This study aimed to investigate the relationship between dietary acidity load and clinical symptoms in the patients with rheumatoid arthritis (RA). This case-control study examined 55 patients with RA and 215 healthy individuals in a Ravansar non-communicable diseases (RaNCDs) cohort study, Iran. Participants' food intakes were assessed using a validated food frequency questionnaire. The dietary acidity was calculated using potential renal acid load (PRAL), net endogenous acid production (NEAP), and dietary acid load (DAL) scores. The patients with RA were identified based on the self-reporting, medications history, and the approval of the cohort center physician following patients' examination. The odds ratio (OR) of joint stiffness in fully adjusted model was greater in the upper median of dietary acidity than in the lower median (PRAL: odds ratio [OR], 1.18; 95% confidence interval [CI], 0.59-2.36), but there was no statistically significant difference. The OR of joint pain in the upper median of dietary acidity was less than in the lower median in fully adjusted model (PRAL: OR, 0.70; 95% CI, 0.46-1.29), but the difference was not statistically significant. After adjusting potential confounders, people in the upper median of dietary acidity had a higher OR of developing RA than those in the lower median (PRAL: OR, 1.39; 95% CI, 0.70-2.76); however, it was not statistically significant. There was not any statistically significant relationship among dietary acidity and the odds of joint pain, joint stiffness, and developing RA.
This study examined changes in health behavior and prevalence of hypertension and diabetes during five years and analyzed determinants affecting on geographic variations of them. Data from Korean Community Health Survey in the period of 2008 and 2013 with 246 small districts were analyzed. Data were analyzed using convergence tools such as geographic information system tool and decision tree. During the five years period, areas of the increases in smoking and drinking were southwest regions showed increased smoking and areas of increases in physical activity are western regions. Areas of the increases in the prevalence of hypertension were west and south regions and in the prevalence of diabetes were east and north regions. Determinants affecting on regional variations in the prevalence of hypertension and diabetes were drinking, physical activity, obesity, arthritis, depressive symptom and stress. Mental health program should be developed for non-communicable disease. Thus, to decrease the prevalence of hypertension and diabetes, our study emphasized the necessity to develop customized mental health policies according to the region-specific characteristics.
The purpose of this study are ( i ) to examine operating situation of physical therapy department and job satisfaction of physical therapists in health centers, (ii) to analyze utilization patterns and patient satisfaction of physical therapy services among health center visitors, and finally, (iii) to suggest policy implications in facilitating improvement on physical therapy services of health centers. The materials are collected from 105 physical therapists among nationwide health centers and 203 patients of 5 health centers in Pusan, Korea. The survey is conducted from February 13 to March 30, 1996 with a structured self - administered questionnaire. Major results of the study are as follows. First, the result of regression analysis between job satisfaction and affecting factors identify following variables as the significant determinants; self-development(+), job itself(+), and co-worker support (+). Second, the current operating situation of physical therapy department shows such problem as; i )shortage and unstable job security of physical therapists, ii )absence of rehabilitation specialist, iii )lack of understanding on physical therapy of co-workers, iv)shortage of physical therapy equipment and facility, v)burdensome task of physical therapists, and vi) inappropriate purchase process of equipment. Third, patient satisfaction for physical therapy services are revealed relatively high. And the result of regression analysis between patient satisfaction and affecting factors identify following variables as the significant determinants; credibility of physical therapist(+), satisfaction for waiting time(+), cleanliness(+). Fourth, the patients appeal about physical therapy services such problem as; i) shortage of physical therapists, physical therapy equipment, and facility, ii) inconvenient administrative procedure for utilization physical therapy services. Fifth and last, recommendations for the improvement of physical therapy services of health centers are as follows; i )recruiting more physical therapists, ii )regular employment of physical therapists instead of daily use employment, iii )re-arrangement of facility for patient's convenience, iv )establishing reasonable purchasing system of equipment for physical therapy, v) reforming administrative procedure for patient focused care.
Objectives : This study aimed to analyze the characteristics of uninsured herbal medicine(UHM) users and the economic and social barriers of UHM utilization. Methods : We used the Korea Health Panel Data, representative national survey on medical utilization and cost, provided by National Health Insurance Service and Korea Institiute of Health and Social Affairs. The frequency analysis was used to identify the characteristics of the respondents, and the cross-analysis (${\chi}^2-test$) was used to verify the relationship between their characteristics and the usage of UHM. In order to analyze the determinants of using the UHM considering the individual's characteristics, logistic regression analysis and multiple regression analysis were conducted for those who used the Korean medicine (KM) outpatient service in 2015. Results : The usage of UHM was significantly lower for those (1) who's age of 20 to 65; (2) who have the university or higher education degree; (3) who live in Jeju province, and (4) who bought the herbal medicine for other health related purposes. On the other hand, the usage of UHM for those (1) who have the first quintile of household income; (2) who have the chronic respiratory disease; (3) who have been taking the medicine for health promotion purpose for more than 3 months and (4) who have purchased the food which has health promotion function was significantly higher than others. The patients who have chronic musculoskeletal diseases accounted the most among the UHM users. Conclusions : There was the considerable inequality in the usage of UHM among household income groups, which provides policy rationale for UHM to be covered by national health insurance. To facilitate the coverage expansion, restrictive covering model can be considered for children and adolescents, or for patients with muskuloskeletal diseases who have the high demand for UHM.
