• Title/Summary/Keyword: low income patients

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Utilization of nutrition labels and related factors among patients with diabetes in Korea

  • So-Jung Lee;Mi Ah Han;Jong Park;So Yeon Ryu
    • Nutrition Research and Practice
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    • v.17 no.2
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    • pp.297-306
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    • 2023
  • BACKGROUND/OBJECTIVES: The prevalence of diabetes has continued to increase globally. Changes in eating habits, lack of exercise, increased stress, and aging are major contributors. Glycemic control is the key strategy of diabetes management. The purpose of this study was to analyze the utilization of nutrition labels and related factors among patients with diabetes. MATERIALS/METHODS: Data from the 7th Korea National Health and Nutrition Examination Survey were used. General, health-related, diabetes-related characteristics from 1,587 adults with diabetes history were included. Nutrition label utilization was assessed with awareness and use of nutrition labels and effects on food choice. For statistical analyses, chi-square test and multiple logistic regression analysis were performed. RESULTS: The prevalence of awareness, use, and effects of nutrition labels on food choice among diabetic patients were 48.8%, 11.4%, and 9.6%, respectively. High monthly income, walking frequency, family history of diabetes, younger age at diagnosis, and shorter duration of diabetes were associated with higher nutrition label awareness. Nutrition label use and effect on food choice were higher in women, those with high monthly income, those diagnosed at younger than 45 yrs, those with diabetes for less than 10 yrs, those with meal therapy, or patients who had undergone a fundus examination. CONCLUSIONS: Nutrition label utilization status was low in Korean patients with diabetes. Strategies are needed to promote nutrition label use as a diet management tool for patients with diabetes.

Income-related differences in cancer screening in Korea : Based on the 6th(2014) Korea National Health and Nutrition Examination Survey (소득수준에 따른 암 검진 이용현황 분석: 2014년 국민건강영양조사 자료를 중심으로)

  • Lim, Ji-Hye
    • Journal of Digital Convergence
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    • v.15 no.1
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    • pp.329-338
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    • 2017
  • This study aims to identify factors to affect cancer screening utilization and differences in cancer screening by household income. This research selected 3,393 adults aged ${\geq}40years$ among surveyees from the 6th(2014) Korea National Health and Nutrition Examination Survey. We analyzed state of cancer screening utilization according to general characteristics, life style, health status, income level using descriptive statistics. Logistic regression analysis was used to examine the factors associated with cancer screening utilization. In result, cancer screening rate was significantly different according to household income. And the significant factors associated with cancer screening utilization were sex, age, marital status, education level, economic activity, private insurance, smoking, presence or absence of high physical activity, number of chronic diseases, and household income. This indicates that the effective cancer screening program on the low household income, chronic disease patients is needed, suitable for digital age. We believe that these results will be used positively for the equity of cancer screening utilization, providing the basic materials for the further research on the establishment of the health-related policy.

Value of Nutritional Screening Tools Versus Anthropometric Measurements in Evaluating Nutritional Status of Children in a Low/Middle-Income Country

  • Shaimaa Sayed;Mortada H. F. El-Shabrawi ;Eman Abdelmonaem ;Nehal El Koofy;Sara Tarek
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.4
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    • pp.213-223
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    • 2023
  • Purpose: Pediatric patients in low-income countries are at a high risk of malnutrition. Numerous screening tools have been developed to detect the risk of malnutrition, including the Subjective Global Nutritional Assessment (SGNA), Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and Screening Tool for Risk of Nutritional Status and Growth (STRONGkids). However, anthropometry remains the main tool for assessing malnutrition. We aimed to identify the value of four nutritional screening tools versus anthropometry for evaluating the nutritional status of children. Methods: We conducted a cross-sectional study of 1,000 children aged 1-12 years who visited the outpatient clinic of Cairo University Pediatric Hospital. Each participant was evaluated using anthropometric measurements (weight, length/height, and weight for length/height) as well as the PYMS, STAMP, STRONGkids, and SGNA screening tools. The sensitivities and specificities of these four tools were assessed using anthropometry as the gold standard. Results: Of the patients, 1.7% were underweight, 10.2% were wasted, and 35% were stunted. STRONGkids demonstrated the highest sensitivity (79.4%) and a high specificity (80.2%) for detecting malnutrition compared with weight for height, followed by STAMP, which demonstrated lower sensitivity (73.5%) but higher specificity (81.4%). PYMS demonstrated the lowest sensitivity (66.7%) and the highest specificity (93.5%), whereas SAGA demonstrated higher sensitivity (77.5%) and lower specificity (85.4%) than PYMS. Conclusion: The use of nutritional screening tools to evaluate the nutritional status of children is valuable and recommended as a simple and rapid method for identifying the risk of malnutrition in pediatric patients.

