• 보건행정학회지
• /
• 제31권1호
• /
• pp.100-113
• /
• 2021

Background: This study aims to figure out the gaps in health status by estimating amenable mortality rate by region, reflecting the characteristics of Korea, and estimating the years of life lost (YLL) per capita by disease. Methods: People who died from amenable diseases between 2008 and 2018 were extracted from the cause of death statistics provided by Statistics Korea. The age-standardized amenable mortality rates were estimated to compare the health status of 229 regions. YLL per capita was calculated to compute the burden of diseases caused by treatable deaths by region. The YLL per capita by region was calculated to identify the burden of disease caused by amenable deaths. Results: First, while the annual amenable mortality rate in Korea is on a steady decline, but there is still a considerable gap between urban and rural areas when comparing the mortality rates of 229 areas. Second, YLL per capita due to the amenable deaths is approximately 14 person-years during the analysis period (2008-2018). Conclusion: Although the health status of Koreans has continuously improved, there is still a gap in health status region by region in terms of amenable mortality rates. Amenable death accounts for a loss of life equivalent to 14 person-years per year. Since the amenable mortality rate is an indicator that can measure the performance of the health care system, efforts at each local area are required to lower it.

• 대한간호학회지
• /
• 제35권1호
• /
• pp.47-55
• /
• 2005

Purpose: This study was to evaluate the validity of the Pediatric Index of Mortality Ⅱ(PIM Ⅱ). Method: The first values on PIM Ⅱ variables following ICU admission were collected from the patient's charts of 548 admissions retrospectively in three ICUs(medical, surgical, and neurosurgical) at P University Hospital and a cardiac ICU at D University Hospital in Busan from January 1, 2002 to December 31, 2003. Data was analyzed with the SPSSWIN 10.0 program for the descriptive statistics, correlation coefficient, standardized mortality ratio(SMR), validity index(sensitivity, specificity, positive predictive value, negative predictive value), and AUC of ROC curve. Result: The mortality rate was 10.9% (60 cases) and the predicted death rate was 9.5%. The correlation coefficient(r) between observed and expected death rates was .929(p<.01) and SMR was 1.15. Se, Sp, pPv, nPv, and the correct classification rate were .80, .96, .70, .98, and 94.0% respectively. In addition, areas under the curve (AUC) of the receiver operating characteristic(ROC) was 0.954 (95% CI=0.919～0.989). According to demographic characteristics, mortality was underestimated in the medical group and overestimated in the surgical group. In addition, the AUCs of ROC curve were generally high in all subgroups. Conclusion: The PIM Ⅱ showed a good, so it can be utilized for the subject hospital. better.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권10호
• /
• pp.6181-6184
• /
• 2013

Background: Lung cancer is the most frequent cancer in males and the fourth most frequent site in females, worldwide. This study is the first to explore the profile of lung cancer in Kuwait. Materials and Methods: Cases of primary lung cancer (Kuwaiti) in Kuwait cancer Registry (KCR) were grouped in 4 periods (10 years each) from 1970-2009. Epidemiological measures; age standardized incidence rate (ASIR) with 95% confidence intervals (CI), Standardized rate ratio (SRR) and Cumulative risk and Forecasting to year 2020-2029 used for analysis. Results: Between years, 2000-2009 lung cancer ranked the 4th and the 9th most frequent cancer in males and females respectively. M:F ratio 1:3. Mean age at diagnosis (95%CI) was 65.2 (63.9-66.4) years. The estimated risk of developing lung cancer before the age of 75 years in males is 1.8% (1/56), and 0.6 (1/167) in females. The ASIR for male cases was 11.7, 17.1, 17.0, 14.0 cases/100,000 population in the seventies, eighties, nineties and in 2000-2009 respectively. Female ASIR was 2.3, 8.4, 5.1, 4.4 cases/100,000 population in the same duration. Lung cancer is the leading cause cancer death in males 168 (14.2%) and the fifth cause of death due to cancer in females accounting for 6.1% of all cancer deaths. The ASMR (95%CI) was 8.1 (6.6-10.0) deaths/100,000 population and 2.8 (1.3-4.3) deaths/100,000 population in males and females respectively. The estimated Mortality to incidence Ratio was 0.6. Conclusions: The incidence of lung cancer between years 2000-2009 is not different from that reported in the seventies. KCR is expecting the number of lung cancer cases to increase.

