• Title/Summary/Keyword: low income patients

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The Trend of cataract surgery most common in Koreans and the Occurrence risk factors in middle-aged and older Adults - Focused on National Health Service's Surgical Statistics in 2020 -

  • Seonahr, Cho
    • International Journal of Advanced Culture Technology
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    • v.10 no.4
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    • pp.19-27
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    • 2022
  • The purpose of this study is to investigate the incidence rate, surgery tendency, and risk factors of cataracts among the elderly in Korea. The subjects were 40-95 years old men and women using the National Health Services' surgical statistics. Among the 33 major surgeries, which increased by 1.1% per year for the last 20years (1.6 million), the most operated surgery in 2020 was cataract surgery (454,000), the number of which was 858.8 per 100,000 people. Among the surgical patients, cataract patients (7.9% increased) was the third largest among the top (2016-2020) constantly with annually 2.2% increasing for 20 years (19.95 million). The medical expenses of major surgeries (excluding non-benefit) increased by an average rate of 9.3% per year over the 20 years (7,204 billion won) out of a total medical expenses of 7.2 trillion won, and the cataract surgery (813.2 billion won) was the second largest among the medical expenses in 2020 (top 3). This study showed that there was a high correlation between cataract and smoking, low income, and low-educated, whereas being no concentration of cataract patient in tertiary hospitals.

Evaluation of Nutrient Intakes in the Hemodialysis Patients According to the Socioeconomic Status - In Daejeon and Chungnam Areas - (혈액투석환자의 사회경제적 수준에 따른 영양소 섭취상태의 평가 - 충남지역을 중심으로 -)

  • Chung, Young-Jin;Park, Yoo-Sin;Kim, Han-Sook;Chang, Yu-Kyung;Kim, Chan
    • Journal of Nutrition and Health
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    • v.35 no.5
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    • pp.544-557
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    • 2002
  • This study was performed to evaluate the quality of nutrient intakes of the hemodialysis patients (26 men and 23 women) according to the socioeconomic status by 3-day dietary recall in Daejeon city and Chungnam area, Korea. Mean age of the subjects was 50.7 yrs and BMI was 22.0 $\pm$ 0.4 kg/$m^2$. Education level was divided into two groups ($\leq$ 9 years: LE group, 9 years: HE group), and monthly family income level was divided into three groups (< 500,000 won: LI group, 500,000-1,499,999 won: MI group, $\geq$ 1,500,000 won : HI group). The data were analyzed by Student t-test and Oneway ANOVA using SPSS 9.0 version at p < 0.05 level. Intakes of energy, carbohydrates, cholesterol, potassium, thiamin and riboflavin were significantly higher in HE group than in LE group (p < 0.05). Intakes of all the nutrients except protein and phosphorus were less than Korean RDA, and INQs (Index of Nutritional Quality) of most nutrients were lower than 1.0 but cholesterol, phosphorus. thiamin and niacin being over 1.0 in HE group. MAR (Mean adequacy ratio) of all the nutrients (e.g., energy, protein, calcium, phosphorus, iron, vitamin A, vitamin C, thiamin, riboflavin and niacin) was significantly higher in HE group (0.61 $\pm$ 0.04) than in LE group (0.48 $\pm$ 0.03) at p = 0.036. Intakes of energy, protein (total, animal and plant), fat, cholesterol, potassium, calcium, phosphorus, iron, vitamin A, thiamin and riboflavin were also significantly higher in HI group than in LI and MI group (p < 0.05). Daily intakes of most nutrients were less than Korean RDA except protein ed phosphorus in HI poop, and INQs of thiamin, niacin and phosphorus were higher than 1.0, while those of calcium, iron, vitamin A and riboflavin were lower than 1.0. MAR of energy and 9 nutrients was significantly higher in HI group (0.70 $\pm$ 0.04) than in LI group (0. 56 0.04) and MI poop (0.47 $\pm$ 0.03) at p = 0.000. In conclusion, quality of nutrient intakes, especially energy and protein, was significantly influenced by socioeconomic status such as education and monthly income (p < 0.05). This result suggests that it would be very helpful to develop nutritional education programs considering hemodialysis patients' education levels, and to improve public supports (e.g., medical insurance system, low-rate lease system of dialysis equipments, etc.) focusing on the patients' family income levels f3r their better nutrition and health.