Background: Catastrophic health expenditure (CHE) occurs when medical expenditure of a household passes over a certain ratio of household income. This research studied the effect of gender on CHE based on Korea Health Panel data. Methods: This study implemented binary logistic regression model to figure out whether gender affects CHE and how different gender groups show pattern of CHE process. With gender, age, marital status, income level, economic activity, membership of private insurance, existence of chronic disease, and self-rated health were included in the model. Results: Results showed that females faced CHE 1.5 times more than males (odds ratio, 1.241). Also, main determinants of CHE in female groups were marital status, while age and economic activity status were significant in male groups. Subgroup analysis displayed that married female under 35 years old are located in intersectionality of CHE including pregnancy and delivery, multiple health risk behaviors, mental stress, and relatively vulnerable social status due to lower income. Meanwhile, both gender above 50 years old faced remarkably high chance of CHE, which seems to be caused by complex health risk behaviors and chronic diseases. Conclusion: Such results implied not only that gender is an important determinant of CHE, but also other determinants of CHE differ according to gender, which suggests a necessity of gender-based CHE support and rescue policy.
Island regions suffer from a shortage of health care in part because they are less developed, they cover a widespread area relative to the population, and due to transportation barriers. The purpose of this study was to assess the level of illness and the magnitude of medical care utilization, and to investigate the determinants of utilization in these area. The data were collected by means of a household survey conducted from February 16 to 25, 1987 on S islands which were selected in consideration of the size of the population, the distance from the main land, and the distribution of health care facilities. The household response rate was 89.1% (491 of 551 households), and 1971 persons were surveyed. The major findings of this study are as follows: 1) The morbidity rate of the island inhabitants was 27.7% during the two weeks, and 25.5 chronic illnesses and 9.1 acute illnesses per 100 persons, were noted. Differences in the magnitude of illness were statistically significant by sex, age, education, and family size. 2) The magnitude of total ambulatory carl utilization was 16.8 visits per 100 persons during the two weeks, which was less than that of other regions; and differences in the magnitude of total ambulatory care were statistically significant by sex, age, education, occupation, and family size. 3) Unmet needs were classified as 56.0% in chronic illnesses and 19.6% in acute illnesses; and differences in unmet needs were statistically significant by sex, age, education, occupation, income, and family size. 4) Statistically significant determinants in medical care utilization included the frequency of acute illness and chronic illness, and income in total utilization; the frequency of chronic illness and acute illness, and medical care insurance in physician visits. 5) According to the results of the path analysis, need factors had the greatest effect on utilization, and predisposing factors had more indirect effects through enabling or need factors than direct effects.
Journal of the Korea Academia-Industrial cooperation Society
/
v.17
no.3
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pp.252-261
/
2016
This study examined the health status of female foreign spouses of multicultural families in Korea. More specifically, this study examined whether within-group difference exists depending on their country of origin in health status as well as determinants of their health status. For the analyses, data from the 2012 National Survey of Multicultural Families was used and a total of 165,451 spouses from China (both Korean-Chinese and Han Chinese), Vietnam, and The Philippines were included. The result showed that Vietnamese and Filipino women were healthier than Korean-Chinese and Han Chinese. The determinants and their size of the effect also varied across four groups of women. The results of this study highlight the importance of understanding immigrant women in the context of their ethnic background for interventions of their health. In addition, understanding their status and experiences in Korea must be in place for immigrant health studies, and potential differences by their country of origin must be considered in the development of health policies and practice.
You, Chang Hoon;Kang, Sungwook;Choi, Ji Heon;Kwon, Young Dae
The Journal of the Korea Contents Association
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v.18
no.10
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pp.99-110
/
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.
Background: Prostate cancer (PC) is one of the leading causes of death, especially in developed countries. The human development index (HDI) and its dimensions seem correlated with incidence and mortality rates of PC. This study aimed to assess the association of the specific components of HDI (life expectancy at birth, education, gross national income per 1000 capita, health, and living standards) with burden indicators of PC worldwide. Materials and Methods: Information of the incidence and mortality rates of PC was obtained from the GLOBOCAN cancer project in year 2012 and data about the HDI 2013 were obtained from the World Bank database. The correlation between incidence, mortality rates, and the HDI parameters were assessed using STATA software. Results: A significant inequality of PC incidence rates was observed according to concentration indexes=0.25 with 95% CI (0.22, 0.34) and a negative mortality concentration index of -0.04 with 95% CI (-0.09, 0.01) was observed. Conclusions: A positive significant correlation was detected between the incidence rates of PC and the HDI and its dimensions including life expectancy at birth, education, income, urbanization level and obesity. However, there was a negative significant correlation between the standardized mortality rates and the life expectancy, income and HDI.
Hugenholtz, Nathalie I.R.;Slutter, Judith K.;Van Dijk, Frank J.H.;Nieuwenhuijsen, Karen
Safety and Health at Work
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v.3
no.3
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pp.199-208
/
2012
Objectives: Although evidence-based medicine (EBM) is a useful method for integrating evidence into the decision-making process of occupational physicians, occupational physicians lack EBM knowledge and skills, and do not have the time to learn the EBM method. In order to enable them to educate themselves at the time and place they prefer, we designed an electronic EBM course. We studied the feasibility and utility of the course as well as its effectiveness in increasing EBM knowledge, skills, and behaviour. Methods: Occupational physicians from various countries were included in a within-subjects study. Measurements were conducted on participants' EBM knowledge, skills, behaviour, and determinants of behaviour at baseline, directly after finishing the course and 2 months later (n = 36). The feasibility and utility of the course were evaluated directly after the course (n = 42). Results: The course is applicable as an introductory course on EBM for occupational physicians in various countries. The course is effective in enhancing EBM knowledge and self-efficacy in practising EBM. No significant effect was found on EBM skills, behaviour, and determinants of behaviour. After the course, more occupational physicians use the international journals to solve a case. Conclusion: An electronic introductory EBM course is suitable for occupational physicians. Although it is an effective method for increasing EBM knowledge, it does not seem effective in improving skills and behaviour. We recommend integrating e-learning courses with blended learning, where it can be used side by side with other educational methods that are effective in changing behaviour.
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