• Journal of Preventive Medicine and Public Health
• /
• 제38권2호
• /
• pp.147-153
• /
• 2005

Objectives: Studies on the geographical differences in mortality tend to use a census population, rather than a registration population, as the denominator of mortality rates in South Korea. However, an administratively determined registration population would be the logical denominator, as the geographical areas for death certificates (numerator) have been determined by the administratively registered residence of the deceased, rather than the actual residence at the time of death. The purpose of this study was to examine the differences in the total number of a district population, and the associated district-specific mortality indicators, when two different measures as a population denominator (census and registration) were used. Methods: Population denominators were obtained from census and registration population data, and the numbers of deaths (numerators) were calculated from raw death certificate data. Sex- and 5-year age-specific numbers for the populations and deaths were used to compute sex- and age-standardized mortality rates (by direct standardization methods) and standardized mortality ratios (by indirect standardization methods). Bland-Altman tests were used to compare district populations and district-specific mortality indicators according to the two different population denominators. Results : In 1995, 9 of 232 (3.9%) districts were not included in the 95% confidence interval (CI) of the population differences. A total of 8 (3.4%) among 234 districts had large differences between their census and registration populations in 2000, which exceeded the 95% CI of the population differences. Most districts (13 of 17) exceeding the 95% CI were rural. The results of the sex- and age-standardized mortality rates showed 15 (6.5%) and 16 (6.8%) districts in 1995 and 2000, respectively, were not included in the 95% CI of the differences in their rates. In addition, the differences in the standardized mortality ratios using the two different population denominators were significantly greater among 14 districts in 1995 and 11 districts in 2002 than the 95% CI. Geographical variations in the mortality indicators, using a registration population, were greater than when using a census population. Conclusion: The use of census population denominators may provide biased geographical mortality indicators. The geographical mortality rates when using registration population denominators are logical, but do not necessarily represent the exact mortality rate of a certain district. The removal of districts with large differences between their census and registration populations or associated mortality indicators should be considered to monitor geographical mortality rates in South Korea.

• Journal of Preventive Medicine and Public Health
• /
• 제30권2호
• /
• pp.293-307
• /
• 1997

In Korea, sudden deaths of middle-aged and older male workers who are the responsible persons at home as well as workplace, have aroused social concern. Besides, U. N. has reported recently that mortality of Korea male in 40-50's was one of the highest among newly developed countries in 1992. Not much is, however, known about the nature of the work contributing to the mortality of different groups of workers. Therefore, this study was done to examine mortality of public servants, comprising about 5% of all the employed in Korea, according to their job titles and grades. The datas of 1753 official deaths, comprised 323 (only disease-oriented deaths) applicants of survivors' compensation, were used to examine age-adjusted Standardized Mortality Ratios(SMRs) according to their job titles, grades, tenures and cause of deaths. Controlling age and sex difference was conducted using 26,950,481 general population, 95,340 general deaths and 864,560 working public servants. All the groups were aged 20-64, who were being observed January - December in 1993, at the same time. Results and discussions are as follows. 1. SMRs standardized by general population was significantly low (SMR 44.9 CI 42.8-52.7) for all job titlses. Of public servants, 90.0% was graduated from high school, although 17.5% in general population. The distinction of social status such a education may produce a strong healthy worker effect. Besides, SMRs for different tenure groups showed a steady increase as tenure increases. This suggests that the magnitude of healthy-worker effect may be greater with increasing tenures. 2. SMRs standardized by own public servants was significantly elevated for work-men(SMR 121.0, CI 110.2-132.6) in solitue. When SMRs for different grade, of work-men was examined, 9th(SMR 124.2, CI 104.4-146.7) and 10th(SMR 137.9 CI 120.8-156.8)grade, lower grade in workmen, showed significantly elevated SMRs. Of workmen, 57.0% were graduated from high school and 50.1% in 9th grade, as well. These mean that low economic states made up social class, education may increase mortality rate. 3. Of SMRs according to all causes of death, only policemen on 'cause of death related hypertensive disease'(SMR 282.5, CI 121.6-556.7) was significantly high except for' cause of death related other signs, symptoms and ill-defined conditions'. 4. When SMRs on cause of death related hypertensive disease for different grade of policemen was examined, senior policemen(SMR 241.9), in charge of the front service, showed elevated SMR, in spite of statistical no significance. Especially, the working hour of senior policemen is quite long and also the work schedule is even more irregular for policemen. The results of this study showed that mortality for different jobs differed, and it differed also for different grades in the same job. This difference in mortality may reflect the difference in the nature of job contents, and further studies are warranted to elucidate which job characteristics are responsible.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권sup3호
• /
• pp.101-105
• /
• 2016

