• Environmental Analysis Health and Toxicology
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• v.23 no.4
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• pp.231-245
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• 2008

Various methods for detecting changes in response behaviors of indicator specimens are presented for monitoring effects of toxic treatments. The movement patterns of individuals are quantitatively characterized by statistical (i.e., ANOVA, multivariate analysis) and computational (i.e., fractal dimension, Fourier transform) methods. Extraction of information in complex behavioral data is further illustrated by techniques in ecological informatics. Multi-Layer Perceptron and Self-Organizing Map are applied for detection and patterning of response behaviors of indicator specimens. The recent techniques of Wavelet analysis and line detection by Recurrent Self-Organizing Map are additionally discussed as an efficient tool for checking time-series movement data. Behavioral monitoring could be established as new methodology in integrative ecological assessment, tilling the gap between large-scale (e.g., community structure) and small-scale (e.g., molecular response) measurements.

• Korean Journal of Community Nutrition
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• v.18 no.6
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• pp.644-651
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• 2013

Although there has been a significant increase in breast-feeding (BF) rate in Korea, it is plateaued since 2008 and still low compared with that of other countries. Because BF has been related to lower obesity prevalence in many studies and the increase in childhood obesity became evident in Korea, we wondered if a relatively lower BF rate has anything to do with this increase. Therefore, we looked into the relationship between mode & duration of BF during infancy and weight status of toddlers using the data from Korea National Health and Nutrition Examination Survey 2008 through 2011. Number of 2-3 year old toddlers with complete information on BF, anthropometry and normal birth weight was 674. While 87% of them were ever-breastfed, 6.2% each of them were either obese or overweight based on the Standard Growth Chart for Korean Children. Not only the obesity prevalence was different among groups of different mode of feeding, but also the mean duration of BF was significantly longer in normal weight group (9.2 mo.) compared with obese group (5.5 mo.). Accordingly, overweight and obesity prevalence of the toddlers breast-fed for 12 months or longer was significantly lower than that of the toddlers breast-fed for less than 12 months (OR 0.53, 95% CI 0.32-0.87). This study revealed that both BF and duration of BF affect the childhood obesity and, BF for 12 months or longer should be encouraged more aggressively as one of the main strategies to prevent and/or decrease childhood obesity in Korea.

• The Korean Journal of Applied Statistics
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• v.31 no.6
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• pp.693-706
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• 2018

It is very important to support the elderly with disability ageing in place. Assisting devices can help them to live independently in their community; however, they have to be used appropriately to meet care needs. This study develops an assisting device recommendation system for the beneficiaries of long-term care insurance that include algorithms to decide the most appropriate type of assisting device for beneficiaries. We used long-term care (LTC) insurance data for grade assessment including 8,084 beneficiaries from July 2015 to June 2016. In addition, we collected standard care plans for assisting devices, that power-assessors made, considering their performance and ability that could subsequently be matched with grade assessment data. We used a decision-tree model in data-mining to develop the model. Finally, we developed 15 algorithms for recommending assisting devices. The findings might be useful in evidence-based care planning for assisting devices and can contribute to enhancing independence and safety in LTC.

• Journal of Preventive Medicine and Public Health
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• v.56 no.2
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• pp.180-189
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• 2023

