• Health Policy and Management
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• v.10 no.2
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• pp.120-130
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• 2000

Studies on the relation between socio-economic factors and metermal and child health have found that poverty, lack of edcation, inappropriate health serives are affecting to maternal and child health. The Gender Related Development Index (GDI) focuses on equality between men and women as well as on the average achiement of all people taken together, using same cariables as the Human Development Index (HDI) which are life expectancy, literacy rate, and per capita GDP. This research is to inverstigate whether HDI and GDI are useful determinants for maternal infant mortality. Using 146 UN member countries date, we condented multiple regression analysis for maternal and infant mortality with three models which are Model(individual variables-literacy rate, per capita GDP), Model(HDI) and Model(GDI). The results showed that HDI and GDI are powerful determinants of both maternal and infant mortality, respectively HDI($\beta$=-1.18, t=3.3; $\beta$=1.04, t=5.1) GDI($\beta$=-1.44, t=3.9; $\beta$=1.28, t=6.5) The higher power in model with GDI for both maternal and infant mortalities represented that GDI was more powerful determinant of maternal and infant mortality, than HDI respectively HDI($R^2$=0.824, $R^2$=0.842), GDI($R^2$=0.834, $R^2$=0.865). In conclusion, the maternal and infant mortalities are explained by GDI than HDI and may be lower in the societies where there are less discimination between men and women.

• 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.

• Journal of fish pathology
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• v.32 no.1
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• pp.1-8
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• 2019

Rock bream iridovirus (RBIV) is a member of the Megalocytivirus genus that causes severe mortality to rock bream (Oplegnathus fasciatus) with characteristic clinical signs of spleen enlargement. In this study, we assessed spleen size and RBIV copy number patterns in RBIV-infected rock bream to determine lethal and safe levels of virus copy number/spleen index that may define disease progress. We found that rock bream infected with RBIV ($1.1{\times}10^7virus\;copy\;number/100{\mu}l$) and held at 29, 26, 23 or $20^{\circ}C$ exhibited significantly higher levels of spleen size compared to $17^{\circ}C$. In dead condition (100% mortality at $20{\sim}29^{\circ}C$), the spleen index ($spleen\;weight/fish\;weight{\times}100$) and virus copy number were 3.00~5.38 and $10^6{\sim}10^8/{\mu}l$, respectively. Conversely, in survived condition (0% mortality at $17^{\circ}C$), spleen index and virus copy number was as low as not-infected control ($0.34{\sim}1.22/10^0{\sim}10^1/{\mu}l$, respectively). These findings suggest that spleen index can be an indicator of disease severity of RBIV disease.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4251-4257
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• 2016

Background: Testicular cancer is one of the most common cancers among young men between ages 20-34 in countries with high or very high levels of the Human Development Index (HDI). This study investigated the incidence and mortality of prostate cancer and the relationship with the HDI and its dimensions in Asia in 2012. Materials and Methods: The study was conducted based on data from the world data of cancer and the World Bank (including the HDI and its components). Standardized incidence and mortality rates of testicular cancer were calculated for Asian countries. Correlations between incidence and/ormortality rates, and the HDI and its components were assessed with the use of the correlation test, using SPSS software. Results: There was a total of 14902 incidences and 5832 death were recorded in Asian countries in 2012. Among the Asian countries, the five countries with the highest standardized incidence rates of testicular cancer were Israel, Georgia, Turkey, Lebanon and Kazakhstan and the five countries with the highest standardized mortality rates were Turkey, Georgia, Jordan, Cambodia and the Syrian Arab Republic. A positive correlation of 0.382 was observed between the standardized incidence rates of testicular cancer and the HDI (p=0.009). Also a negative correlation of 0.298 between the standardized mortality rate of testicular cancer and the Human Development Index was noted although this relation was statistically non-significant (p=0.052). Conclusions: There is a positive correlation between HDI and the standardized incidence rate of testicular cancer and negative correlation with standardized mortality rate.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1701-1704
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• 2016

Background: Stomach cancer (SC) is the second leading cause of cancer death with the rate of 10.4% in the world. The correlation between the incidence and mortality rates of SC and human development index (HDI) has not been globally determined. Therefore, this study aimed to determine the association between the incidence and mortality rates of SC and HDI in various regions. Materials and Methods: In this global ecological study, we used the data about the incidence and mortality rate of SC and HDI from the global cancer project and the United Nations Development Programme database, respectively. Results: In 2012, SCs were estimated to have affected a total of 951,594 individuals (crude rate: 13.5 per 100,000 individuals) with a male/female ratio of 1.97, and caused 723,073 deaths worldwide (crude rate: 10.2 per 100,000 individuals). There was a positive correlation between the HDI and both incidence (r=0.28, P<0.05) and mortality rates of SC (r=0.13, P = 0.1) in the world in 2012. Conclusions: The high incidence and mortality rates of SC in countries with high and very high HDI is remarkable which should be the top priority of interventions for global health policymakers. In addition, health programs should be provided to reduce the burden of this disease in the regions with high incidence and mortality rates of SC.

• Journal of Preventive Medicine and Public Health
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• v.46 no.1
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• pp.1-9
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• 2013

Objectives: We examined the association between social expenditures of the local government and the mortality level in Korea, 2004 to 2010. Methods: We used social expenditure data of 230 local governments during 2004 to 2010 from the Social Expenditure Database prepared by the Korean Institute for Health and Social Affairs. Fixed effect panel data regression analysis was adopted to look for associations between social expenditures and age-standardized mortality and the premature death index. Results: Social expenditures of local governments per capita was not significantly associated with standardized mortality but was associated with the premature death index (decline of 1.0 [for males] and 0.5 [for females] for each expenditure of 100 000 Korean won, i.e., approximately 100 US dollar). As an index of the voluntary effort of local governments, the self-managed project ratio was associated with a decline in the standardized mortality in females (decline of 0.4 for each increase of 1%). The share of health care was not significant. Conclusions: There were associations between social expenditures of the local government and the mortality level in Korea. In particular, social expenditures per capita were significantly associated with a decline in premature death. However, the voluntary efforts of local governments were not significantly related to the decline in premature death.

