Kim, Hongsoo;Yoon, Nan-He;Lee, Seyune;Hashimoto, Hideki
Health Policy and Management
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v.30
no.1
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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.
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.
Journal of the Korean Association of Geographic Information Studies
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v.14
no.3
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pp.223-235
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2011
Although ordinary least squares (OLS) regression analysis can be used to examine the spatial relationships between environmental equity and urban quality of life, this global method may mask the local variations in the relationships between them. These geographical variations can not be captured without using local methods. In this context, this paper explores the spatially varying relationships between environmental equity and urban quality of life across the Atlanta metropolitan area by geographically weighted regression (GWR), a local method. Environmental equity and urban quality of life were quantified with an integrated approach of GIS and remote sensing. Results show that generally, there is a negatively significant relationship between them over the Atlanta metropolitan area. The results also suggest that the relationships between environmental equity and urban quality of life vary significantly over space and the GWR (local) model is a significant improvement on the OLS (global) model for the Atlanta metropolitan area.
Park, Young-Yong;Park, Ju-Hyun;Park, Yu-Hyun;Lee, Kwang-Soo
The Korean Journal of Health Service Management
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v.13
no.1
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pp.15-30
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2019
Objectives: This study aimed to analyze people's accessibility to medical institutions providing national gastric cancer screening services in Gangwon-do using a geographic information system(GIS). Methods: To assess the spatial accessibility, network analysis was applied. Two types of network analysis-Service area analysis and origin-destination cost matrix(OD-cost matrix)-were applied to create network dataset. Results: The results of the analysis of the service area revealed that it took more than 60 minutes each to reach tertiary hospitals and general hospitals from 74.4% and 9.6% of Gangwon-do areas, respectively. Similarly, it took more than 60 minutes each to reach hospitals and clinics from 4.2% and 3.4% of Gangwon-do areas, respectively. The results of the OD-cost revealed that there were large regional variations in distance and time taken to reach the medical institutions. Conclusions: there were regional variations of spatial accessibility between Si and Gun in Gangwon-do.
Small area variations in health care utilization have long been studied as an important issue related to boto cost containment and quality assurance. This study was conducted to investigate if variations in hospital services across small geographic areas in Korea existed. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows : 1. Extremal Quotients(EQ) of hospital expenditure per capita and hospital days per capita varied among diagnosis types. The EQ ranged from 2.05(cataract) to 41.67(pneumonia) in hospital expenditure per capita and from 1.86(cataract) to 45.89(pneumonia) in hospital days per capita. The diagnosis groups which showed high variation were pneumonia, cephalo-pelvic disproportion, gastritis and duodenitis, fracture of rib, and acute bronchitis. Those which showed low variation were acute appendicitis and cataract. 2. The EQ level of admission rate was different in terms of diagnosis types, ranging from 2.57(catarct) to 44.45(pneumonia). The variations were high in medical disorders such as pneumonia, oephalo-pelvic disproportion, gastritis and duodenitis and acute bronchitis, while relatively low in surgical conditions such as acute appendicitis and cataract. 3. As an indicator of service intensity, the EQ of expenditure per admission ranged from 1.67(acute appendicitis) to 31.27(essential hypertension). The diagnoses which had high variation were essential hypertension, gastric ulcer, whereas those which had low variation were cephalopelvic disproportion and acute appendicitis. With regard to hospital days per admission, the EQ ranged from 1.55(acute appendicitis) to 28.13(gastric ulcer) by diagnosis types. The diagnosis groups with showed high variation were gastric ulcer, essential hypertension, and acute bronchitis, whereas those with low variation were cephalo-pelvic disproportion, intervertebral disc disorders, and acute appendicitis. Both the expenditure and hospital days per admission showed lewwer variations than the expenditure per capita, hospital days per capita and admission rate. 4. Comparing patterns of variation in utilization indices, diagnoses such as essential hypertension, gastric ulcer, fracture of rib showed higher variations in expenditure per admission than in admission rates, whereas diagnoses such as pneumonia, cephalo-pelvic disproportion and gastric ulcer showed higher variations in admission rate than expenditure per admission. These findings suggest that wide variations existed in several diagnoses groups across small areas in Korea. Further research should be performed to investigate factors related to small area variations including provider behavior.
The gDNA isolated from Cyclina sinensis from Gochang (GOCHANG), Incheon (INCHEON) and a Chinese site (CHINESE), were amplified by PCR. Here, the seven oligonucleotide decamer primers (BION-66, BION-68, BION-72, BION-73, BION-74, BION-76, and BION-80) were used to generate the unique shared loci to each population and shared loci by the three cyclina clam populations. As regards multiple comparisons of average bandsharing value results, cyclina clam population from Chinese (0.763) exhibited higher bandsharing values than did clam from Incheon (0.681). In this study, the dendrogram obtained by the seven decamer primers indicates three genetic clusters: cluster 1 (GOCHANG 01~GOCHANG 07), cluster 2 (INCHEON 08~INCHEON 14), cluster 3 (CHINESE 15~CHINESE 21). The shortest genetic distance that displayed significant molecular differences was between individuals 15 and 17 from the Chinese cyclina clam (0.049), while the longest genetic distance among the twenty-one cyclina clams that displayed significant molecular differences was between individuals GOCHANG no. 03 and INCHEON no. 12 (0.575). Individuals of Incheon cyclina clam population was somewhat closely related to that of Chinese cyclina clam population. In conclusion, our PCR analysis revealed a significant genetic distance among the three cyclina clam populations.
