• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2431-2440
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• 2015

Background: Registry data from four major public hospitals indicate trends in clinical care and survival from colorectal cancer over three decades, from 1980 to 2010. Materials and Methods: Kaplan-Meier productlimit estimates and Cox proportional hazards models were used to investigate disease-specific survival and multiple logistic regression analyses to explore first-round treatment trends. Results: Five-year survivals increased from 48% for 1980-1986 to 63% for 2005-2010 diagnoses. Survival increases applied to each ACPS stage (Australian Clinico-Pathological Stage), and particularly stage C (an increase from 38% to 68%). Risk of death from colorectal cancer halved (hazards ratio: 0.50 (0.45, 0.56)) over the study period after adjusting for age, sex, stage, differentiation, primary sub-site, health administrative region, and measures of socioeconomic status and geographic remoteness. Decreases in stage were not observed. Survivals did not vary by sex or place of residence, suggesting reasonable equity in service access and outcomes. Of staged cases, 91% were treated surgically with lower surgical rates for older ages and more advanced stage. Proportions of surgical cases having adjuvant therapy during primary courses of treatment increased for all stages and were highest for stage C (an increase from 5% in 1980-1986 to 63% for 2005-2010). Radiotherapy was more common for rectal than colonic cases. Proportions of rectal cases receiving radiotherapy increased, particularly for stage C where the increase was from 8% in 1980-1986 to 60% in 2005-2010. The percentage of stage C colorectal cases less than 70 years of age having systemic therapy as part of their first treatment round increased from 3% in 1980-1986 to 81% by 1995-2010. Based on survey data on uptake of adjuvant therapy among those offered this care, it is likely that all these younger patients were offered systemic treatment. Conclusions: We conclude that pronounced increases in survivals from colorectal cancer have occurred at major public hospitals in South Australia due to increases in stage-specific survivals. Use of adjuvant therapies has increased and the patterns of change accord with clinical guideline recommendations. Reasons for sub-optimal use of radiotherapy for rectal cases warrant further investigation, including the potential for limited rural access to impede uptake of treatments at metropolitan-based radiotherapy centres.

• 한국노년학
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• v.31 no.1
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• pp.171-188
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• 2011

The purpose of this study is to examine the factors associated with the probability and levels of the health service utilization among the disabled elderly in Korea. The sample includes 2,111 people older than 65 who are extracted from the 2008 National Survey on People with Disabilities. More than half (54.3%) of the sample experienced at least 1 outpatient physician visit within two weeks and 26.7% were hospitalized within a year. The key factors associated with the outpatient visits were health insurance status, the existence of chronic disease, self-rated health, the Activities of Daily Living (ADLs), as well as renal impairment. Similarly, the utilization of inpatient care was related to health insurance status along with the existence of the internal organ disabilities such as cardiac or respiratory disorders. The study implies the need for the health care policies regarding the prevention of chronic diseases, dependency for daily activities of the elderly, and a management system that specifically targets those with internal organ disabilities. Moreover, the study suggests that financial supports for the low-income group would be helpful to increase their access to health service utilization.

• Journal of Korean society of Dental Hygiene
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• v.18 no.6
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• pp.911-920
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• 2018

Objectives: This study investigated the relationship between demographic and socioeconomic characteristics of the Korean elderly and their unmet dental care needs, by using the 2015 data from the $6^{th}$ Korea National Health and Nutrition Examination Survey (NHANES). Methods: In total, 1,372 elderly persons aged 65 and over, who responded to the $6^{th}$ NHANES, were included in the final analysis. Logistic regression analysis was performed in order to identify any relationship between demographic and socioeconomic characteristics and unmet dental care needs. Results: The rate of unmet dental care needs was shown to be less by 0.799 times in the elderly who reside in dong than those who live in eup and myeon (OR: 0.799, 95% CI: 0.679-0.959). Unmet dental care needs were higher in participants with 'low' and 'below average' than 'above average' income, by 1.645 times (OR: 1.645, 95% CI: 1.087-2.366) and 1.172 times (OR: 1.172, 95% CI: 1.108-1.880), respectively. Elderly individuals living alone had a higher rate of unmet dental care needs than those living with their family by 1.157 times (OR: 1.157, 95% CI: 1.084-1.498). Conclusions: Demographic and socioeconomic factors influenced unmet dental care needs, causing inequality. Proper policy support to the vulnerable should be considered in order to enhance the elderly's access to dental care.