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has led to a global shortage of medical resources; therefore, we investigated whether COVID-19 impacted the quality of non-COVID-19 hospital care in Korea by comparing hospital standardized mortality rates (HSMRs) before and during the pandemic. Methods: This retrospective cohort study analyzed Korean National Health Insurance discharge claim data obtained from January to June in 2017, 2018, 2019, and 2020. Patients' in-hospital deaths were classified according to the most responsible diagnosis categories. The HSMR is calculated as the ratio of expected deaths to actual deaths. The time trend in the overall HSMR was analyzed by region and hospital type. Results: The final analysis included 2 252 824 patients. In 2020, the HSMR increased nationwide (HSMR, 99.3; 95% confidence interval [CI], 97.7 to 101.0) in comparison to 2019 (HSMR, 97.3; 95% CI, 95.8 to 98.8). In the COVID-19 pandemic zone, the HSMR increased significantly in 2020 (HSMR, 112.7; 95% CI, 107.0 to 118.7) compared to 2019 (HSMR, 101.7; 95% CI, 96.9 to 106.6). The HSMR in all general hospitals increased significantly in 2020 (HSMR, 106.4; 95% CI, 104.3 to 108.5) compared to 2019 (HSMR, 100.3; 95% CI, 98.4 to 102.2). Hospitals participating in the COVID-19 response had a lower HSMR (HSMR, 95.6; 95% CI, 93.9 to 97.4) than hospitals not participating in the COVID-19 response (HSMR, 124.3; 95% CI, 119.3 to 129.4). Conclusions: This study suggests that the COVID-19 pandemic may have negatively impacted the quality of care in hospitals, especially general hospitals with relatively few beds. In light of the COVID-19 pandemic, it is necessary to prevent excessive workloads in hospitals and to properly employ and coordinate the workforce.

• Korean Journal of Clinical Pharmacy
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• v.25 no.4
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• pp.273-279
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• 2015

Objective: Codeine may result in death or respiratory depression in children, particularly who are rapid metabolizer of CYP2D6, therefore it should be used cautiously among children under 12 years of age. This study was to investigate the prescribing pattern of codeine among children according to the age group, prescribed diagnosis, type of medical service and medical specialties. Method: We used Korea Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) database. Study subjects included inpatients or outpatients, who were prescribed codeine between January, 1, 2011 and December, 31, 2011. Contraindicated use of codeine was defined as the use of codeine at least one times under aged 12. Age groups were subclassified according to the <2 years, 2-4 years, 5-8 years, and 9-11 years. Frequently prescribed diagnosis (ICD-10), type of medical service, and medical specialties were also described among codeine users under aged 12. Results: Codeine users were 6,411 inpatients (9,958 prescriptions), and 3,397 outpatients (6,258 prescriptions), respectively. Codeine prescription under 12 years of age were 2.1% (210 prescriptions) among inpatients, and 12.3% (776 prescriptions) among outpatients (p-value<0.05). Outpatient prescriptions of codeine under 12 aged were issued mostly from primary care clinics and frequent diagnosis were unspecified bronchopneumonia (51.6%), and vasomotor rhinitis (23.7%). Conclusion: This study found prescribing of codeine under 12 aged is common in outpatient and primary clinics. Nationwide and community-based efforts should be needed to reduce inappropriate prescribing among children.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.1737-1742
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• 2013

Early diagnosis has a major role in improving prognosis of breast cancer. The purpose of this study was to assess the risk status of women 35-69 years of age using risk assessment models and the prevalence of mammography in a community setting. The sample of this cross sectional study consisted of 227 women, 35-69 years of age residing in Izmir, a city located in western region of Turkey. A questionnaire was used to collect data and the Gail and Cuzick-Tyrer models were applied to assess the risk of breast cancer. In this study, 52.7% of women had mammography at least once, and 41.3% of the women over the age of 40 had mammography screening in the last two years. The five years risk for breast cancer was high in 15.8% of women according to the Gail model and ten years risk was high in 21.7% with the Cuzick-Tyrer model. In the present study, the breast cancer risk levels were assessed in a population setting for the first time in Turkey using breast cancer risk level assessment models. Being in 60-69 age group, having low education and not being in menopause were significant risk factors for not having mammography according to logistic regression analysis. Mammography utilization rate was low. Women must be educated about breast cancer screening methods and early diagnosis. The women in the high risk group should be informed on their risk status which may increase their attendance at breast cancer screening.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.10
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• pp.382-395
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• 2016