An analysis of factors affecting aspects of disease and satisfied medical treatments for oriental medical users (한방의료(韓方醫療) 이용자의 질병양상(疾病樣相)과 치료만족도(治療滿足度)에 영향(影響)을 미치는 요인분석(要因分析))

  • An Chang-Su;Nam Chul-Hyun
    • Journal of Society of Preventive Korean Medicine
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    • v.3 no.2
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    • pp.101-128
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    • 1999
  • A study on disease treated at oriental medical treatment facilities (OMTF) and patients' satisfaction levels was conducted in order to figure out why the patients visited oriental medical doctors and the level of satisfaction of the patients for the services offered to them by oriental medical doctors. This study was performed from March 2 through May 31, 1998 by interviewing 1.532 persons living in major and small cities in korea. The results obtained were summarized as follows; 1. The general characteristics of subjects. The highest portion of each part was, 66.9% female, persons in the age group of over 60's 22.7%, high school graduated 34.9%, house wife 30.8%, The married 65.0%, Buddhist 36.9%, maj or city residents 60.2%, company covered insurance benefiter 39.0% and etc. 2. 40.5% of subjects visited OMTF for skeletal and connective tissue diseases. 21.5% for digestive system diseases. 16.2% for respiratory system diseases. 13.3% for circulatory system diseases and 9.0% for neurological problems. 3. 42.7% of males visited OMTF for skeletal and connective tissue diseases, which were the highest and respiratory system disorders, digestive system disorders, circulatory system disorders and neurological diseases in order. 39.4% of females visited OMTF for skeletal and connective tissue disorders which were the highest and other conditions such as digestive system, circulatory, respiratory, and neurological disorders in order. 4. The males with circulatory system disorders were treated by herbal medicine, combination of herbal medicine and acupuncture, only in order. The females with the some conditions above were treated by combination of herbal medicine and herbal medical and acupuncture only in order. The males and females with respiratory system and digestive system diseases were treated by herbal medicine, combination of herbal medicine and acupuncture only in order. But the males and females with skeletal and connective tissue diseases were by acupuncture are the highest in order. 5. The females and persons in the age group of over 60' s and house wife. the not married, the unhealthy persons, residents living in small cities, the persons with high income by medical treatments frequency in circulatory system diseases are the highest. 6, The females, middle school graduated and the married, persons in the age group of over 60's, unemployed, sales and service industry workers, Buddhists, major city residents, the unhealthy persons, the persons with middle income by medical treatments frequency in respiratory system diseases are the highest. 7. The females, persons in the age group of over 60's, under graduated or elementary school graduated, the unemployed and house wife, the unmarried, Buddhists, major city residents, the unhealthy persons, the persons with low income by medical treatments frequency in digestive system diseases are the highest. 8. The males, major city residents, old ages, under graduated or elementary school graduated, go earn officials, people grown in small city, the persons who had health insurance policies, the persons with low income, the unhealthy persons by medical treatments frequency in skeletal and connective tissue disorders diseases. 9. 50.8% of the respondents said that the treatments at the OMTF were very effective. 47.7% of them said that the treatments were effective. The males, persons in the age group of 40's, high school graduates, official workes, the married, the persons who did not have religion, major city residents, the persons who had health insurance policies, the persons with high income and the healthy persons said that the treatment effects at OMTF were satisfactory. 10. The patients' satisfaction rate for OMTF on each disease is, 1st. Musculo-Skeletal system(most satisfied), 2nd. the pregnancy & delivery complications, 3rd. Eye & ophthalmics, 4th. Respiratory system, 5th. Mental & bodily disorder, 6th. Digestive system and etc. 11. The factors affect OMTF are age, satisfaction for OMTF, current disease, religion, efficiency of Oriental Medicine, health condition and etc. This explained power of variable were 39.0%. 12. The satisfied factors for OMTF is correlate to educational level, and economical variables.

