimated national spending on CHD in 2005 was $2.52 billion. The majority of the spending was attributable to medical costs (53.3%), followed by productivity loss due to morbidity and premature death (33.6%), transportation (8.1%), and informal caregiver costs (4.9%). While medical cost was the predominant cost attribute in treating angina (74.3% of the total cost), premature death was the largest cost attribute for patients with MI (66.9%). Annual per-capita cost of treating MI, excluding premature death cost, was $3183, which is about 2 times higher than the cost for angina ($1556). Conclusions: The total insurance-covered medical cost ($1.13 billion) of CHD accounted for approximately 6.02% of the total annual NHI expenditure. These findings suggest that the current burden of CHD on society is tremendous and that more effective prevention strategies are required in Korea.

• Journal of Preventive Medicine and Public Health
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• 제25권4호
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• pp.399-412
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• 1992

This study was designed to investigate factors relating to fiscal deficit for regional health insurance. The financial statements for the fiscal year 1990 of nationwide 254 regional medical insurance societies were analyzed. Important findings are summarized below: 1. There were differences in the main reason fur the financial deficit among regions when deficit and surplus societies were compared by regions. The total revenue per enrollee, especially revenue from the premium contribution of a deficit society was significantly smaller than that of a surplus society in large cities and counties. On the other hand, the total expenditure per enrollee of a deficit society was larger than that of a surplus society in small cities. 2. Both low premium rate at the beginning of health insurance program and less effort to increase the premium rate were main factors for the smaller revenue from the contribution of a deficit society in large cities and counties. 3. Larger expenditures per covered person of a deficit society in small cities were explained with larger medical expenditures especially for out-patients services rather than larger administrative expenses. 4. A regression analysis showed that utilization rates in out-patient services were significantly associated with income and numbers of total medical care institution per capita within a region where a health insurance society located. Also expenses paid by insurer per visit were associated with the proportion of utilization for tertiary care hospitals as well as the proportion of utilization of public health centers.

• Journal of Preventive Medicine and Public Health
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• 제9권1호
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• pp.31-37
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• 1976

This study was conducted for the purpose of obtaining basic information on the patterns of medical care expenditures, and identifying some determinants of medical care expenditures in the rural Korea. Nine guns were chosen from the eight provinces, excluding Cheju island. One gun in each province and two villages were selected from the each myon or ub within the selected guns. The total number of households was 1,789 and the sample size was 9,826 non-institutionalized people. Followings are the major findings of the study : 1) Medical care expenditures increase proportionally with age in terms of cost per patient, per episode of illness, per treated case, and per person. Averagely, it cost 2,756 won per patient, 2,614 won per spell of illness, 4,361 won per treated case, and 413 won per person. 2) Medical care expenditures increase proportionally with educational level of patients. College graduates spent the most, 4,726 won per patient, 5,987 won per treated case, and 670 won per person. 3) The male spent a little more than the female in terms of per patient, per episode, and per person. For example, a male spent 23 won more than a female. 4) Those who were suffering from illnesses longer than 1 year spent three times more than that had illnesses of less than 1 year duration. 5) The simple correlation coefficient between activity restriction and medical care expenditures was the highest among others, 0.491. The next was 0.294 between duration of illness and medical care expenditures. 6) Attempts are made to identify the explanatory variables in medical care expenditures. Thirty one per cent of the variances in tile expenditures can be accounted for by the selected 15 predictors. Those predictors belonged to clinical renditions, such as activity restriction, duration of illness, and nature of conditions, are proved to be the most potent independent variabes. Level of education and monthly family income are also significant in terms of beta coefficient. Further studies are called for to unreveal the determinants of medical expenditures.