The effect of change of mandatory referral system in an ophthalmology of tertiary care medical institution (의료전달체계 변경이 3차 의료기관 안과에 미친 영향)

  • Kim, Yang-Soo;Yu, Seung-Hum;Oh, Hyohn-Joo;Kwon, Oh-Whoong
    • Korea Journal of Hospital Management
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    • v.7 no.1
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    • pp.88-104
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    • 2002
  • According to the change of mandatory referral system in July 1, 2000, the effect to the medical utilization of outpatient clinic and medical income in ophthalmology of tertiary care medical institute, S Hospital in Seoul was evaluated for 6 months before(1999. 12$\sim$2000. 5) and after(2000. 12$\sim$2001. 5). The results were as follows: 1. The number of outpatients was reduced by 16.6%. The number of patient with blindness low vision, retina, glaucoma increased and that of patient with accommodation refractive error, cataract decreased. 2. The number of cataract patients was reduced by 36.6%. The major location of patient's address was changed to nearer to the hospital. The number of cataract surgery reduced in 4.1%, the waiting time reduced in 42.2%, however surgery time increased in 20.2% and number of postoperative complications increased in 11.4%. 3. The income of outpatient clinic and cataract surgery reduced. Among items of outpatient clinic income, the most increased was ocular examination and the most reduced was injection and drugs. Among items of cataract surgery income, the most increased was operation fee and the most decreased was doctor's fee. In conclusion, for the patient, due to the lowered density of outpatient population more space was provided to the patients with more severe disease entity such as blindness' low vision, retina and glaucoma. For the hospital, the need for the expansion of ophthalmology was not found, however that for creation of the special clinics dealing with more severe disease entity was found. Due to reduced income and increased need of financial investment for the equipment and manpower for the more severe disease entity, the ophthalmology of tertiary care medical institute is faced with financial disaster. It is strongly suggested that the cost of medical practice of more severe disease entity be raised to achieve the success after change of mandatory referral system in ophthalmology.

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Exploring the Factors of Selecting National and Public Hospitals of Hospitalization Service Users (입원의료서비스 이용자의 국공립병원 선택 결정요인)

  • Gil, Mi-Ryeong;Choi, Cheon Geun
    • The Journal of the Korea Contents Association
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    • v.17 no.8
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    • pp.290-300
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    • 2017
  • This study concerns whether the public spirit of medical services, which is the foundational goal of national hospitals, is being realized. To derive results regarding this question, it is necessary to identify the determinants that influence the choice of national hospitals. The data are based on the number of cases of medical service use among the data for 6 years from 2008 to 2013 in the Korea Medical Panel, and the subjects were limited to those who were 18 years old or older. In the final analysis, 14,365 cases of hospitalization service uses were employed. For the research method, Andersen's behavioral model theory was applied, and predisposing, enabling, and individual factors were determined to be variables. Logistic regression analysis was conducted to analyze the determinants of national hospital choice factors. It was found that the rate of use of national hospitals was very low, with 5.23% for hospitalization services. Furthermore, socioeconomically vulnerable people, such as the elderly, low-income people, the national meritorious and medical care beneficiaries, chronic patients, and disabled patients are more likely to choose national hospitals than private hospitals. Therefore, for the appropriate management of medical service use for low-income vulnerable groups, it is necessary to discuss the enhancement of primary medical care in national healthcare.

