• The Korean Journal of Health Service Management
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• v.9 no.4
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• pp.197-206
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• 2015

Objectives : This study presents comparison results of the correlations between ODA grants and health indicators among 23 countries in Asia. Methods : Data from 2005~2013 were collected through the World Development Indicator (WDI) provided by the World Bank (WB). The health-related variables used in this study included the maternal mortality ratio, infant mortality rate under five, infant mortality rate, incidence of tuberculosis, and prevalence of AIDS. Results : Based on the results, there were positive correlations between ODA grants and health indicators, which means that the overall ODA grants would drop when the health indicators improved. As for differences in the health indicators by income groups among the countries, there were differences in the maternal mortality ratio, infant mortality rate under five, infant mortality rate, and overall ODA grants. The maternal mortality ratio, infant mortality rate under five, and infant mortality rate were lower in the order of upper middle, lower middle, and poorest income countries. Conclusions : The findings raise a need for the integrated and horizontal development of Goals 4, 5 and 6 of MDGs in the ODA projects of health sector in the future.

• Journal of Preventive Medicine and Public Health
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• v.37 no.2
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• pp.120-126
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• 2004

Objectives : This study sought to examine relationships between alcohol drinking and cardiovascular disease mortality and all-cause mortality. Methods : From March 1985 through December 1999, 2,696 males and 3,595 females aged 55 or over as of 1985 were followed up for their mortality until 31 December 1999. We calculated the mortality risk ratios by level of alcohol consumption. Among the drinker, the level of alcohol consumption was calculated by the frequency of alcohol comsumption and the type of alcohol. Cox proportional hazard model was used to adjust for confounding factors. Results : Among males, compared to abstainer, heavy drinker had significantly higher mortality in all cause(Risk ratio=1.35), cardiovascular disease(Risk ratio=1.52) and cerebrovascular disease(Risk ratio =1.66). Although not significant, moderate drinker had lower ischemic heart disease mortality(Risk ratio =0.38). Among females, there was no statistically significant association between alcohol comsumption and mortality. Conclusion : The results of this study suggest that alcohol drinking has harmful effect on all-cause mortality, cardiovascular disease mortality and cerebrovascular disease mortality among males, especially in heavy drinker among males. Minimal evidence on protective effect for cardiovascular disease mortality in low or moderate drinker is observed.

• Journal of Korean Clinical Nursing Research
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• v.28 no.1
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• pp.1-12
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• 2022

Purpose: The purpose of this study is to investigate the association between the nurse staffing level and the patient mortality using Korean National Health Insurance data. Methods: The data of 1,068,059 patients from 913 hospitals between 2015 and 2016 were analyzed. The nurse staffing level was categorized based on the bed-to-nurse ratio in general wards, intensive care units (ICUs), and hospitals overall. The x² test and generalized estimating equations (GEE) multilevel multivariate logistic regression analyses were used to explore in-hospital mortality and 30-day mortality after admission. Results: The in-hospital mortality rate was 2.9% and 30-day mortality after admission rate was 3.0%. Odd Ratios (ORs) for in-hospital mortality were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.72, 95% CI=0.63~0.84) and in ICUs with a bed-to-nurse ratio of less than 0.88 compared to that with 1.25 or more (OR=0.78, 95% CI=0.66~0.92). ORs for 30-day mortality after admission were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.83, 95% CI=0.73~0.94) and in ICUs with a bed-to-nurse ratio of less than 0.63 compared to that with 1.25 or more (OR=0.85, 95% CI=0.72~1.00). Conclusion: To reduce the patient mortality, it is necessary to ensure a sufficient number of nurses by improving the nursing fee system according to the nurse staffing level.

• Clinical and Experimental Pediatrics
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• v.63 no.1
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• pp.20-24
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• 2020