• 대한간호학회지
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• 제16권3호
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• pp.38-66
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• 1986

Based on the statistical data of FKMIS during five years from 1981 to 1985, the major findings of studying on the treatments of employee's modical insurance covered people were made as follows. 1. During five years, the total number of trratment case was increased 25.14% annually, and so doubled. The consultation rate was increased from 2.086 to 2.856, showng annual increase of 8.17% and total increase of 36.91%. In the cafe, of in-patient, the rate was from 0.056 to 0.602, . showing annual increase of 2.58%. And in out-patient, the rate was from, 2.030 to 2.794, showing annual increase of 8.31%. The male: female ratio of treatment case was changed from 1 : 1.1 to 1 : 1.2. 2. Case of chronic disease was on the increase .every year. The ratio of medical expenditure of that disease to the total medical expenditure was increased from 22.99% in 1984 to 25.0% in 1985. 3. As a whole, the consultation rate of circulatory disease was increased from 26.10 in 1981 to 46.53 in 1985, showing an nual increase of 15.55 %. The rate of in-patient was increased from 2.06 to 2.94, showing annual increase of 9.30%. The rate of out-patient wag from. 24.04 to 43.59, showing annual increase of 16.04%. 4. The duration (days) of circulatory disease in 1985 by types is as follows. In the case of in-patient, rheumatic fever rheumatic heart disease, (22. 67), ischaemic disease (17.39), cerebrovascular disease (17.18), disease of pulmonary circulation and other from of heart disease (15.82), hypertensive disease (13.18), other disease of circulatory disease(11.55). In the case of out-patient, visiting day (11.57 day) and medical expenditure per case (7,853 won) is lower than that of other diseases (4.39 day, 4,361 won). 5. Cases of circulatory chronic disease were two times as many as those of non-chronic disease. Incidence of the out-patient was shown higher than that of in-patient. In the case of duration per case, the chronic disease(12.92 days) was longer that of non-chronic disease (9.8 day). 6. The male: female ratio of chronic rheumatic heart disease is 34.56 : 65.44 (in-patient) and 34. 67 : 65.33 (out-patient). The consultation rate(case per 1,000 persons) was increased from 1.11 in 1983 to 1.30 in 1985, showing annual increase of 8.22 %. The duration, visiting day, was decreased slightly, but medication day wasincreased from 13.93 in 1983 to 16.72 in 1985, showing annual increase of 9.56%. 7. The male: female ratio of hypertensive disease (case) was 39.36 : 60.64(in-patient) and 40.67 : 59.33 (out-patient). The consultation rate was increased from 19.59 in 1983 to 25.36 in 1985, showing annual increase of 13.78%. Duration, visting day was decreased slightly, but medication day was increased from 11.82 in 1983 to 12.77 in 1985, showing annual increase of 3.94%. 8. The male： female ratio of chronic pulmonary-ischaemic heart disease (case) was 48.90 : 51.10 (in-patient) and 43.66 : 56.34 (out-patient). The consultation rate of chronic pulmonary-ischaemic heart disease was increase from 0.69 in 1983 to 1. 12 in 1985, showing annual increase of 27.40％. Duration, visiting day, was decreased from 2.67 in 1983 to 2.36 in 1985, and medication day was decreased from 0.69 in 1983 to 1.12 in 1985, showing annual decrease of 2.09%. 9. The male: female ratio of cerebrovascular disease (case) was 47.90 : 52.10 (in-patient) and 52.28 : 47.72 (out: patient). The consulatation rate was increased from 2.12 in 1983 to 2.89 in 1985, showing annual increase of 16.76%, Duration, visiting day, was decreased slightly, but medication day was increased from 12. 67 in 1983 to 13.85 in 1985, showing annual increase of 4.55%. 10. In case of artery and capillary disease, the male: female ratio of case was 61.80 : 38.20 (in-patient) and 51.77 : 48.23 (out-patient). But durntion, visiting day, was increased from 3.45 in 1983 to 3.60 in 1985, showing annual increase of 2.15 % and the medication day was increased from 10. 06 to 10.18, showing annual increase of 0.59%.

• 대한가정학회지
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• 제36권7호
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• pp.57-67
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• 1998

This study was to compare the financial status between elderly households - retired vs employed. The sample obtained from 1994 KHPS, and consisted of 628 Korean aged households who are currently married. Statistics employed to analyze the data are mean, frequency, percentile, t-test, and relative-ratio. The results of this study were as follows ; In income sources, earned income was majority of employed households, but the percent of unearned income was greater than retired households. While the percent of cloth, education, recreation expenditures were high in employed, and medical, housing expenditures wee high percentage in retired. The percentage of real asset(housing) was majority of total asset in two groups. And the percentage of safe liquid asset of retired households was relatively higher than employed households.