In the present study, muscle tissues were obtained separately from individuals from Atlantic hairtail population (AHP), Gunsan hairtail population (GHP) and Chinese hairtail population (CHP), respectively. The seven decamer primers were used to generate the shared loci, specific, unique shared loci to each population and shared loci by the three hairtail populations. Here, averagely, a decamer primer generated 64.7 amplified products per primer in the AHP population, 55.7 in GHP population and 56.4 in CHP population. The number of unique shared loci to each population and number of shared loci by the three populations generated by genetic analysis using 7 decamer primers in AHP, GHP and CHP population. 119 unique shared loci to each population, with an average of 17 per primer, were observed in the AHP population, and 28 loci, with an average of 4 per primer, were observed in the CHP population. The hierarchical dendrogram point out three main branches: cluster 1 (ATLANTIC 01 ~ ATLANTIC 07), cluster 2 (GUNSAN 08 ~ GUNSAN 14) and cluster 3 (CHINESE 15 ~ CHINESE 21). The shortest genetic distance displaying significant molecular difference was between individuals' CHINESE no. 16 and CHINESE no. 18 (0.045). In the long run, individual no. 01 of the AHP population was most distantly related to CHINESE no. 19 (genetic distance = 0.430). Consequently, PCR analysis generated on the genetic data displayed that the geographic AHP population was widely separated from CHP population, while individuals of CHP population were fairly closely related to those of GHP population.
Temporal and spatial variations of precipitation in South Korea are investigated using 60 observation data of the recent 30-years from 1976 to 2005. The area averaged annual precipitation amount is about 1310 mm and shows a strong spatial variation, maximum at the southern and Kyoungki province (>1300 mm) and minimum at the Kyungpook province(<1100 mm). The precipitation days show a strong spatial variation with maximum at the Sobaik mountain region(>100 days) and minimum at the Kyungpook province (<90 days). The interannual variations (IAV) of precipitation amount and days are more significant at the southern and eastern part of Sobaik and Taebaik mountain, and along the Sobaik mountain, respectively. So, the difference of annual precipitation amount reaches to about 800mm between wet and dry years at the southern part of Korean peninsula. Whereas, the IAV of precipitation intensity is strong at the southern and middle part of South Korea with a minimum between two maxima. Also, seasonal variations are closely linked with the geographic environments (elevation, distance from ocean, location relative to the Taebaik mountain). Therefore, maximum and minimum of seasonal variations of precipitation are occurred at the northern inland region (ratio of summer to the annual precipitation (RSAP) is greater than 60%), eastern and southern coastal regions (RSAP is less than 53%),respectively. And the RSAP is slightly increased from 50% to 55% comparing the Ho and Kang (1988). The consistent and strong positive relation between the heavy rainfalls, the ratio of heavy rainfalls to annual precipitation and the annual precipitation indicates that heavy rainfall is more frequent and strong at the maximum annual precipitation region.
Thais Roding, 1798, commonly known as rock-shell, is among the most frequently found gastropod genera worldwide on intertidal rocky shores including those of Japan, China, Taiwan and Korea. This group contains important species in many marine environmental studies but species-level taxonomy of the group is quite complicated due to the morphological variations in shell characters. This study examined the genetic variations and relationships among three Korean Thais species based on the partial nucleotide sequences of mitochondrial cox1 gene fragments. Phylogenetic trees from different analytic methods (maximum parsimony, neighbor-joining, and maximum likelihood) showed that T. bronni and T. luteostoma are closely related, indicating the most recent common ancestry. The low sequence divergence found between T. luteostoma and T. bronni, ranging from 1.53% to 3.19%, also corroborates this idea. Further molecular survey using different molecular marker is required to fully understand a detailed picture of the origin for their low level of interspecific sequence divergence. Sequence comparisons among conspecific individuals revealed extensive sequence variations within the three species with maximum values of 2.43% in T. clavigera and 1.37% in both T. bronni and T. luteostoma. In addition, there is an unexpectedly high level of mitochondrial genotypic diversity within each of the three Korean Thais species. The high genetic diversity revealed in Korean Thais species is likely to reflect genetic diversity introduced from potential source populations with diverse geographic origins, such as Taiwan, Hong Kong, and a variety of different coastal regions in South China and Japan. Additional sequence analysis with comprehensive taxon sampling from unstudied potential source populations will be also needed to address the origin and key factors for the high level of genetic diversity discovered within the three Korean Thais species studied.
Journal of the Korean Association of Geographic Information Studies
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v.11
no.2
/
pp.1-12
/
2008
This paper identifies public transit-poors and derives spatial characteristics of the poors' distribution in an urban area by utilizing buffering analysis of geographic information systems and remote sensing techniques in the case of Daegu metropolitan city. Since special attention is given to elderlies, this study assigns three hundred meter buffer from bus/subway station as service boundary for elderlies. The results of this study tell us that 1) the transit-poors are concentrated on suburban and rural regions, 2) high proportions of the transit poors are elderlies with spatial variations in many regions, 3) the main housing type of the transit-poors is single detached house. We expect that this study can contribute to build an effective policy-making by showing essential technical processes and methods in identifying policy-need groups and their characteristics of spatial distribution.
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