The number of deaths is often measured to monitor the population health status and priority of health problems. However, number of years of life lost (YLL) is a more appropriate indicator in some cases. We have calculated the YLL of adult cancers and its trend over the past few years in Yazd to provide planners with baseline data. Data obtained from death registration system were used to calculate the YLL, based on each individual's age at death, and the standardized expected YLL method was applied with a discount rate of 0.03, an age weight of 0.04, and a correction factor of 0.165. All data were analyzed and prepared in Epi6 and Excel 2007. A total of 3,850 death records were analyzed. Some 550 patients in Yazd province aged ${\geq}20$ die annually due to cancer (male: female ratio 1.3). The average ages at death in lung, CNS, breast cancer and leukemia cases were 68.5, 59, 58.7 and 61, respectively. The age group of 40-59 with 21 % had the highest cancer mortality percentage. Premature cancer deaths have caused 40,753 YLL (5,823 YLL annually). Females lose on average more life years to cancer than do men (11.6 vs 9.8 years). Lung cancer (12.1%), CNS tumors (11.7%) and leukemia (11.4 %) were the leading causes terms of YLL due to all cancers in both sexes. From 2004 to 2010, cancer-caused YLL as a fraction of all YLL increased from 12.8 to 15.2 %. This study can help in the assessment of health care needs and prioritization. Cancer is the major cause of deaths and the trend is increasing. The use of YLLs is a better index for measurement of premature mortality for ranking of diseases than is death counts. Longer periods of observation will make these trends more robust and will help to evaluate and develop, better public health interventions.

• 한국인구학
• /
• 제26권1호
• /
• pp.1-30
• /
• 2003

이 연구는 거주지역의 생태학적 환경과 사회경제적 요인이 사망력 수준에 미치는 영향력을 확인하고 그 변화 추이를 파악하기 위한 것이다. 이를 위해 1990년, 1995년, 2000년 세 시점의 인구센서스 자료와 동태통계 원자료, 그리고 각 시$.$군별 통계자료를 활용하였다. 사망력의 지표로는 조사망률, 표준화사망률과 장수비율을 사용하였다. 이 논문은 우선 GIS를 이용하여 세 시점의 시$.$군별 사망률 지도와 장수 지도를 제시하였다. 그리고 거주지역의 생태학적 환경과 사회경제적 요인들이 사망력의 지표들에 미치는 영향력에 대한 일반화된 설명을 위해 분산분석과 회귀분석을 실시하였다. 이 연구에서 사망률 지도와 장수 지도를 비교한 결과. 전라남도 남서해안지역에서 조사망률, 표준화사망률과 장수비율이 모두 높은 것으로 확인되었다. 반면 수도권과 부산권역에서는 사망력의 세 지표가 모두 낮게 나타났다. 표준화사망률과 장수비율의 지역별 편차는 1990년 이후 점차 줄어드는 추세를 보인다. 또한 표준화사망률과 장수비율 간에는 의미 있는 선형관계가 나타나지 않았으며, 그 인과구조가 서로 다른 것으로 확인되었다. 사망력의 지역별 편차를 분석한 결과, 산간과 농촌이라는 입지조건을 지닌 시$.$군들의 조사망률과 표준화사망률이 대체로 높으며, 해안과 농촌지역에서는 장수비율이 높아지는 경향이 있는 것으로 나타났다. 그러나 이러한 분석결과는 교육, 소득, 혼인상태, 의료수준, 보건수준 등 사회 경제적 요인들의 영향력을 통제하는 과정에서 대체로 약화되는 것으로 드러났다. 이는 특히 표준화사망률의 경우에 그러하였다. 거주지역의 입지조건에 따른 사망력 수준의 편차는 사회경제적인 요인은 물론 지난 40여 년간의 인구이동으로 인한 인구연령구조의 차이와도 관련이 있는 것으로 판단된다.