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Nationwide Study on the Usage and Characteristics of Patients Visiting Korean Medical Facilities - Based on the Treatment of Major Disorders, Effectiveness, Satisfaction and Occurrence Rate of Side Effects From the Ministry of Welfares Report on Usage and Consumption of Korean Medicine in 2011 - (전국민을 대상으로 한 한의원과 한방병원 외래이용환자의 이용실태 및 특성비교연구 - 2011년 한방의료이용 및 한약소비실태조사 보고서(보건복지부)중 이용환자의 질병치료방법 및 치료효과를 중심으로 -)

  • Lee, Sundong;Jo, Jaegoog;Kim, Hyundo;Park, Hae-Mo;Yang, Jun-Mo;Choi, Sung-Yong
    • Journal of Society of Preventive Korean Medicine
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    • v.17 no.2
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    • pp.29-46
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    • 2013
  • A survey conducted on 1,103 patients or caretakers visited Korean medical clinics and hospitals between August 25, 2011 to September 30, 2011 by the Ministry of Health and Welfares and Korea Institute for Health and Social Affairs was analyzed and obtained following results: 1. For sociodemographic distribution, female(813) outnumbered male(290) patients with majority of patients ranging from 30s to 60s. Married patients(793) outnumbered unwed(150) patients and 65.0% with higher than high school education. Statistical significance was seen in gender, age, marital status, and education level but no significant difference for status of employment, income level, and types of insurance between the clinics and hospitals. (P<0.05). 45.1% had less than \2,000,000 in monthly salary and most of coverage was provided by either regional or work insurance. 2. 67.9% of the patients rated health conditions to be better than average and 32.1% listed as poor. People in good health showed tendency to visit Korean medical facilities. Musculo-skeletal conditions such as arthritis, ankle sprain, lumbago, muscular injury, and frozen shoulder were common conditions, followed by gastric disorders, common cold and herbal tonics. No significant difference was observed between the clinics and hospitals for above conditions, but significance was seen in atopic dermatitis, stroke, and sequela from traffic accidents (P<0.05). 3. Ten most common conditions addressed at Korean medical facilities were lumbago, arthritis, muscular injury, back sprain, gastric disorders, ankle sprain, common cold, herbal tonics, frozen shoulder and stroke. Major treatment modalities rendered were herbal medicine, herbal supplements, acupuncture and moxibustion, cupping, tuina, and Korean midical physical therapy. No significant difference existed between the clinics and hospitals. 4. All modalities showed at least 85% effectiveness. No statistical significant difference between the clinics and hospitals except for herbal decoction. (P=0.0452) 5. 88.3% of responses showed treatment satisfaction with significant difference between the clinics and hospitals (P=0.002). The occurrence of side effects was at 2%, mostly corning from treating digestive, skin, kidney disorders and neurological issues. No significant difference was observed between the clinics and hospitals. From the above results, the typical population visiting Korean medical facilities can be summarized as being middle aged female with relatively higher education and moderately low income. The health condition is generally good and the purpose of visit is to receive traditional treatments of acupuncture, herbal medicine, and physical therapy. Treatment efficacy and satisfaction were high with no significant differences between the clinics and hospitals.