• Journal of Communications and Networks
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• v.13 no.2
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• pp.102-112
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• 2011

In this paper, we propose a privacy-preserving emergency call scheme, called PEC, enabling patients in life-threatening emergencies to fast and accurately transmit emergency data to the nearby helpers via mobile healthcare social networks (MHSNs). Once an emergency happens, the personal digital assistant (PDA) of the patient runs the PEC to collect the emergency data including emergency location, patient health record, as well as patient physiological condition. The PEC then generates an emergency call with the emergency data inside and epidemically disseminates it to every user in the patient's neighborhood. If a physician happens to be nearby, the PEC ensures the time used to notify the physician of the emergency is the shortest. We show via theoretical analysis that the PEC is able to provide fine-grained access control on the emergency data, where the access policy is set by patients themselves. Moreover, the PEC can withstandmultiple types of attacks, such as identity theft attack, forgery attack, and collusion attack. We also devise an effective revocation mechanism to make the revocable PEC (rPEC) resistant to inside attacks. In addition, we demonstrate via simulation that the PEC can significantly reduce the response time of emergency care in MHSNs.

• The Korean Journal of Health Service Management
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• v.13 no.4
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• pp.9-17
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• 2019

Objectives: The purpose of this study is to explore the developmental direction of the hospital management field that contributes to the academic and practical development of the health care industry and to establish its identity by using the Korean Journal of Health Service Management. Methods: A total of 156 papers were analyzed from April 2007 to December 2018. Frequency analysis and descriptive statistics were performed using SPSS 25.0. Results: The volume of articles published in the hospital management field was decreasing and the ratio was relatively low due to the nature of the journal. The disposition of the papers in the hospital management field excessively focused on the organizational behavior field, and research in the management field that was difficult to access was decreasing. In addition, about 83% of the participants were drawn from hospitals. Conclusions: It is necessary to present guidelines for publication of theses so that a managerial approach can be made rather than an approach to industrial psychological theory verification.

• Journal of Korean Academy of Nursing
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• v.47 no.6
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• pp.756-769
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• 2017

Purpose: To identify the effects of a smart program for the patients who underwent percutaneous coronary intervention (SP-PCI) on coronary disease-related knowledge, health behaviors, and quality of life. Methods: A nonequivalent control group with a non-synchronized design was utilized and 48 participants (experimental=22, control=26) were recruited from a university hospital in Gyeongsang area from May to December, 2016. The 12-week SP-PCI consisted of self-study of health information using smart phone applications (1/week), walking exercise (>5/week) using smart band, feedback using Kakao talk (2/week), and telephone counseling (1/week). Patients in the control group received usual care from their primary health care providers and a brief health education with basic self-management brochure after the PCI. Data were analyzed using the SPSS 21.0 program through descriptive statistics, $x^2$ test, and t-test. Results: After the 12-week SP-PCI, the experimental group showed higher levels of coronary disease-related knowledge (t=2.43, p=.019), heart-related health behaviors (t=5.96, p<.001), regular exercise (Z=-4.47, p<.001), and quality of life-MCS (t=3.04, p=.004) and showed lower levels of stress (Z=-3.53, p<.001) and sodium intake (t=-4.43, p<.001) than those in the control group. There were no significant group differences in medication adherence and food intake in total energy, lipids, and cholesterol. Conclusion: The suggested SP-PCI provided easy access and cost-effective intervention for patients after PCI and improved their knowledge of the disease, performance of health behaviors, and quality of life. Further study with a wider population is needed to evaluate the effects of SP-PCI on disease recurrence and quality of life for patients after PCI.

