• Health Policy and Management
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• v.29 no.3
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• pp.288-302
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• 2019

Background: The one-person households (OPH) are rapidly increasing and vulnerable to socioeconomic and health problems. Because it is predicted to be inequitable to health care utilization, we would like to find out about the equity of health care utilization of the OPH by comparison with the multi-person households (MPH). Methods: This study followed the theoretical framework of Wagstaff and van Doorslaer (2000), O'Donnell and his colleagues (2008), where the horizontal inequity index is the difference between the concentration indices of actual health care utilization and health care needs. This study employed the 9th Korea Health Panel survey, and a total of 10,807 cases were analyzed. Health care needs were measured by age, sex, subjective health status, chronic disease count, Charlson's Comorbidity Index, limitation of activities, and disability. Results: Compared with the MPH, there were pro-poor inequities in hospitalization, emergency utilization, hospitalization out-of-pocket payments, and pro-rich inequities in outpatient out-of-pocket payments for the OPH. The decomposition of the concentration index revealed that chronic disease count made the largest contribution to socioeconomic inequality in outpatient utilization. Age, health insurance, economic activities, and subjective health status also proved more important contributors to inequality. The variables contributing to the hospitalization and emergency utilization inequity were age, education, Charlson's Comorbidity Index, marital status, and income. Conclusion: Because the OPH was more vulnerable to health problems than the MPH and there were pro-poor inequities in medical utilization, hospitalization, and emergency costs, it is necessary to develop a policy that can correct and improve the portion of high contribution to medical utilization of the OPH.

• The Journal of Korean Society for School & Community Health Education
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• v.23 no.3
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• pp.1-13
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• 2022

Objectives: The purpose of this study is to identify the life satisfaction of women with disabilities and the factors affecting their life satisfaction to improve their quality of life. Methods: This study used secondary data, the 2020 Survey of the Disabled. The subjects were 2,725 women with disabilities aged 20 or older who responded to the survey. The SPSS Windows 26.0 program was used for data analysis. Technology analysis, chi-test, and multi-logistic analysis were performed to identify the factors affecting the life satisfaction of women with disabilities. Results: Age, education level, marital status, type of medical insurance type, subjective economic status, disability severity, subjective health status, health screening, chronic disease, stress, depression, suicidal ideation, and variables that can go out alone. As a result of multi-logistic regression analysis on factors affecting life satisfaction of women with disabilities, it was analyzed that education level, marital status, subjective economic status, subjective health status, health screening, chronic disease, stress cognitive status, depression, suicide ideation, and variables that can go out alone had a statistically significant effect. Conclusion: Based on the analysis results of this study, it is required to develop and operate health education and health promotion programs for physical and mental health management of women with disabilities.

• Journal of Korean Academy of Nursing
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• v.37 no.2
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• pp.242-248
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• 2007

Purpose. Parkinson's disease (PD) is a common neurodegenerative disorder characterized by motor disabilities and increasing dependence on others for daily life activities with consequent impact on patients' and caregivers' quality of life. The aim of this study was to elucidate the burden on primary caregivers of patients with PD, and identify related factors. Methods. A cross-sectional descriptive study. Seventy-six primary caregivers of PD patients in a neurology out-patient clinic, Seoul, Korea completed structured questionnaires, of which 68 were analyzed. The structured self-report questionnaire included (1) demographic information on the caregivers, (2) information regarding the disease characteristics of the patients, and (3) the subjective and objective caregiver burdens as assessed on Montgomery, Gonyea, & Hooyman's scale. Results. The mean age of the caregivers was 54.56 years, and spouses represented the largest proportion (47.0%). Caregivers of PD patients experienced high levels of burden (mean scores on the subjective and objective burdens were 45.22 and 34.90, respectively), which were comparable to the caregiver burdens in stroke, and higher than the caregiver burdens in general chronic disease. Older caregivers and spousal caregivers experienced significantly higher burdens (p=.004 and p=.019, respectively). A greater motor disability and higher modified Hoehn and Yahr grade were related to higher caregiver burden (p=.001 and p=.018, respectively). Conclusion. Caring for PD patients is associated with a high level of caregiver burden. Therefore, healthcare professionals should identify the burden of caregivers who look after PD patients and develop comprehensive management strategies both for patients and their caregivers.

• Tuberculosis and Respiratory Diseases
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• v.61 no.2
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• pp.121-128
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• 2006