A Study on the Relationship of Incidence of Facial Palsy with Socioeconomic Factors (안면신경마비의 발생과 사회경제적인 요인과의 관계)

  • Jung, Dal-Lim;Kim, Ji-Hoon;Lee, Seung-Deok;Hong, Seung-Ug
    • Journal of Acupuncture Research
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    • v.28 no.1
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    • pp.117-124
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    • 2011
  • Objectives : Bell's palsy is the most common acute facial paralysis but its causes still unclear. At present, one of the most widely accepted cause is viral infections, and generally socioeconomic factors influence the viral infections. The purpose of this study is to investigate the relationship of incidence of facial palsy with socioeconomic factors. Methods : Seventeen patients with a acute facial palsy, who volunteered and completed all of the assessment measures participated. Using data on 17 participants, we examined the independent contribution of education, income, and occupation to a risk factor of severe facial palsy. Severity of global facial impairment was assessed by the facial disability index (FDI), the house-brackmann facial nerve grading system, WHO quality of life - bref (WHOQOL-BREF) and visual analogue scale (VAS) about discomfort of life. Results : There was no correlation between severity of facial palsy and gender, marriage, education, or occupation. Age greater than 60 years (p<0.05), and low monthly income(p<0.05), poor self-rated health was associated with greater severity of idiopathic facial paralysis. Conclusions : The number of subjects with facial palsy in our study (n-17) was small, and therefore generalization to larger patient populations might be unwarranted. But according to the outcome, we suggest that socioeconomic factors, especially low monthly income influence severity of bell's palsy.

Prevalence of Known Risk Factors in Women Diagnosed with Breast Cancer at Inmol Hospital, Lahore, Punjab

  • Mansha, Muhammad;Saleem, Maryam;Wasim, Muhammad;Tariq, Muhammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.563-568
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    • 2016
  • Background: Breast cancer is the most prevalent cancer in women worldwide and its frequency is increasing gradually in many countries. Over the last three decades an increase in the breast cancer has been witnessed in the earlier low-risk Asian countries including Pakistan. Purpose: The objective of the current study was to assess the prevalence of known risk factors like early menarche, late menopause, socio economic, reproductive and demographic factors, among women diagnosed with breast cancer at INMOL hospital, Lahore, Punjab, as little information exists in this regard. Materials and Methods: A survey study was conducted on 200 women diagnosed with breast cancer who were seen at Institute of Nuclear Medicine and Oncology (INMOL) hospital, Lahore. A structured questionnaire was administered to these patients regarding the known risk factors through face to face interviews after obtaining appropriate consent. Results: Regarding non-modifiable risk factors, our study showed that majority of the breast cancer patients were diagnosed at 35-45 years (32.5%) or at older age (${\leq}46$) and experienced menarche at 12 years or older (66 %). Likewise, a large number of patients reached menopause at the age of 45 years (60%), had no family and personal history of breast cancer (80%) and hence fell in a low risk category. Regarding modifiable risk factors in women diagnosed with breast cancer, most of the patients fell in low risk strata as the majority were married (98%) at young age, breastfed their children for 12 months or more (88%) and bore two to three children (80%). Considering income criteria, the majority of the patients had a low risk profile as they belonged to middle class (70%), urban area (60%) and were house wives (80%). However, it was noted that a considerable number of women (34%) diagnosed with breast cancer experienced menarche at an early age (<12) and reached menopause after the age of 45 years. This situation is further augmented by environmental changes and dietary habits and places them in a high risk category.

Effects of Nutrition Education on Improvement of Blood Glucose in Type 2 Diabetic Patients with Low Income (저소득층 당뇨병 환자의 영양교육을 통한 혈당개선 효과)

  • Lim, Eun-Jin;Kim, Mi Jeong;Han, Ji-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.1
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    • pp.141-150
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    • 2014
  • This study was carried out to investigate the effects of nutrition education on blood glucose in type 2 diabetic patients with low income. There were 50 (27 male and 23 female) study subjects with type 2 diabetes under national medical support, and the monthly income in most of them was less than 500,000 won. Anthropometric measurement, biochemical blood indices, food intake, dietary habits, and nutrition knowledge of the subjects were investigated before nutrition education. Nutrition education was conducted 6 times within 12 weeks. After nutrition education, the glycosylated hemoglobin was significantly decreased (male: $8.4{\pm}1.6%$ to $8.0{\pm}1.7%$, female: $8.3{\pm}1.6%$ to $8.0{\pm}1.3%$) and the total cholesterol was also significantly decreased in both groups. The group of female resulted in a significant decrease in fasting blood glucose ($169.7{\pm}28.2$ mg/dL to $152.8{\pm}22.0$ mg/dL) and triglyceride ($177.8{\pm}56.3$ mg/dL to $162.3{\pm}36.1$ mg/dL), but the group of male did not show a significant decrease in fasting blood glucose and triglyceride. Nutritional knowledge and dietary habit scores of the subjects were significantly improved after nutrition education. The results demonstrate that nutrition education for type 2 diabetic patients with low income are effective in improving their blood glucose.