The Use and its Affecting Factors of patients aged 30 and over with single and multiple chronic diseases and their usage outpatient Korean medicine clinics - Based on the Ministry of Health and Welfare's 2011 Report on usage of Korean medicine - (30세 이상 한방의료기관 외래환자 중 비복합 및 복합만성질환자의 의료이용과 결정요인 - 2011년 한방의료이용 및 한약소비실태조사보고서(보건복지부)자료를 중심으로 -)

  • Yoon, Jinwon;Choi, Sungyong;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.1
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    • pp.95-107
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    • 2015
  • Objective : To use and its affecting factors of patients' outpatient treatment that have single and multiple chronic illnesses Method : We used the 2011 study by the Ministry of Health and Welfare, "Report on Usage and Consumption of Korean Medicine." This report was conducted on outpatients and inpatients that visited Korean traditional medicine, from August 25th, 2011, to September 30th, 2011. Our research was based on 1729 patients with chronic diseases aged 30 and over who received outpatient treatment during the last three months. Results : There were 1365 patients with non-complex chronic diseases, while there were 364 patients with complex chronis diseases. Patients had 1 - 8 chronic diseases, and the average number (standard deviation) was 1.26 (0.59). There were statistically significant differences by sex(P<0.0001), age(p=0.0045), marriage (p=0.0060), education level(p<0.0001), income level(P=0.0063), and types of health insurance(p=0.0023). The diseases most common among patients with non-complex chronic diseases were: low back pain, arthritis, gastrointestinal disorder, frozen shoulder, side effects from motor accidents, high blood pressure, fracture, stroke, diabetes, cancer, atopic dermatitis, and asthma. The diseases most common among patients with non-complex chronic diseases were: arthritis+low back pain, low back pain+gastrointestinal disorder, low back pain+side effects from motor accidents, low back pain+frozen shoulder, arthritis+gastrointestinal disease, gastrointestinal disease+frozen shoulder, arthritis+low back pain+gastrointestinal disease, high blood pressure+arthritis, arthritis+low back pain+frozen shoulder, arthritis+fracture, and arthritis+side effects from motor accidents. There were statistically significant differences among the usage of medical clinics by: frequently used clinic (p<0.0001), number of treatment (p<0.0001), the cost of outpatient treatment (p=0.0073), the satisfaction rate (p=0.0171), whether the clinic is the preferred clinic (p=0.0040). In model 1, men than women, people who had local benefits instead of type 1 medical aid, and patients with complex chronic diseases were more likely to use Korean medical clinics. In model 2, men than women, people who had local benefits than people with types 1 and 2 medical aids, people who went to pharmacies and Korean medicine pharmacies than people who went to hospitals, people who went to get treatment 1-10 times than people who visited 11-20 times and more than 41 times, and people who spent less than ten thousand Korean won than people who spent 1 to 2 million Korean won, and people without complex chronic diseases were more likely to use Korean medical treatment. Conclusion : There were differences in sociodemographic characteristics and the usage of medical clinics between patients with non-complex chronic diseases and patients with complex chronic diseases. Among patients with complex chronic diseases, women, patients with types 1 and 2 medical aid, patients who used Korean medical clinics, patients who were treated 11-20 times and more than 41 times, and patients who spent 1 million to 2 million Korean won on outpatient treatment used less treatment than patients with non-complex chronic diseases. However, patients with complex chronic diseases used pharmacies and Korean medicine pharmacies more.

The analysis of stress reactions ana coping patterns of cancer patients who perceived stress by radiotherapy. (방사선요법을 받는 암환자의 스트레스 지각에 따른 반응과 대체유형의 분석)