Background: The "health-related quality of life" (HRQL) for patients with chronic respiratory disease has been emphasized, because chronic respiratory disease (CRD) is chronic and progressive, and it finally causes disability. HRQL instruments may be useful for monitoring patients' progress or for determining the most appropriate choice of treatment. We describe the adapting St George's Respiratory Questionnaire (SGRQ), which is a self-administered questionnaire developed by Jones et al. (1991), into the Korean version for covering three domains of health for the patients suffering with airways disease. Method: We obtained the original SGRQ from the author after gaining permission. For adaptation, we created an expert panel and translated the original questionnaire into Korean language. The translated questionnaire was then back-translated by bilingual experts and we compared it with the original questionnaire. After correction and feasibility testing, 74 patients with chronic respiratory disease (COPD, asthma, destroyed lung) completed the Korean version of the SGRQ. The clinical status of each patients was evaluated concurrently with measurement of their health status. Result: The Korean version of the SGRQ was acceptable and easy to understand. Cronbach's alpha reliability coefficient was 0.92 for the overall scale and 0.63 for the "Symptoms", subscale, 0.87 for the "Activity", subscale, and 0.89 for the "Impacts" subscales. The correlation coefficients between the overall score and the Borg scale score, oxygen saturation, and forced expiratory volume in one second ($FEV_1$) were 0.52, -0.32 and -0.26, respectively. These results support that the Korean SGRQ was correlated with other measurements. Conclusion: The Korean SGRQ was reliable and valid for patients with chronic respiratory disease, such as COPD, asthma, and destroyed lung. The SGRQ score was well correlated with other respiratory measurements as well. Although further studies should complete the adaptation work, our results suggest that the SGRQ may be used in Korea and also for international studies involving Korean CRD patients.

• Journal of muscle and joint health
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• v.10 no.2
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• pp.167-187
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• 2003

Ankylosing spondylitis(AS) is one of the most common forms of chronic arthritis causing pain and progressive disability. The purposes of this study were 1) to develop an offline educational program and online educational program for the patients with ankylosing spondylitis; and 2) to test the effectiveness of each program in terms of changes in ankylosing spondylitis self-efficacy, exercise continuity disease activity, physical functioning, and depression. The convenient samples for three groups were selected acceding to the inclusion criteria. Online education group consists of 7 patients, and 14 patients were included for the offline group, while 12 patients were assigned to the control group. Outcomes variables included self efficacy, exercise continuity, disease activity, physical function, and depression and the reliability of each measure was ranged from .88 to .95 in the present study. The offline educational program demonstrated positive effects on self-efficacy, exercise continuity, disease activity, and depression, whereas the online educational program on exercise continuity, disease activity, and depression. The self-efficacy was showed positive effect only in the offline educational program, whereas physical functioning did not improve in both intervention groups. These partial improvements may be due to the small sample size and the methods of online education program. In conclusion, the effectiveness of the offline and online educational programs was partially supported in the present study. For the improvement of these programs, the further study would be necessary to apply this kind of intervention program with larger sample and to test the psychometric of the newly development tools.

• Tuberculosis and Respiratory Diseases
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• v.70 no.4
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• pp.307-314
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• 2011

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability worldwide and one of the most prevalent diseases in Korea. We examined trends and risk factors of health care utilization for COPD in Korea. Methods: We retrospectively analyzed the database of Patient Surveys from 1990 through 2008, which were nationwide surveys of health services utilization through outpatient department (OPD) visits and hospitalization. Physician-diagnosed COPD patients whose ages were 45 years and older were included. Results: OPD visits and hospitalization of COPD patients between 1990 and 2008 were estimated to be 68,552 and 17,774 persons, respectively. Trends in OPD visits and hospitalization for COPD significantly increased from 1990 through 2008 (p=0.019, p=0.001, respectively). The increment rate for OPD visits was 2.0 fold over those years; for hospitalization it was 3.3 fold. Risk factors for OPD visits for COPD were male gender (odd ration [OR], 1.41; 95% confidence interval [CI], 1.39~1.43), those aged 65 years and older (OR, 1.50; 95% CI, 1.47~1.53), residential area other than a metropolis (OR, 1.08; 95% CI, 1.07~1.010) and access to a physician's office (OR, 1.17; 95% CI, 1.14~1.21). Risk factors for hospitalization were male gender (OR, 2.15; 95% CI, 2.07~2.23), those aged 65 year and older (OR, 2.86; 95% CI, 2.72~3.00), residential area other than a metropolis (OR, 1.98; 95% CI, 1.90~2.07) and access to a hospital (OR, 2.88; 95% CI, 2.59~3.22) (p<0.001, both). Conclusion: Health care utilization for COPD subjects increased from 1990 to 2008. Risk factors for the utilization were male gender, older age, and residential area other than a metropolis.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.103-114
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• 2001