• 한국인구학
• /
• 제11권1호
• /
• pp.197-203
• /
• 1988

한국 사망력의 수준 및 특징을 일본과 비교하고자 양국의 1995년 공식통계를 사용하여 사망원인별로 성$\cdot$연령$\cdot$혼인상태별 사망률, 연령표준화사망률, 생존기간손실년수(PYLL) 및 동 측정치의 남녀간 비와 한일간 비를 계산하였다. 사망원인 항목은 모든 사인(총사망), 결핵, 악성신생물, 당뇨병, 고혈압성 질환, 심장 질환, 뇌혈관 질환, 간 진환, 교통사고, 자살을 포함한다. 일본과 비교하여 한국 사망력의 두드러진 특징은 다음과 같다 : (1)자살을 제외한 대부분의 사인에서 한국의 사망률이 일본보다 높은데 , 특히 결핵, 고혈압성 질환, 간 질환 및 교통사고의 경우 한국 생산활동연령층의 사망률이 두드러지게 높다 : (2)결핵, 간질환, 교통사고, 암사망이 한국의 소아에게서도 발생한다 : (3)한국의 생산활동연령층에서 간 질환, 결핵, 교통사고에 의한 성별 사망력 격차가 큰데, 남성의 사망률이 여성의 사망률보다 높기 때문이다 : (4)자살률이 한국생산활동연령층 남성의 경우 일본보다 낮고, 10대와 20대 여성의 자살률은 일본보다 높다 : (5)한국의 45세 미만에서는 사인에 따라 사별이나 이혼상태에서, 45세 이상에서는 모든 사인에 대해 남녀 모두 미혼상태에서 사망력이 가장 높다. : (6)한국은 사별상태에서, 일본은 이혼상태에서 성별 사망력 격차가 가장 크다.

• 한국인구학
• /
• 제26권2호
• /
• pp.1-32
• /
• 2003

시도의 사망원인별 사망력 분석은 정책수립에 필수적인 정보를 제공하고, 각종 질병 및 사망 원인에 대한 가설을 설정하게 한다. 사회경제적, 문화적, 의료적, 생태학적 이유 등 다양한 원인이 시도의 사망원인별 사망수준에 복합적으로 영향을 주지만, 이 연구에서는 시도의 사망원인별 사망력에 대한 설명보다는 공통점과 차이점 파악을 주 목적으로 하였다. 이를 위하여 1998년 기준 사망신고 및 주민등록인구 자료를 활용하여, 시도별로 지연신고와 영아사망 신고누락을 보완하고, 연령표준화사망률과 생명표를 작성하였다. 모든 사인에 의한 사망수준 관련 주요 결과는 다음과 같다: (1) 남녀전체를 합하여 서울이 가장 낮은 사망수준을 전남은 가장 높은 사망수준을 보였다: (2) 시도간 사망수준의 차이가 여자보다 남자에게서, 65세 이상보다 604세 이하 연령층에서 더 컸다. 사망원인별 사망력 관련 남녀별 및 남녀 전체를 합하여 연령표준화 사망률이나 출생시 사망확률이라는 지표 모두에서 일관된 유형을 보이는 주요 결과는 다음과 같다: (1) 심장질환에 의한 사망수준은 부산에서 최고, 강원도에서 최저를 나타냈고: (2) 간질환에 의한 사망수준은 전남에서 최고를; (3) 운수사고에 의한 사망수준은 충남에서 최고 인천에서 최저로 나타났다. 시도의 사망수준 차이에는 다양한 요인이 관련되어 있으므로 사회경제적 변수를 포함한 25개의 설명 변수와 총90개의 사망력 변수에 대한 탐색적 통계분석을 실시하였다. 모든 사인에 의한 사망력은 사회경제적 변수와 밀접한 관련이 있으며, 사망원인별로는 간질환 및 운수사고에 의한 사망력이 사회경제적 변수와 관련이 있는 것으로 나타났다. 끝으로 사망신고 자료의 질 개선 필요성을 논의하고 있다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권9호
• /
• pp.4115-4121
• /
• 2015

Background: Colorectal cancer is the second most common cause of cancer death with half a million deaths per year. Incidence and mortality rates have demonstrated notable changes in Asian and African countries during the last few decades. In this study, we first aimed to determine the trend of colorectal cancer mortality rate in each Institute for Health Metrics and Evaluation (IHME) region, and then re-classify them to find more homogenous classes. Materials and Methods: Our study population consisted of 52 countries of Asia and North Africa in six IHME pre-defined regions for both genders and age-standardized groups from 1990 to 2010.We first applied simple growth models for pre-defined IHME regions to estimate the intercepts and slopes of mortality rate trends. Then, we clustered the 52 described countries using the latent growth mixture modeling approach for classifying them based on their colorectal mortality rates over time. Results: Statistical analysis revealed that males and people in high income Asia pacific and East Asia countries were at greater risk of death from colon and rectum cancer. In addition, South Asia region had the lowest rates of mortality due to this cancer. Simple growth modeling showed that majority of IHME regions had decreasing trend in mortality rate of colorectal cancer. However, re-classification these countries based on their mortality trend using the latent growth mixture model resulted in more homogeneous classes according to colorectal mortality trend. Conclusions: In general, our statistical analyses showed that most Asian and North African countries had upward trend in their colorectal cancer mortality. We therefore urge the health policy makers in these countries to evaluate the causes of growing mortality and study the interventional programs of successful countries in managing the consequences of this cancer.