  • BANG DONG WAN;KIM JIN SU;PARK GIL YONG;SON MI SUK
    • The Journal of Korean Society for Radiation Therapy
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    • v.13 no.1
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    • pp.1-13
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    • 2001
  • I. Purpose This study is performed to encourage cancer patients to identify, relieve and effectively overcome the stress caused by radiotherapy, by analyzing stress reactions and coping patterns of cancer patients who perceived stress due to radiotherapy. II. Materials & Methods The study group was composed of 85 cancer patients of the age 20 or higher who were undergoing radiotherapy in four hospitals located in Seoul and Kyonggi-do. The survey questionnaire was used, which had 161 questions inquiring respondents of general status, perceived stress, stress reactions and coping patterns. The surveyed data were analyzed by a SAS program, which employed descriptive statistics. Pearson Correlation Coefficient, t-test, ANOVA and Stepwised Multiple Regression. III. Results The stress perception and reaction rates were low in cancer patients comparing to patients of the other study. In the coping patterns. the problem-focused coping patterns were significantly higher than emotion-focused coping patterns. The statistically meaningful differences were observed in the stress perception and reactions depending on the time of diagnosis and perceived health level. As for the problem-focused coping patterns, significant differences were found depending on age, marital status, education, income and the number of family members as well as perceived health level of patients. The level of perceived stress and that of stress reactions was found to have positively significant correlation(r=.764, p<.001) while the perceived stress and the problem-focused coping patterns was correlated negatively (r=-.288, p<.01). The stress reactions and the problem-focused coping patterns was found to have negatively significant correlation(r=-.289, p<.01). IV. Conclusion The problem-focused coping behavior, which cooperated with doctors, technologists, nurses and families of cancer patients, is advisable for the cancer patients to overcome uncertainty and uneasiness by effectively release the stress.

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Hookworm Infection: A Neglected Cause of Overt Obscure Gastrointestinal Bleeding

  • Wei, Kun-Yan;Yan, Qiong;Tang, Bo;Yang, Shi-Ming;Zhang, Peng-Bing;Deng, Ming-Ming;Lu, Mu-Han
    • Parasites, Hosts and Diseases
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    • v.55 no.4
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    • pp.391-398
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    • 2017
  • Hookworm infections are widely prevalent in tropical and subtropical areas, especially in low income regions. In the body, hookworms parasitize the proximal small intestine, leading to chronic intestinal hemorrhage and iron deficiency anemia. Occasionally, hookworms can cause overt gastrointestinal bleeding, but this is often ignored in heavily burdened individuals from endemic infectious areas. A total of 424 patients with overt obscure gastrointestinal bleeding were diagnosed by numerous blood tests or stool examinations as well as esophagogastroduodenoscopy, colonoscopy, capsule endoscopy or double-balloon enteroscopy. All of the patients lived in hookworm endemic areas and were not screened for hookworm infection using sensitive tests before the final diagnosis. The patients recovered after albendazole treatment, blood transfusion, and iron replacement, and none of the patients experienced recurrent bleeding in the follow-up. All the 31 patients were diagnosed with hookworm infections without other concomitant bleeding lesions, a rate of 7.3% (31/424). Seventeen out of 227 patients were diagnosed with hookworm infections in the capsule endoscopy (CE), and 14 out of 197 patients were diagnosed with hookworm infections in the double balloon enteroscopy (DBE). Hookworm infections can cause overt gastrointestinal bleeding and should be screened in patients with overt obscure gastrointestinal bleeding (OGIB) in endemic infectious areas with sensitive methods. Specifically, the examination of stool specimens is clinically warranted for most patients, and the proper examination for stool eggs relies on staff's communication.

A study on the Family Caregiver Burden for Psychiatric Out-Patients (정신과 외래환자의 자가간호수행 및 가족기능과 가족 부담감의 관계)