Background: Predicting the prognosis of patients admitted to the pediatric intensive care unit (PICU) is very important in determining further management and resource allocation. The prognostication of critically ill children can be challenging; hence, accurate methods for predicting outcomes are needed. Purpose: To evaluate the role of microalbuminuria at admission as a prognostic marker in comparison to standard Pediatric Risk of Mortality (PRISM) and Pediatric Logistic Organ Dysfunction (PELOD) mortality scores in children admitted to the PICU. Methods: This cross-sectional study was conducted from January 2015 to October 2016. Eighty-four patients aged 1 month to 18 years admitted to the PICU of teaching hospitals for more than 24 hours were enrolled by convenience sampling method. Microalbuminuria was estimated by spot urinary albumin-creatinine ratio. PRISM and PELOD scores were calculated using an online calculator. Outcome measures were PICU length of stay, inotrope usage, multiorgan dysfunction, and survival. ACR was compared with mortality scores for predicting survival. Results: Microalbuminuria was present in 79.8% with a median value of 85 mg/g (interquartile range, 41.5-254 mg/g). A positive correlation was found between albumin-creatinine ratio and PICU length of stay (P=0.013, r=0.271). Albumin-creatinine ratio was significantly associated with organ dysfunction (P=0.004) and need for inotropes (P=0.006). Eight deaths were observed in the PICU. The area under the curve for mortality for albumin-creatinine ratio (0.822) was comparable to that for PRISM (0.928) and PELOD (0.877). Albumin-creatinine ratio >109 mg/g predicted mortality with a sensitivity of 87.5% and specificity of 63.2%. Conclusion: Microalbuminuria is a good predictor of PICU outcomes comparable with mortality scores.

• Journal of Cardiovascular Imaging
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• v.31 no.4
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• pp.200-206
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• 2023

BACKGROUND: Right ventricular (RV) dysfunction is a significant risk of major adverse cardiac events in patients with acute heart failure (AHF). In this study, we evaluated RV-pulmonary artery (PA) coupling, assessed by tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) and assessed its prognostic significance, in AHF patients. METHODS: We measured the TAPSE/PASP ratio and analyzed its correlations with other echocardiographic parameters. Additionally, we assessed its prognostic role in AHF patients. RESULTS: A total of 1147 patients were included in the analysis (575 men, aged 70.81 ± 13.56 years). TAPSE/PASP ratio exhibited significant correlations with left ventricular (LV) ejection fraction(r = 0.243, p < 0.001), left atrial (LA) diameter(r = -0.320, p < 0.001), left atrial global longitudinal strain (LAGLS, r = 0.496, p < 0.001), mitral E/E' ratio(r = -0.337, p < 0.001), and right ventricular fractional area change (RVFAC, r = 0.496, p < 0.001). During the median follow-up duration of 29.0 months, a total of 387 patients (33.7%) died. In the univariate analysis, PASP, TAPSE, and TAPSE/PASP ratio were significant predictors of mortality. After the multivariate analysis, TAPSE/PASP ratio remained a statistically significant parameter for all-cause mortality (hazard ratio [HR], 0.453; p = 0.037) after adjusting for other parameters. In the receiver operating curve analysis, the optimal cut-off level of TAPSE/PASP ratio for predicting mortality was 0.33 (area under the curve = 0.576, p < 0.001), with a sensitivity of 65% and a specificity of 47%. TAPSE/PASP ratio < 0.33 was associated with an increased risk of mortality after adjusting for other variables (HR, 1.306; p = 0.025). CONCLUSIONS: In AHF patients, TAPSE/PASP ratio demonstrated significant associations with RVFAC, LA diameter and LAGLS. Moreover, a decreased TAPSE/PASP ratio < 0.33 was identified as a poor prognostic factor for mortality.

• Journal of Preventive Medicine and Public Health
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• v.47 no.6
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• pp.336-342
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• 2014

Objectives: Child mortality remains a critical problem even in developed countries due to low fertility. To plan effective interventions, investigation into the trends and causes of child mortality is necessary. Therefore, we analyzed these trends and causes of child deaths over the last 30 years in Korea. Methods: Causes of death data were obtained from a nationwide vital registration managed by the Korean Statistical Information Service. The mortality rate among all children aged between one and four years and the causes of deaths were reviewed. Data from 1983-2012 and 1993-2012 were analyzed separately because the proportion of unspecified causes of death during 1983-1992 varied substantially from that during 1993-2012. Results: The child (1-4 years) mortality rates substantially decreased during the past three decades. The trend analysis revealed that all the five major causes of death (infectious, neoplastic, neurologic, congenital, and external origins) have decreased significantly. However, the sex ratio of child mortality (boys to girls) slightly increased during the last 30 years. External causes of death remain the most frequent origin of child mortality, and the proportion of mortality due to child assault has significantly increased (from 1.02 in 1983 to 1.38 in 2012). Conclusions: In Korea, the major causes and rate of child mortality have changed and the sex ratio of child mortality has slightly increased since the early 1980s. Child mortality, especially due to preventable causes, requires public health intervention.