• Journal of Preventive Medicine and Public Health
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• v.44 no.6
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• pp.242-248
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• 2011

Objectives: Busan is reported to have the highest mortality rate among 16 provinces in Korea, as well as considerable health inequality across its districts. This study sought to examine overall and cause-specific mortality and deprivation at the town level in Busan, thereby identifying towns and causes of deaths to be targeted for improving overall health and alleviating health inequality. Methods: Standardized mortality ratios (SMRs) for all-cause and four specific leading causes of death were calculated at the town level in Busan for the years 2005 through 2008. To construct a deprivation index, principal components and factor analysis were adopted, using 10% sample data from the 2005 census. Geographic information system (GIS) mapping techniques were applied to compare spatial distributions between the deprivation index and SMRs. We fitted the Gaussian conditional autoregressive model (CAR) to estimate the relative risks of mortality by deprivation level, controlling for both the heterogeneity effect and spatial autocorrelation. Results: The SMRs of towns in Busan averaged 100.3, ranging from 70.7 to 139.8. In old inner cities and towns reclaimed for replaced households, the deprivation index and SMRs were relatively high. CAR modeling showed that gaps in SMRs for heart disease, cerebrovascular disease, and physical injury were particularly high. Conclusions: Our findings indicate that more deprived towns are likely to have higher mortality, in particular from cardiovascular disease and physical injury. To improve overall health status and address health inequality, such deprived towns should be targeted.

• Journal of Preventive Medicine and Public Health
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• v.42 no.6
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• pp.392-402
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• 2009

Objectives : The aims of this paper were to develop the composite deprivation index (CDI) for the sub-district (Eup-Myen-Dong) levels based on the theory of social exclusion and to explore the relationship between the CDI and the standardized mortality ratio (SMR). Methods : The paper calculated the age adjusted SMR and we included five dimensions of social exclusion for CDI; unemployment, poverty, housing, labor and social network. The proxy variables of the five dimensions were the proportion of unemployed males, the percent of recipients receiving National Basic Livelihood Security Act benefits, the proportion of households under the minimum housing standard, the proportion of people with a low social class and the proportion of single-parent household. All the variables were standardized using geometric transformation and then we summed up them for a single index. The paper utilized the 2004-2006 National Death Registry data, the 2003-2006 national residents' registration data, the 2005 Population Census data and the 2005-2006 means-tested benefit recipients' data. Results : The figures were 115.6, 105.8 and 105.1 for the CDI of metropolitan areas (big cities), middle size cities and rural areas, respectively. The distributional variation of the CDI was the highest in metropolitan areas (8.9 - 353.7) and the lowest was in the rural areas (26.8 - 209.7). The extent and relative differences of deprivation increased with urbanization. Compared to the Townsend and Carstairs index, the CDI better represented the characteristics of rural deprivation. The correlation with the SMR was statistically significant and the direction of the CDI effects on the SMR was in accordance with that of the previous studies. Conclusions : The study findings indicated mortality inequalities due to the difference in the CDI. Despite the attempt to improve deprivation measures, further research is warranted for the consensus development of a deprivation index.

• Korea Journal of Hospital Management
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• v.14 no.1
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• pp.23-35
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• 2009

The objectives of the present study is to examine the validity of Charlson Comorbidity Index(CCI) based on medical record data; to utilize the index to determine outcome indexes such as mortality, length of stay and cost for the domestic patients whose have received total hip arthroplasty. Based on medical record date, 1-year Mortality was analyzed to be 0.664 of C statistic. The $R^2$ for the predictability for length of stay and the cost was about 0.0181, 0.1842. Fee of national health insurance and total cost including the cost not covered by insurance, also had statistically significance above 3 points of Charlson point score(p=0.0290, 0.0472; $p.{\le}0.05$). The 1-year mortality index, length of stay and cost of the total hip arthroplasty patients which was obtained utilizing CCI have a limitative prediction power and therefore should be carefully analyzed for use.

• Health Policy and Management
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• v.21 no.4
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• pp.541-564
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• 2011

This study aimed to investigate health outcome of acute myocardial infarction (AMI) patients such as mortality and length of stay in hospital and to identify factors associated with the health outcome according to the comorbidity index. Nation-wide representative samples of 3,748 adult inpatients aged between 20-85 years with acute myocardial infarction were derived from the Korea National Hospital Discharge Injury Survey, 2005-2008. Comorbidity index was measured using the Charlson Comorbidity Index (CCI). The data were analyzed using t-test, ANOVA, multiple regression, logistic regression analysis in order to investigate the effect of comorbidity on health outcome. According to the study results, the factors associated with length of hospital stay of acute myocardial infarction patients were gender, insurance type, residential area scale, admission route, PCI perform, CABG perform, and CCI. The factors associated with mortality of acute myocardial infarction patients were age, admission route, PCI perform, and CCI. CCI with a higher length of hospital stay and mortality also increased significantly. This study demonstrated comorbidity risk adjustment for health outcome and presented important data for health care policy. In the future study, more detailed and adequate comorbidity measurement tool should be developed, so patients' severity can be adjusted accurately.