Smoking Cessation Treatment and Outcomes in Medium to Heavy Cigarette Smokers being Treated for Cancer in Jordan

  • Hawari, Feras Ibrahim;Obeidat, Nour Ali;Ayub, Hiba Salem;Dawahrah, Sahar Sattam;Hawari, Saif Feras
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6875-6881
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    • 2013
  • Background: Studies evaluating smoking cessation treatment outcomes in cancer patients are scarce, despite smoking cessation importance in cancer care. We sought to add to the literature by evaluating smoking cessation in a challenging group of cancer patients (medium-to-heavy smokers) visiting an out-patient smoking cessation clinic (SCC) in a cancer center in Amman, Jordan. Materials and Methods: Patients smoking >9 cigarettes per day (CPD) and referred to the SCC between June 2009 and May 2012 were studied. Clinic records were reviewed to measure demographic and baseline clinical characteristics, and longitudinal (3-, 6- and 12- month) follow-up by phone/clinic visit was conducted. At each follow-up, patients were asked if they experienced medication side-effects, if they had returned to smoking, and reasons for failing to abstain. Descriptive and multivariable logistic regression analyses were performed. Results: A total of 201 smokers were included in the analysis. The 3-month abstinence was 23.4% and significantly associated with older age, being married, and presenting with lower (${\leq}10ppm$) baseline carbon monoxide (CO) levels. On a multivariable level, lower CO levels, a higher income (relative to the lowest income group), being older, and reporting severe dependence (relative to dependence reported as 'somewhat' or 'not') were significant predictors of higher odds of abstinence at three months. Reasons for failing to quit included not being able to handle withdrawal and seeing no value in quitting. Long-term ARs did not reach 7%. Conclusions: In a sample of Jordanian smokers (>9CPD) with cancer and receiving smoking cessation treatment, ARs were low and further declined with time. Results underscore the need for more aggressive patient management and rigorous follow-up during and after smoking cessation treatment, particularly when this takes place in challenging settings. Observed reasons for failure to abstain should be used to tailor counseling practices.

The socioeconomic impact of Korean dental health insurance policy on the elderly: a nationwide cohort study in South Korea

  • Seo, Hyewon;Lee, Bo-Ah;Lim, Hyunsun;Yoon, Joon-Ho;Kim, Young-Taek
    • Journal of Periodontal and Implant Science
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    • v.49 no.4
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    • pp.248-257
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    • 2019
  • Purpose: The purpose of this retrospective study was to investigate the relationships of types of dental insurance coverage in Korea with sociodemographic characteristics and the prevalence of systemic and oral diseases, as well as to evaluate the socioeconomic impact of Korean dental insurance policies. Methods: Sample cohort data from 2006 to 2015 were obtained from the National Health Insurance Service. Patients were divided into 2 groups. The exposed group comprised patients who received insurance benefits for complete dentures, removable partial dentures, and implant care, while the control group comprised patients who did not receive these benefits. The type of insurance coverage and the prevalence of systemic and oral diseases were compared between the 2 groups. Results: Patients who received benefits in the form of complete dentures, removable partial dentures, and implants had similar sociodemographic characteristics in terms of sex, age, income quintile, and type of insurance coverage to the control group. The prevalence of hypertension, anemia, renal disease, rheumatoid arthritis, osteoporosis, asthma, and cerebral infarction was higher in the exposed group than in the control group (P<0.05). The prevalence of periodontal diseases and dental caries was also higher in the exposed group. Conclusions: Korean dental health insurance policy has been beneficial for the medical expenses of low-income and elderly people suffering from a cost burden due to systemic diseases. However, since there is a tendency to avoid invasive interventions in older patients due to the high risk of systemic diseases, insurance coverage of dentures may be more helpful from a socioeconomic perspective than coverage of dental implant treatments.