• Health Policy and Management
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• v.25 no.4
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• pp.285-294
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• 2015

Background: Suicide is one of important health problems in Korea. Previous studies showed factors associated with suicide in individual levels. However, suicide was influenced by society that individuals belong to, so it was required to analyze suicide in local levels. The purpose of this study was to analyze the regional disparities of suicide mortality by gender and the association between local characteristics and suicide mortality. Methods: This study included 229 city county district administrative districts in Korea. Age- and sex-standardized suicide mortality and age-standardized suicide mortality (male/female) were used as dependent variables. City county district types, socio-demographics (number of divorces per 1,000 population, number of marriages per 1,000 population, and single households), financial variable (financial independence), welfare variable (welfare budget), and health behavior/status (perceived health status scores and EuroQol-5 dimension [EQ-5D]) were used to represent the local characteristics. We used hot-spot analysis to identify the spatial patterns of suicide mortality and negative binomial regression analysis to examine factors affecting suicide mortality. Results: There were differences in distribution of suicide mortality and hot-spot regions of suicide mortality by gender. Negative binomial regression analysis provided that city county district types (city), number of divorces per 1,000 population, financial independence, and EQ-5D had significant influences on the age- and sex-standardized suicide mortality per 100,000. Factor influencing suicide mortality was the number of divorces per 1,000 population in both male and female. Conclusion: Study results provided evidences that suicide mortality among regions was differed by gender. Health policy makers will need to consider gender and local characteristics when making policies for suicides.

• Journal of Trauma and Injury
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• v.35 no.4
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• pp.268-276
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• 2022

Purpose: Rib fractures are common injuries that can lead to morbidity and mortality. Methods: Data on all patients with rib fractures admitted to a single trauma center between January 1, 2008 and December 31, 2018 were reviewed. Results: A total of 1,671 admissions for rib fracture were examined. Patients' median age was 57 years, the median Injury Severity Score (ISS) was 14, and the median number of fractured ribs was three. The in-hospital mortality rate was 4%. Age, the number of rib fractures, and Charlson Comorbidity Index scores were poor predictors of mortality, while the ISS was a slightly better predictor, with area under the receiver operating characteristic curve values of 0.60, 0.55, 0.58, and 0.74, respectively. Multivariate regression showed that age, ISS, and Charlson Comorbidity Index score, but not the number of rib fractures, were associated with significantly elevated adjusted odds ratios for mortality (1.03, 1.14, and 1.28, respectively). Conclusions: Age, ISS, and comorbidities were independently associated with the risk of mortality; however, they were not accurate predictors of death. The factors associated with rib fracture mortality are complex and cannot be explained by a single variable. Interventions to improve outcomes must be multifaceted.

• Quality Improvement in Health Care
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• v.7 no.2
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• pp.218-228
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• 2000

Background : Among 'structure', 'process' and 'outcome' approaches, outcome evaluation is considered as the most direct and best approach to assess the quality of health care providers. Risk-adjustment is an essential method to compare outcome across providers. This study has aims to judge performance of hospitals by severity adjusted mortality rates of coronary artery bypass graft (CABG) surgery. Methods : Medical records of 584 patients who got the CABG surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups was used to quantify severity of patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex. For evaluation of hospital performance, we calculated ratio of observed number to expected number of deaths and z score [(observed number of deaths - expected number of deaths)/square root of the variance in the number of deaths], and compared observed mortality rate with confidence interval of adjusted mortality rate for each hospital. Results : The overall in-hospital mortality was 7.0%, ranged from 2.7% to 15.7% by hospital. After severity adjustment the mortality by hospital was from 2.7% to 10.7%. One hospital with poor performance was distinctly divided from others with good performance. Conclusion : In conclusion, severity-adjusted mortality rate of CABG surgery might be applied as an indicator for hospital performance evaluation in Korea. But more pilot studies and improvement of methodologies has to be done to use it as quality indicator.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.279-294
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• 1996

This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are : 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. We concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard e proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study. However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.

• Asian Journal of Atmospheric Environment
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• v.11 no.2
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• pp.61-70
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• 2017

This study evaluated the human health risk in terms of the excess number of mortality and morbidity in the megacity Mumbai, India due to air pollution. AirQ software was used to enumerate the various health impacts of critical pollutants in Mumbai in past 22 years during 1992-2013. A relationship concept based on concentration-response relative risk and population attributable-risk proportion was employed by adopting World Health Organization (WHO) guideline for concentrations of air pollutants like $PM_{10}$, $SO_2$ and $NO_2$. For the year 1992 in Mumbai, it was observed that excess number of cases of total mortality, cardiovascular mortality, respiratory mortality, hospital admission due to COPD, respiratory disease and cardiovascular disease were 8420, 4914, 889, 149, 10568 and 4081 respectively. However, after 22 years these figures increased to 15872, 9962, 1628, 580, 20527 and 7905 respectively, but all of these reached maximum in the year 2006. From the result, it is also noted that except COPD morbidity the excess number of cases from 1992-2002 to 2003-2013 increased almost by 30%; and the excess number of mortality and morbidity is basically due to particulate matter ($PM_{10}$) than due to gaseous pollutants.