Tourette's disorder is a disease which manifests one or more motor tics and vocal tics for more than a year. Chronic motor tic or vocal tic disorders are characterized by only one kind of tics for more than a year. We intended to investigate the clinical characteristics of the patients with chronic motor tic disorders or Tourette's disorders who had admitted from May 1, 1998 to May 1, 1999 to Seoul National University Hospital Child and Adolescent Psychiatry ward. In addition, we compared the clinical characteristics of the patients in order to elucidate the relationship between the two disorders. The patients with learning disabilities were selected as controls. There was no statistically significant difference between the onsets of the patients with chronic motor tic disorders(n=13, $7.3{\pm}2.5$ years), and Tourette's disorder(n=39, $7.2{\pm}2.2$ years), but with learning disability($4.2{\pm}1.9$ years). Also, the patients with chronic motor tic disorder and Tourette's disorder showed similar age at admission($11.7{\pm}2.7$ versus $11.5{\pm}2.6$ years), duration of admission($5.7{\pm}5.4$ versus $11.0{\pm}8.7$ weeks), mothers' ages at child birth($27.3{\pm}2.9$ versus $28.3{\pm}6.7$ years old),and fathers' age at child birth($32.2{\pm}3.2$ versus $33.3{\pm}5.2$ years old). We observed that those who had learning disabilities were alike in those aspects, except for age at visit to clinic($9.8{\pm}3.2$ years old). Family history of psychiatric illnesses(24.1% versus 46.2%), recognized precipitating factors(11.1% versus 35.7%) and response to pharmacological treatments(77.8% versus 76.9%) of the patients with chronic motor tic disorders and Tourette's disorders were observed and no differences were found. Comorbid patterns of diseases were noted. Intrafamilial conflicts were more common in the patients with learning disabilities than those with chronic tic disorders or Tourette's disorders. Precipitating factors were observed more frequent in chronic tic disorder and Tourette's disorder than learning disability. Neurocognitive profiles were investigated, and verbal IQs of the patients with chronic motor tic disorder, Tourette's disorder and learning disability were $92.3{\pm}10.7$, $94.7{\pm}14.9$, $94.3{\pm}13.8$, performance IQs $93.0{\pm}20.5$, $97.5{\pm}13.0$, $95.0{\pm}16.9$ and full-scale IQs $91.9{\pm}20.1$, $95.8{\pm}14.5$, $93.9{\pm}15.1$, respectively, which were found to be not significantly different. No difference was found in structural neurological abnormalities and EEG profiles. The patients with learning disabilities showed more common Bender-Gestalt test abnormalities. In conclusion, we have not found any affirmative clues for the division of chronic motor tic disorder and Tourette's disorder in clinical perspective.

• The Journal of the Korea Contents Association
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• v.18 no.10
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• pp.99-110
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• 2018

As interest in adolescent and children's health risks increases, there is an increase in subscriptions to indemnity private health insurance. The purpose of this study was to investigate determinants of purchasing indemnity private health insurance. We conducted panel logit regression analysis on the sample of 4,567 adolescent and children using Korean Health Panel data from 2009 to 2015. As a result, it was analyzed that the participation of private health insurance for children and adolescents was affected not only by the characteristics of children and adolescents (age, birth order, residence, disability) but also by the characteristics of father (indemnity, disability, chronic disease) and mother (age difference between her and her children, indemnity, unmet needs) and the economic level of households (income). In views of this study, it is necessary to continuously implement policies to strengthen the healthcare of children and adolescents in order to alleviate the anxiety about the health risks of children and the burden of medical expenses caused by late marriages and maternal births. In particular, it is necessary to consider policies for multi-child families and vulnerable classes.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.1
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• pp.284-290
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• 2020

This study was undertaken to determine the effects of SNAGs (sustained natural apophyseal glides) and visual convergence biofeedback on the proprioception and neck disability of patients with chronic neck dysfunction. A total of 31 patients with neck dysfunction were assigned to either SNAGs (n = 16) or biofeedback (n = 15). The groups were assessed for proprioception and neck disability, before and after the intervention. The SNAGs were performed using belt with flexion, extension and right-left rotation, whereas biofeedback training included visual feedback training with deep neck flexor. Intervention was implemented for 20 minutes, twice a week for 4 weeks. Biofeedback training a showed significant effect on the joint position sense (left and right rotation) as compared to the SNAGs group (p< 0.05), whereas neck disability index was significantly effective for SNAGs (p< 0.05). Ed. Notes: The previous statement lacked clarity. I have suggested the edit as per my understanding. Please review and revise appropriately, if required. Therefore, the SNAGs technique is effective for neck function, and biofeedback training is a positive intervention method for enhancing the proprioceptive sensation. In future studies on patients with neck pain, it may be possible to select an intervention method based on the characteristics of the disease.

• 한국노년학
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• v.31 no.1
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• pp.143-155
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• 2011

Disabled elderly faced with disability and the aged problems at the same time. So, this research creates two research questions and examines. First research question is how nine dimensions of daily life satisfaction according to gender difference. Second research question is how the factor of daily life satisfaction by gender difference. The data is sixty-five disabled elderly, 386 among Panel Survey of Employment for the Disabled(PSED, 2008). The methods of analysis for identifying research questions is t-test and multiple linear regression. The result of analysis on first research question, the gender difference six dimensions among nine dimensions of daily life satisfaction come out statistically significant. And The result of analysis on second research question, come out statistically significant, too. Socioeconomic status: the lower class, physical condition: bad health, chronic disease is or not, family and other people's social supports, disability: serious turn out to be factors in common. It has been suggested social policies from the results of studies that the provision of health support policy and program, enlarge assistance on daily life, support system on serious disabled elderly. On the other hand, analysis showed that distinctive factors between disabled elderly man and woman was age and education level. In other words, disabled elderly woman come out into the open that the more grow old, the less daily life satisfaction low, while disabled elderly man appeared higher daily life satisfaction in case of junior and senior high school graduate than uneducated.