• Women's Health Nursing
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• v.28 no.4
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• pp.348-357
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• 2022

Purpose: This study aimed to identify maternal, infant, and perinatal mortality using the national population data of South Korea between 2018 and 2020, and to analyze mortality rates according to characteristics such as age, date of death, and cause of death in each group. This study updates the most recent study using 2009 to 2017 data. Methods: Analyses of maternal, infant, and perinatal mortality were done with data identified through the supplementary investigation system for cases of death from the Census of Population Dynamics data provided by Statistics Korea from 2018 to 2020. Results: Between 2018 and 2020, a total of 99 maternal deaths, 2,427 infant deaths, and 2,408 perinatal deaths were identified from 901,835 live births. The maternal mortality ratio was 11.3 deaths per 100,000 live births in 2018; it decreased to 9.9 in 2019 but increased again to 11.8 in 2020. The maternal mortality ratio increased steeply in women over the age of 40 years. An increasing trend in the maternal mortality ratio was found for complications related to the puerperium and hypertensive disorders. Both infant and perinatal mortality continued to decrease, from 2.8 deaths per 1,000 live births in 2018 to 2.5 in 2020 and from 2.8 in 2018 to 2.5 in 2020, respectively. Conclusion: Overall, the maternal, infant, and perinatal mortality statistics showed improvements. However, more attention should be paid to women over 40 years of age and specific causes of maternal deaths, which should be taken into account in Korea's maternal and child health policies.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2018.05a
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• pp.149-151
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• 2018

The purpose of this paper is to visualize and to analyze differences of regional mortality rates by major causes of death. We use causes of death statistics from KOSIS and compare regional mortality rates divided by national mortality rates by three causes of death. To do this, we define regional mortality ratio and regional age-standardized mortality ratio, and visualized by choropleth map using R. As a result, In case of neoplasm, there was no significant difference by region. In case of circulatory system, Ulsan, Daegu, Busan and Gyungnam showed relatively high regional age-standardized mortality ratio. In case of respiratory system, the ratios were in order of Gangwon, Sejong, and Chungbuk.

• Journal of Ginseng Research
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• v.27 no.4
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• pp.158-164
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• 2003

Recently, there are much concerns about ginseng as disease therapeutics. There are no epidemiologic study on relationship between ginseng intake and all cause mortality based from general population Cohort. This study sought to examine relationships between ginseng intake and all cause mortality from Kangwha Cohort data. From March 1985 through December 1999, 2696 males and 3595 females who were aged 55 or over as of 1985 were followed up. We calculate the mortality rate, standardized mortality ratio and risk ratios by ginseng intake. Cox proportional hazard model was used to adjust various confounding factors. Ginseng intake group had the lower all cause mortality(Risk ratio(RR)=0.88, 95%Confidence Interval(CI)=0.79-0.97) among males. Increasing ginseng intake, lower all cause mortality(Low ginseng intake: RR=0.88, 95%CI=0.79-0.98; high ginseng intake : RR=0.87, 95%CI=0.75-1.00) among males. There is no statistically significant difference between ginseng intake and mortality among females. The results of this study suggests that ginseng intake may prolong the human life among males.

• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.323-330
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• 2001

Objective : To examine the association between age at menopause and mortality in a population-based sample of women in Kangwha, Korea. Methods : From the Kangwha Cohort, followed-up from 1985 to 1999, the data of the over 55 year old female group(n=3,596) was used in this study to examine the association between age at menopause and mortality. We calculated the all causes mortality risk ratio and the cancer mortality risk ratio by age at menopause grouping using the Cox Proportional Hazards Model with adjustments for age, BMI, smoking, education, chronic disease, self-rated health status, alcohol consumption and age at first birth. Result and conclusion : Compared to women who had menopause at 45-49 years, the all causes mortality risk ratio was 1.24 for women with menopause at less than 40 years(95% CI=1.01-1.53) and 1.05 for women with menopause at over 50 years(95% CI=0.92-1.20). Also, compared to women who had menopause at 45-49 years, the cancer mortality risk ratio was 1.53 for women with menopause at less than 40 years(95% CI=0.78-2.98) and 1.17 for women with menopause at over 50 years(95% CI=0.77-1.80).