  • Kim, Yeon-Hee
    • Research in Community and Public Health Nursing
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    • v.5 no.1
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    • pp.64-80
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    • 1994
  • The purpose of this study was to identify factors affecting family caregiver burden, and to identify the relationship between family caregiver burden and family function /self-care of psychiatric out-patient. These data were collected by questionnaire from September 20 to October 8, 1993. The subjects were 285 family caregiver of psychiatric out-patients. The instruments used in this study were Caregiver Burden Inventory(CBI) by Novak(1989), self-care performing by Yu(1992), and Family APGAR by Smilkstein(1979). The data were analyzed by cronbach's $\alpha$, mean, standard deviation, percentage, t-test, ANOVA, Pearson's correlation coefficient, and Stepwise Multiple Regression with SPSS /pc+ program. The result of this study were as follows ; 1. The means of family caregiver Burden revealed total 2.00, Time-Dependence Burden 78, developmental Burden 2.22, physical Burden 1.90, social Burden 1.43, emotional Burden 2.18, financial Burden 1.51. family caregiver burden score showed moderate level. time-dependence burden showed the highest score and social burden showed the lowest score. 2. The means of family function revealed total 5.67. 7 through high-21.4% (61), low through 3-38.6%(110). family function score showed moderate level. 3. The means of patient's self-care performance revealed total 137.71. self-care performance showed moderate level. 4. A ststistically significant correlation between family caregiver burden and patient's demographic variables, age (F=3.83, p<.01), marrital status(F=3.50, p<.01), job(F=3.17, p<.01), diagnosis(F=4.46, p<.01), income (F=4.46, p<.01). No significant differences between family caregiver burden and prevalent period, religion, sex (p>.05). S. A ststistically significant correlation between family caregiver burden and family's demographic variables, age (F=7.34, p<.01), sex(t=-2.63, p<.01), education level(F=7.61, p<.01), income (F=8.13, p<.01), relation with patient (F=6.92, p<.01), job(F=2.03, p<.05), medical service (F=3.89, p<.05), presence of chronically ill without patient(t=-2.01, p<.05) 6. Family function was the highest factor predicting family caregiver burden(R=.4168, $R^2=.1737$), low education level of family, patient's self-care, family income accounted for 36% in family caregiver burden.

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Effects of Periodontal Disease on Cardio-Cerebrovascular Disease: A Focus on Personal Income and Social Deprivation (치주질환이 심뇌혈관질환 발생에 미치는 영향: 지역결핍과 개인소득을 중심으로)

  • Kim, Min-Young;Shin, Hosung
    • Journal of dental hygiene science
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    • v.17 no.4
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    • pp.375-381
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    • 2017
  • The study aimed to investigate the effects of differences between personal income and social deprivation on the association between cardio-cerebrovascular disease (hypertension, stroke) and periodontal disease. This study used 12 years of cohort data from the Korea National Health Insurance Service covering the years 2002 to 2013. Among the patients aged more than 40 years who had received treatment for periodontal disease 224,067 and 284,730 who had not received treatment for hypertension and stroke, respectively, were included in the analysis. The Kaplan-Meier analysis revealed differences in the rate of treatment for cardio-cerebrovascular disease (hypertension, stroke) according to regional differences, the rate of treatment increased as the composite deprivation index value increased. The difference in treatment rates for cardio-cerebrovascular disease (hypertension, stroke) according to income was found to be higher in the treatment group with low income. This study empirically proved that the association between systemic disease and periodontal disease varies depending on personal income and the regional socioeconomic deprivation level. This shows that the clinical influence of periodontal illness on systemic disease differs according to the personal socio-demographic characteristic and residential area and that an individual's characteristic (income and the regional) needs to be considered along with the patient's clinical intervention in the disease treatment process.

How Much should the Poor Pay for their Health Care Services under the National Health Insurance System? (계층간 진료비 본인부담의 형평성에 관한 연구)

  • Kim, Hak-Ju
    • Korean Journal of Social Welfare
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    • v.56 no.3
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    • pp.113-133
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    • 2004
  • Although National Health Insurance(NHI) in the South Korea has guaranteed access to health insurance coverage to virtually all the people, a significant portion of out-of-pocket spending can create substantial financial burdens for some beneficiaries, particularly those with low incomes. Previous studies have estimated the magnitude of out-of-pocket spending by types of chronic illness or in- and out-patients. Prior estimates, however, have not given a complete picture of the impact of health care costs on lower-income populations. The result from this study shows that 20 percent of beneficiaries in the lowest-income quintile spent more than twelve percent of their household equivalent income out-of-pocket health services, whether they were enrolled in a Health care services or not. In comparison, the beneficiaries in the highest-income quintile level spent only 2 percent of their income out-of-pocket on health care. Also, the regression analysis suggests that age, household income, number of chronic illness, type of hospital in addition to the number of usage may affect the size of out-of-pocket spending.

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