• Korean Journal of Organic Agriculture
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• v.26 no.3
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• pp.453-462
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• 2018

This study was conducted to compare the mortality number of swine between before and after HACCP implementation on different scales of swine farm. The study was carried out by randomly selected sixty swine farms (twenty small, twenty midium and twenty large scales of farm) located in all around Korea. The results were as follows: In small scale swine farm, The mortality number due to respiratory, diarrhea and accidental death tended to be decreased compared to before HACCP implementation. In the case medium scale farm, the mortality number due to diarrhea significantly decreased after HACCP compared to before HACCP. Also, in both medium and large scale farms, the number of total mortality number significantly decreased with HACCP implementation. We believe that this effect is considered to be due to the operation of the HACCP prerequisite program. We are expecting that our results might be used for producing safer livestock products by improving livestock products HACCP policy.

• Research in Community and Public Health Nursing
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• v.23 no.1
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• pp.31-39
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• 2012

Purpose: The purpose of this paper was to compare community health status by region and to investigate related factors using community health and social indicators. Methods: Data were collected from statistics of local districts that were provided by KNSO and KCDC. ANOVA and correlation were analyzed using PASW 18.0. Results: The standardized cancer mortality rate was higher in metropolitan areas than in other areas. On the contrary, the mortality of respiratory disease, traffic accident, and suicide were higher in rural areas. Small cities and county districts showed higher prevalence in obesity prevalence than metropolitan areas. Metropolitan areas presented higher prevalence in alcohol drinking during the previous month, perceived stress, and seat belt use. The age-adjusted standardized mortality rate was correlated with higher prevalence of smoking, obesity, percentage of the elderly, number of beds, number of social welfare facilities, number of registered cars, lower percentage of financial independence, number of doctors, and percentage of water supply service & sewage. Conclusion: Since significant differences in mortality rate and prevalence of health risk behaviors exist between regional areas and the mortality rate was correlated with other social indicators and health indicators, health policies and social policies considering these differences should be develop and implemented to the communities.

• Korean Journal of Health Education and Promotion
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• v.32 no.3
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• pp.11-22
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• 2015

Objectives: This study was to examine the influences of community characteristics on the mortality rates. Community characteristics included socioeconomic environmental characteristics, health care resources, and health lifestyle practice. Methods: This study used secondary data whose units of analyses were 249 administrative districts. Mortality rates were estimated with hierarchical regression models entered in the order of (1) socioeconomic environmental characteristics, (2) health care resources, and (3) health lifestyle practice. Results: About 70% of mortality rate was explained by socioeconomic environmental characteristics, health care resources, and health lifestyle practice. In particular, socioeconomic environmental characteristics showed the strongest impact on mortality rate. Among socioeconomic characteristics, community with lower rate of households headed with college or more, lower number of inhabitants per on-premise license, higher rate of population in poverty, and rural region showed higher mortality rate. Among health care resources, community with higher number of inhabitants per doctor and lower number of inhabitants per hospital bed showed higher mortality rate. Among health lifestyle practice, community with higher current smoking rate and lower moderate physical activity practice rate showed higher mortality rate. Conclusions: The results suggest that policy makers should take into account socioeconomic environmental characteristics of community in developing community-based health promotion rather than focusing on lifestyle changes of residents.

• The Journal of Fisheries Business Administration
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• v.48 no.3
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• pp.47-59
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• 2017

Fish mortality is the most important success factor in aquaculture management. To order fingerlings considering the effect of mortality is a important problem in aquaculture farm. This study is aimed to decision the number and size of fry in aquaculture farm. This study build the mathematical model that finds the value of decision variable to minimize total cost that sums up the fingerling purchasing cost, aquaculture farm operating cost and feeding cost under mortality constraint. The proposed mathematical model involve biological and economical variables: (1) number of fingerlings (2) fish growth rate (3) mortality (4) price of a fry (5) feeding cost, and (6) possible order period. Numerical simulation model presented here in. The objective of numerical simulation is to provide for decision makers to analyse and comprehend the proposed model. When extensive biological and cost data become available, the proposed model can be widely applied to yield more accurate results.

• The Journal of Fisheries Business Administration
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• v.47 no.4
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• pp.1-13
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• 2016

Fish mortality is the most important success factor in aquaculture management. To analyze the effect of mortality considering biological and economic condition is a important problem in land-based aquaculture. This study is aimed to analyze the effect of mortality for duration of cultivation in land-based aquaculture. This study builds the mathematical model that finds the value of decision variable to minimize cost that sums up the water pool usage cost, sorting cost, fingerling cost and feeding cost under critical standing corp constraint. The proposed mathematical model involves many aspects, both biological and economical: (1) number of fingerlings (2) timing and number of batch splitting event, based on (3) fish growth rate, (4) mortality, and (5) several farming expense. Numerical simulation model presented here in. The objective of numerical simulation is to provide for decision makers to analyse and comprehend the proposed model. When extensive biological and cost data become available, the proposed model can be widely applied to yield more accurate results.