• Korea Journal of Hospital Management
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• v.7 no.4
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• pp.123-151
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• 2002

The objective of this study is to analyze the causal relationship of hospital inpatient's perceived quality, overall satisfaction, service value, and future intention to revisit. To carry out this objective, first we analyzed the dimensions of inpatient care service quality using SERVQUAL scale. The SERVQUAL scale is based on the gap theory, that is, the difference of patients' expectations and the actually received medical care service in hospital. On the basis of this theory, we measured the inpatient's perceived service quality and overall patient satisfaction. Data was gathered from a self-administered questionnaire at a 980 bed university hospital in Inchon City. These questionnaire measuring the service quality were distributed to 250 inpatients. The response rate was 66.4%. A total of 166 questionnaires was finally analyzed. To categorize medical service quality, the factor analysis was performed on 42 items. The reliability and validity of these items was evaluated. Finally to test 6 hypotheses, we analyzed the causal relationship of service quality, overall satisfaction, service value, and intention to revisit through the structural equation modeling(SEM). The major results of this study are as follows. First, the dimension of inpatient service quality was categorized into 7 dimensions, that is, personal caring, communication, access, physical environment, facilities and equipment, cleanliness, appropriateness and health status. Second, the reliability and validity of inpatient service quality items was satisfied. Third, as a result of structural equation modeling, the effect of inpatient's perceived service quality on overall satisfaction, service value, and intention to revisit was statistically significant. And total effect on intention to revisit as the core endogenous variable was perceived service quality(1.100), patient satisfaction(0.006), and service value(0.605).

• Health Policy and Management
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• v.28 no.4
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• pp.360-368
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• 2018

Background: The proportion of pharmaceutical expenditure out of total health-care expenditure in South Korea is high. In 2016, 25.7% of national health insurance (NHI) spending was for pharmaceuticals. Given the increasing demands for the access to newly introduced medicines and following increase in pharmaceutical spending, the management of NHI pharmaceutical expenditure is becoming more difficult. Methods: This study analyzed the data claimed to NHI for pharmaceutical reimbursement from 2010 to 2016. Results: The policy implications with respect to the trends and problems in spending by drug groups were elicited. First, the proportion of off-patent drugs spending which were treated to chronic disease was much higher than anti-cancer drug spending. Second, the spending to the newly introduced high-costed medicine increased, however, current price-reduction mechanism was not sufficient to manage their expenditure efficiently. Conclusion: Our system seems to need several revisions to improve the efficiency of pharmaceutical expenditure and to cope with high-costed medicines. This study suggested that the prices of off-patent drugs need to be regularly readjusted and the Price-Volume Agreement System should be operated more flexibly as well.

• Journal of The Korea Institute of Healthcare Architecture
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• v.27 no.2
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• pp.39-48
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• 2021

Purpose: The study aims to demonstrate regional diagnosis methods and results combined with geographical information to expand the physical infrastructure related to community care services. To this end, the physical infrastructure for the core elements of community care was analyzed in terms of the fulfilment and access of facilities to derive the underserved elements and regions. Methods: Utilizes GIS network analysis techniques that can derive physical infrastructure service areas. Underserved elements are derived by comparing and analyzing the service area for each core element. Next, the underserved regions for each core element are derived through the overlapping of the set service area and the diagnosis population. Results: Among the physical infrastructure by core elements for community care, the housing support element was considerably weak, and the nursing care facility compared to health care was also analyzed to be weak. In addition, underserved regions by dong in Mapo-gu were deduced and presented for each diagnosed population. Implications: The discovery of underserved elements and underserved regions is meaningful as a diagnostic process that can derive the physical infrastructure that needs to be expanded urgently for the realization of community care and determine the priority projects and targets of the projects.

• Journal of Family Resource Management and Policy Review
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• v.23 no.1
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• pp.17-34
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• 2019

Older women who live alone are among society's most vulnerable people, since they experience increased risk of multiple chronic diseases and have limited financial protection. This can lead older women living alone to catastrophic health expenditure(CHE), which is defined as a healthcare expenditure that exceeds a certain portion of a household's ability to pay. Using the Korean Longitudinal Study of Ageing(KLoSA), this study investigated the incidence of CHE among older women living alone and identified the factors related to this incidence. Applying health expenditure thresholds of 10%, 20%, 30% and 40% of ability to pay, the proportions of those with CHE were 41.3%, 22.9%, 14.6%, and 9.4%, respectively. Logistic regression models were used to identify factors related to CHE incidence, which include demographics, income, the number of chronic diseases, perceived health status, and health insurance type. The results show that the health care safety net in South Korea is insufficient for older women living alone. The findings can guide policymakers in improving healthcare and welfare policies to protect people from catastrophic payments. Particularly, welfare policies should be established for poor non-recipients who are not included within the benefits scope of the National Basic Livelihood Security System due to the unrealistic criteria of income recognition and family support obligation.