The purpose of this study is to examine how area characteristics influence the health of a population in a particular area by investigating how area deprivation and social capital influence self-rated health. For this study, a multi-level logistic regression was employed to analyze the data collected by Community Health Survey conducted on a target population of 229,186 living at 253 administrative areas of Korea in 2011. First, an analysis was conducted for subjects who have rated their self-health assessment as 'fair', 'poor', and 'very poor' in a 5 -item response survey. Then, a second analysis was conducted for the same subjects by excluding those with a rating of 'fair'. As a result, we found that area deprivation significantly influenced the population's health, according to our second analysis, while it was not significant according to our first analysis. Moreover, social capital was not significant in both analyses. Area deprivation-although the value of it was not so high-seems to explain the differences of individual self-rated health assessment as a contextual effect. In addition, influence of area characteristics is not limited to certain local areas, but to all local areas of Korea. Therefore, it is suggested that efforts to improve area characteristics are necessary to upgrade the individual's health level. A standardized classification system-distinguishing between good and poor self-rated health-is necessary through further comparative studies on self-rated health assessment.

• Women's Health Nursing
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• v.11 no.1
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• pp.46-51
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• 2005

Purpose: The aim of this study was to identify risk factors for breast cancer and early screening behavior in women in the community. Method: The participants were 125 women residing in W city. Data was collected using an instrument developed by the researchers. Analysis was done using descriptive statistics, and the $x^2$ test. Result: For risk based on the Gail Model, age (above 50 years) had a distribution of 24.8%, first degree family history, 4.9%, age at first full term pregnancy, 13.8%, and benign breast cancer history, 4.9%. For risk based on other common risk factors, menopause had a distribution of 20.7%, did not breast feed, 15.4%, history of HRT, 7.3%, meat preference, 35.0%, and history of smoking or drinking, 2.4% and 43.5%, respectively. There was a significant difference in BSE and mammography screening behavior ($x^2=22.5$, p<.00), but no difference in distribution of risk factors and screening behavior. Conclusion: For effective prevention of breast cancer, it is necessary to develop an instrument for risk assessment and, through assessment, select women at high risk. It is also necessary to provide education and appropriate recommendations on screening behavior.

• YAKHAK HOEJI
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• v.53 no.6
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• pp.368-376
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• 2009

DUR (Drug Utilization Review) originally referred to the evaluation of drug usage details: however DUR refers to the system used to support the services of prescribing and dispensing through linking from Health Insurance Review and Assessment (HIRA) Service in Korea. HIRA is going to begin the DUR enforcement for extending to nationwide coverage after pilot test. Objectives: The aims for this study were to evaluate and clarify the current opinions of the pharmacists for the recognition and acceptance rates before nationwide coverage concerning DUR system. Methods: A 16-question-questionnaire was developed and pilot tested. For 40 days of survey by both on-line and fax paper, it was carried out on 80 pharmacists working at community pharmacy in Goyang-si, Gyeonggi-do. Results: Most of answers were broadly positive and interested in begining the DUR system and kept in mind that the goal of DUR is safety guarantee for people. On the other hand, most of answerers worry that delay of patient waiting time and inharmonious communication with doctors in DUR processing can be a major obstacle to begin the DUR system. Conclusion: To solve several problems, the most important things are to make good reciprocal relationships between doctors and pharmacists, investigate intervention tool to shorten patient waiting time, and activate educational program of inspecting items for the pharmacists.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.3
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• pp.1234-1243
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• 2011

Our study was carried out to develop the severity-adjustment model for length of stay in hospital for community-acquired pneumonia so that we analysed the factors on the variation in length of stay(LOS). The subjects were 5,353 community-acquired pneumonia inpatients of the Korean National Hospital Discharge In-depth Injury Survey data from 2004 through 2006. The data were analyzed using t-test and ANOVA and the severity-adjustment model was developed using data mining technique. There are differences according to gender, age, type of insurance, type of admission, but there is no difference of whether patients died in hospital. After yielding the standardized value of the difference between crude and expected length of stay, we analysed the variation of length of stay for community-acquired pneumonia. There was variation of LOS in regional differences and insurance type, though there was no variation according whether patients receive their care in their residences. The variation of length of stay controlling the case mix or severity of illness can be explained the factors of provider. This supply factors in LOS variations should be more studied for individual practice style or patient management practices and healthcare resources or environment. We expect that the severity-adjustment model using administrative databases should be more adapted in other diseases in practical.