• 대한방사선치료학회지
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• 제20권2호
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• pp.91-102
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• 2008

목적: 방사선 종양학과 업무와 관련 자료 및 치료기기의 관리를 체계적으로 정리하고 사용하기 쉽게 색인하여 데이터베이스(Database)를 구축함으로써 업무 및 교육을 체계화시켜 업무 효율성을 증대시키고, 새로운 방사선 치료 발전의 기반이 되고자 한다. 대상 및 방법: 데이터베이스의 운영을 위해 마이크로 소프트 엑세스(MS OFFICE ACCESS)프로그램을 이용하였다. 방사선 종양학과 자료들을 업무에 관련된 업무 일지, 기기 관리에 대한 수리 내역 및 부속품의 재고 관리로 분류하였고, 학습 및 연구 자료는 부서 직무 교육 자료와 기기 사용자 지침서 및 관련 논문으로 구분하였다. 모든 자료의 등록은 각각의 주제에 맞도록 입력 폼(form)을 디자인하고, 자료의 정보는 보고서를 작성하여 열람할 수 있도록 설계하였다. 기기 수리 내역에서 2008년 1월부터 2009년 4월까지 고장건수와 유형 및 수리시간을 시스템 사용 초기와 사용 1년 후의 결과를 분석하였다. 결 과: 방사선 종양 자료관리 시스템을 업무에 관련된 영역과 학습 및 연구 활동 영역의 자료들로 완성하였다. 자료들은 주제와 분류에 의해 설명과 함께 정리되어 모아지고, 각 분류에서 원하는 자료를 검색하여 설명을 참고하여 첨부된 자료를 얻을 수 있다. 기기 수리 내역을 통하여 2008년 1월부터 2009년 4월까지 고장 건수 및 고장 유형의 정보를 얻을 수 있었고 수리시간을 분석하였을 때, 전체 평균 32.3%의 시간단축효과를 얻었다. 결 론: 방사선 종양 자료관리 시스템을 통하여 과거와 현재의 자료를 주제별로 분류하고 관련 자료를 정리하여 색인함으로써, 정보 이용이 원활하게 이루어져 업무 효율을 높일 수 있을 뿐만 아니라 업무 프로세스 개선의 기초자료가 되고 앞으로 새로운 방사선 치료에 요구되는 여러 가지 정보를 실시간으로 검색하여 얻을 수 있다.

• Journal of Preventive Medicine and Public Health
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• 제28권2호
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• pp.325-333
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• 1995

Laparoscopic cholecystectomy was introduced into Korea in 1990 and has been rapidly replacing open cholecystectomy when the indications were met. In this study a medical utilization and technology was assessed on the selected hospitalized patients with cholelithiasis who underwent open or laparoscopic cholecystectomy from April 1, 1991 to March 31, 1994. The results are as follows. Despite the low reimbursement rate by the health insurance, the number of laparoscopic cases have been steadily increased. The post-operative days before health insurance coverage were significantly shortened from 8.4 days to 4.6 days. The preoperative days before health insurance coverage were significantly shorted from 8.4 days to 4.0 days. The total length-of-stays in the hospital were also significantly shortened from 15.2 days to 10.7 and 9.8 days in laparoscopic cholecystectomy. The laparoscopic cholecystectomy showed low expenses in all aspects expect the average hospital charges per day. For the hospital to have cost containment, it is more effective if length-of-stay is shorter because of high daily inpatient hospital charge. The laparoscopic cholecystectomy also showed shortened anesthesia time and operation time compared with open cholecystectomy that were statistically significant. The mean anesthesia and operation time for open cholecystectomy were 113.2 and 90.2 minutes but those of laparoscopic cholecystectomy were 105.7 and 68.6 minutes. According to this study the laparoscopic cholecystectomy has reduced the medical expenditure and we recommend this procedure over open cholecystectomy. The further discussion on the different morbidity rate between two types of procedure is essential in providing quality medical care, and to educate specialist.